Fabero-Garrido Raúl, Rodríguez-Marcos Iván, Del Corral Tamara, Plaza-Manzano Gustavo, López-de-Uralde-Villanueva Ibai
Department of Radiology, Rehabilitation and Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Complutense University of Madrid, Plaza Ramón y Cajal n° 3, Ciudad Universitaria, 28040 Madrid, Spain.
Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain.
J Clin Med. 2024 May 23;13(11):3053. doi: 10.3390/jcm13113053.
: The aim of this meta-analysis was to determine the effects of respiratory muscle training (RMT) on functional ability, pain-related outcomes, and respiratory function in individuals with sub-acute and chronic low back pain (LBP). : The study selection was as follows: (participants) adult individuals with >4 weeks of LBP; (intervention) RMT; (comparison) any comparison RMT (inspiratory or expiratory or mixed) versus control; (outcomes) postural control, lumbar disability, pain-related outcomes, pain-related fear-avoidance beliefs, respiratory muscle function, and pulmonary function; and (study design) randomized controlled trials. : 11 studies were included in the meta-analysis showing that RMT produces a statistically significant increase in postural control (mean difference (MD) = 21.71 [12.22; 31.21]; decrease in lumbar disability (standardized mean difference (SMD) = 0.55 [0.001; 1.09]); decrease in lumbar pain intensity (SMD = 0.77 [0.15; 1.38]; increase in expiratory muscle strength (MD = 8.05 [5.34; 10.76]); and increase in forced vital capacity (FVC) (MD = 0.30 [0.03; 0.58]) compared with a control group. However, RMT does not produce an increase in inspiratory muscle strength (MD = 18.36 [-1.61; 38.34]) and in forced expiratory volume at the first second (FEV1) (MD = 0.36 [-0.02; 0.75]; and in the FEV1/FVC ratio (MD = 1.55 [-5.87; 8.96]) compared with the control group. : RMT could improve expiratory muscle strength and FVC, with a moderate quality of evidence, whereas a low quality of evidence suggests that RMT could improve postural control, lumbar disability, and pain intensity in individuals with sub-acute and chronic LBP. However, more studies of high methodological quality are needed to strengthen the results of this meta-analysis.
本荟萃分析的目的是确定呼吸肌训练（RMT）对亚急性和慢性下腰痛（LBP）患者的功能能力、疼痛相关结局及呼吸功能的影响。研究选择如下：（参与者）患有下腰痛超过4周的成年个体；（干预措施）呼吸肌训练；（对照）任何将呼吸肌训练（吸气或呼气或混合）与对照组进行比较的对照；（结局指标）姿势控制、腰部功能障碍、疼痛相关结局、疼痛相关的恐惧回避信念、呼吸肌功能和肺功能；（研究设计）随机对照试验。荟萃分析纳入了11项研究，结果显示与对照组相比，呼吸肌训练在姿势控制方面产生了具有统计学意义的改善（平均差值（MD）=21.71 [12.22；31.21]）；腰部功能障碍有所减轻（标准化平均差值（SMD）=0.55 [0.001；1.09]）；腰部疼痛强度降低（SMD = 0.77 [0.15；1.38]）；呼气肌力量增加（MD = 8.05 [5.34；10.76]）；用力肺活量（FVC）增加（MD = 0.30 [0.03；0.58]）。然而，与对照组相比，呼吸肌训练在吸气肌力量（MD = 18.36 [-1.61；38.34]）、第1秒用力呼气量（FEV1）（MD = 0.36 [-0.02；0.75]）以及FEV1/FVC比值（MD = 1.55 [-5.87；8.96]）方面并未产生增加。呼吸肌训练可改善呼气肌力量和用力肺活量，证据质量中等，而低质量证据表明呼吸肌训练可改善亚急性和慢性下腰痛患者的姿势控制、腰部功能障碍和疼痛强度。然而，需要更多方法学质量高的研究来强化本荟萃分析的结果。
