Liu Fang, Jones Alice Y M, Tsang Raymond C C, Yam Timothy T T, Hao Yingzi, Tsang William W N
Department of Physiotherapy, School of Nursing and Health Sciences, Hong Kong Metropolitan University, Hong Kong, China.
School of Health and Rehabilitation Sciences, The University of Queensland, Queensland, Australia.
Disabil Rehabil. 2024 Oct 3:1-16. doi: 10.1080/09638288.2024.2408606.
To examine the effects of inspiratory muscle training (IMT) on pulmonary and diaphragmatic function, exercise capacity, balance and quality of life (QOL), in post-stroke individuals.
A literature search was conducted using MEDLINE, CINAHL, EMBASE, PubMed, PEDro, Web of Science and China Biological Medicine databases. Randomized controlled trials (RCTs) with a PEDro score ≥6 focusing on the effects of IMT were included. The GRADE system was used to determine the certainty of evidence for each outcome.
Nine studies (255 participants) were included. IMT significantly increased forced expiratory volume in one second (FEV) (4 studies, 112 participants, mean difference (MD)=0.18 litre, 95% confidence interval (CI): 0.14-0.23); maximal inspiratory pressure (MIP) (8 studies, 226 participants, MD = 6.37 cm HO, 95% CI: 1.26-11.49); and diaphragm thickness fraction (DTf) on both sides (MD of affected side vs. unaffected side: 51 vs. 37%). The evidence certainty for diaphragmatic function was moderate. No significant change was observed in forced vital capacity (FVC), balance function, exercise capacity and QOL.
This review reveals moderate evidence certainty in support of IMT improving diaphragmatic function. It appears that a training intensity between 30 and 50% MIP results in a significantly improved MIP.
探讨吸气肌训练（IMT）对脑卒中后个体肺功能、膈肌功能、运动能力、平衡能力及生活质量（QOL）的影响。
使用MEDLINE、CINAHL、EMBASE、PubMed、PEDro、Web of Science和中国生物医学数据库进行文献检索。纳入PEDro评分≥6且聚焦于IMT效果的随机对照试验（RCT）。采用GRADE系统确定各结局证据的确定性。
纳入9项研究（255名参与者）。IMT显著增加了一秒用力呼气量（FEV）（4项研究，112名参与者，平均差值（MD）=0.18升，95%置信区间（CI）：0.14 - 0.23）；最大吸气压力（MIP）（8项研究，226名参与者，MD = 6.37厘米水柱，95% CI：1.26 - 11.49）；以及双侧膈肌厚度分数（DTf）（患侧与健侧MD：51%对37%）。膈肌功能的证据确定性为中等。在用力肺活量（FVC）、平衡功能、运动能力和生活质量方面未观察到显著变化。
本综述揭示了支持IMT改善膈肌功能的中等证据确定性。似乎30%至50% MIP之间的训练强度会使MIP显著改善。
