Effects of Inspiratory Muscle Training in People with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis
Bing Han, Zhuying Chen, Bing Ruan, Yongjie Chen, Yuanyuan Lv, Cui Li, Laikang Yu
Abstract
This study aimed to investigate the effects of inspiratory muscle training (IMT) on inspiratory muscle strength, dyspnea, and quality of life (QOL) in COPD patients. A comprehensive search was undertaken on the Web of Science, Scopus, Embase, Cochrane, and PubMed databases, encompassing data published up to 31 March 2024. A meta-analysis was subsequently conducted to quantify the standardized mean difference (SMD) and 95% confidence interval (CI) for the effects of IMT in COPD patients. Sixteen studies met the inclusion criteria. IMT significantly improved inspiratory muscle strength (SMD, 0.86, p < 0.00001), dyspnea (SMD = −0.50, p < 0.00001), and QOL (SMD = 0.48, p = 0.0006). Subgroup analysis showed that <60% maximal inspiratory muscle pressure (PImax) IMT (inspiratory muscle strength, SMD = 1.22, p = 0.005; dyspnea, SMD = −0.92, p < 0.0001), IMT conducted for ≤20 min (inspiratory muscle strength, SMD = 0.97, p = 0.008; dyspnea, SMD = −0.63, p = 0.007; QOL, SMD = 1.66, p = 0.007), and IMT conducted >3 times per week (inspiratory muscle strength, SMD = 1.06, p < 0.00001; dyspnea, SMD = −0.54, p < 0.00001; QOL, SMD = 0.48, p = 0.0009) had greater effects. This meta-analysis provides clinicians with evidence supporting the recommendation that COPD patients engage in IMT at <60% PImax for more than 3 times per week, with each session lasting no more than 20 min, to improve inspiratory muscle strength, dyspnea, and QOL.