Physiotherapy Department, Universidade Federal de Pernambuco, Recife, Brazil.
J Physiother. 2017 Apr;63(2):76-83. doi: 10.1016/j.jphys.2017.02.016. Epub 2017 Mar 14.
Does inspiratory muscle training improve respiratory muscle strength, functional capacity, lung function and quality of life of patients with chronic kidney disease? Does inspiratory muscle training improve these outcomes more than breathing exercises?
Systematic review and meta-analysis of randomised trials.
People with chronic kidney disease undergoing dialysis treatment.
The primary outcomes were: maximal inspiratory pressure, maximal expiratory pressure, and distance covered on the 6-minute walk test. The secondary outcomes were: forced vital capacity, forced expiratory volume in the first second (FEV), and quality of life.
The search identified four eligible studies. The sample consisted of 110 participants. The inspiratory muscle training used a Threshold or PowerBreathe device, with a load ranging from 30 to 60% of the maximal inspiratory pressure and lasting from 6 weeks to 6 months. The studies showed moderate to high risk of bias, and the quality of the evidence was rated low or very low, due to the studies' methodological limitations. The meta-analysis showed that inspiratory muscle training significantly improved maximal inspiratory pressure (MD 23 cmHO, 95% CI 16 to 29) and the 6-minute walk test distance (MD 80m, 95% CI 41 to 119) when compared with controls. Significant benefits in lung function and quality of life were also identified. When compared to breathing exercises, significant benefits were identified in maximal expiratory pressure (MD 6 cmHO, 95% CI 2 to 10) and FEV (MD 0.24litres 95% CI 0.14 to 0.34), but not maximal inspiratory pressure or forced vital capacity.
In patients with chronic renal failure on dialysis, inspiratory muscle training with a fixed load significantly improves respiratory muscle strength, functional capacity, lung function and quality of life. The evidence for these benefits may be influenced by some sources of bias.
PROSPERO (CRD 42015029986). [de Medeiros AIC, Fuzari HKB, Rattesa C, Brandão DC, de Melo Marinho PÉ (2017) Inspiratory muscle training improves respiratory muscle strength, functional capacity and quality of life in patients with chronic kidney disease: a systematic review. Journal of Physiotherapy 63: 76-83].
吸气肌训练是否能提高慢性肾脏病患者的呼吸肌力量、功能能力、肺功能和生活质量？吸气肌训练是否比呼吸练习更能改善这些结果？
系统评价和随机试验的荟萃分析。
接受透析治疗的慢性肾脏病患者。
主要结局为：最大吸气压力、最大呼气压力和 6 分钟步行试验的距离。次要结局为：用力肺活量、第一秒用力呼气量（FEV）和生活质量。
搜索确定了四项符合条件的研究。样本包括 110 名参与者。吸气肌训练使用 Threshold 或 PowerBreathe 装置，负荷范围为最大吸气压力的 30%至 60%，持续 6 周至 6 个月。这些研究存在较高的偏倚风险，由于研究方法的局限性，证据质量被评为低或极低。荟萃分析显示，与对照组相比，吸气肌训练显著提高了最大吸气压力（MD 23 cmHO，95%CI 16 至 29）和 6 分钟步行试验距离（MD 80m，95%CI 41 至 119）。还确定了肺功能和生活质量的显著改善。与呼吸练习相比，在最大呼气压力（MD 6 cmHO，95%CI 2 至 10）和 FEV（MD 0.24 升 95%CI 0.14 至 0.34）方面也有显著获益，但最大吸气压力或用力肺活量没有获益。
在接受透析治疗的慢性肾衰竭患者中，固定负荷的吸气肌训练可显著改善呼吸肌力量、功能能力、肺功能和生活质量。这些益处的证据可能受到一些偏倚来源的影响。
PROSPERO（CRD42015029986）。[de Medeiros AIC、Fuzari HKB、Rattesa C、Brandão DC、de Melo Marinho PÉ（2017 年）吸气肌训练可改善慢性肾脏病患者的呼吸肌力量、功能能力和生活质量：系统评价。物理治疗杂志 63：76-83]。
