Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
Departments of Pathology, Urology, and Radiation Oncology, College of Medicine, OSU Comprehensive Cancer Center, Columbus, Ohio, USA.
J Med Virol. 2023 Aug;95(8):e28956. doi: 10.1002/jmv.28956.
The possible benefits of inspiratory muscle training (IMT) on mechanical and clinical outcomes in patients with Coronavirus disease-2019 (COVID-19) remain controversial. We conducted a meta-analysis to evaluate the effect of IMT in the rehabilitation strategy of patients with COVID-19. The Pubmed, Embase, Web of Science (WOS), and Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify trials evaluating the efficacy of IMT in the treatment of patients with COVID-19. The primary outcome included change from baseline of VO max, maximal inspiratory pressure (PImax), 6-min walk test(6MWT), forced expiratory volume in the first second predicted (FEV1%pred), and quality of life (QOL). Six studies with 349 participants were analyzed. Significant improvements were found in change from baseline of VO max (MD: 4.54, 95% confidence interval [CI]: 1.79-7.30, Z = 3. 32, I = 0, p = 0.001), PImax (MD: 21.43, 95% CI: 1.33-41.52, Z = 2.09, I = 90%, p = 0.04), 6MWD (MD: 40.13, 95% CI: 24.92-55.35, Z = 5.17, I = 0, p < 0.00001) and FEV1%pred (MD: 8.73, 95% CI 3.07-14.39, Z = 3.02, p = 0.002) while no statistical improvements were found in QOL (SMD: 0.70, 95% CI: 0.37-1.03, Z = 4.15, I = 89% p = 0.32) between IMT group and control group. The application of IMT might elicit mechanical and clinical improvement in patients with COVID-19. IMT could be recommended as an effective strategy of pulmonary rehabilitation for COVID-19. However, the proper timing, optimal duration, as well as appropriate frequency and intensity of IMT remain uncertain and further studies are needed.
吸气肌训练（IMT）对 2019 年冠状病毒病（COVID-19）患者的机械和临床结局的可能益处仍存在争议。我们进行了一项荟萃分析，以评估 IMT 在 COVID-19 患者康复策略中的作用。检索了 Pubmed、Embase、Web of Science（WOS）和 Cochrane 对照试验中心注册库（CENTRAL），以确定评估 IMT 治疗 COVID-19 患者疗效的试验。主要结局包括 VO max、最大吸气压力（PImax）、6 分钟步行试验（6MWT）、第一秒用力呼气量预测值（FEV1%pred）和生活质量（QOL）的基线变化。分析了 6 项共 349 名参与者的研究。发现 VO max 的基线变化有显著改善（MD：4.54，95%置信区间[CI]：1.79-7.30，Z=3.32，I=0，p=0.001）、PImax（MD：21.43，95% CI：1.33-41.52，Z=2.09，I=90%，p=0.04）、6MWD（MD：40.13，95% CI：24.92-55.35，Z=5.17，I=0，p<0.00001）和 FEV1%pred（MD：8.73，95% CI 3.07-14.39，Z=3.02，p=0.002），而在 IMT 组和对照组之间，QOL 无统计学改善（SMD：0.70，95% CI：0.37-1.03，Z=4.15，I=89%，p=0.32）。IMT 的应用可能会使 COVID-19 患者的机械和临床状况得到改善。IMT 可以作为 COVID-19 肺康复的有效策略。然而，IMT 的适当时机、最佳持续时间以及适当的频率和强度尚不确定，需要进一步研究。
