The impact of respiratory muscle training on respiratory function in patients with neuromuscular disease: a systematic review and meta-analysis of randomized controlled trials

Authors

Nancy Y. Ortiz-Garcia
Diego Eduardo Rueda-Capristran
Ajay Kumar
Domenica Alejandra Herrera
Angie Carolina Alonso-Ramírez
Diana Othón-Martínez, The University of Texas Rio Grande ValleyFollow
Jonathan Reyes-Rivera
Frances Marie Mejia
Jonathan David Martinez-Illan
Carla Isabella Miret Durazo

Document Type

Article

Publication Date

7-2025

Abstract

Background: Neuromuscular diseases (NMDs) can impair respiratory muscle function, leading to increased morbidity and mortality. Respiratory muscle training (RMT) is widely used to manage these respiratory complications, but its efficacy across different NMDs remains unclear. This systematic review and meta-analysis evaluated the impact of physiotherapy interventions, specifically RMT, on respiratory muscle function in NMD patients.

Methods: A systematic search of multiple databases, including MEDLINE, EMBASE, Web of Science, Cochrane, CRS-Web, PEDro, LILACS, ICTPR, the China National Knowledge Infrastructure database, and ClinicalTrials.gov, was conducted up to February 2025. Randomized controlled trials (RCTs) and cohort studies evaluating RMT's effect on lung volumes and respiratory muscle strength in NMD patients were included. Risk of bias assessment was performed using Cochrane Risk of bias tool for RCTs and Newcastle-Ottawa Scale for cohorts. Meta-analyses were performed using a random-effects model, and heterogeneity was assessed with I² statistics.

Results: Sixteen studies were analyzed from 9,626 screened articles. The meta-analysis demonstrated significant improvements in respiratory muscle strength, particularly in maximal inspiratory pressure (MD: 6.83 cmH₂O, 95% CI: 2.08 to 11.58, p < 0.01, I² = 3.8%) and maximal expiratory pressure (MD: 13.05 cmH₂O, 95% CI: 3.65to 22.42, p < 0.01, I² = 43%). No significant improvements were observed in forced vital capacity (MD: 3.13%, 95% CI: -8.06 to 14.34, p = 0.58), sniff nasal inspiratory pressure (MD: 1.47 cmH₂O, 95% CI: -15.45 to 18.39, p = 0.86), forced expiratory volume in one second (MD: -0.02 L, 95% CI: -0.17 to 0.13, p = 0.78), and vital capacity (MD: -0.10 L, 95% CI: -0.31 to 0.11, p = 0.33).

Conclusion: This review supports the role of respiratory muscle training in improving inspiratory and expiratory muscle strength in patients with neuromuscular diseases. However, variability in study methodologies and patient populations limits the statistical significance of some respiratory parameters. Future studies should aim to standardize interventions and outcome measures to provide more conclusive evidence on the efficacy of RMT.

Comments

© The Author(s) 2025

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Recommended Citation

Ortiz-Garcia, N. Y., Rueda-Capristran, D. E., Kumar, A., Herrera, D. A., Alonso-Ramírez, A. C., Othón-Martínez, D., Reyes-Rivera, J., Mejia, F. M., Martinez-Illan, J. D., Durazo, C. I. M., Perez-Moreno, E. J., Cruz, C. S., & Martinez, E. C. (2025). The impact of respiratory muscle training on respiratory function in patients with neuromuscular disease: a systematic review and meta-analysis of randomized controlled trials. BMC sports science, medicine & rehabilitation, 17(1), 168. https://doi.org/10.1186/s13102-025-01198-z

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Publication Title

BMC sports science, medicine & rehabilitation

DOI

10.1186/s13102-025-01198-z

Academic Level

resident

Mentor/PI Department

Internal Medicine