Lima Thiago Bezerra Wanderley E, Silva Brunna Beatriz Dos Santos, de Souza Ana Paula Silva, Aires Dalyane Mirelly Fonseca, Fagundes Marina Gomes
Fisioterapia Universidade Federal do Rio Grande do Norte.
Fisioterapia Universidade Potiguar.
Can J Respir Ther. 2025 Mar 24;61:51-59. doi: 10.29390/001c.132324. eCollection 2025.
Increases in respiratory work and, consequently, the development of respiratory muscle fatigue can result in activation of the inspiratory muscle metaboreflex (IMM). This central nervous system response includes redirection of blood flow from skeletal muscles to respiratory muscles, which can limit exercise capacity. Therefore, developing approaches that may minimize the need for IMM is important. Recent studies have suggested that inspiratory muscle training (IMT) may reduce the IMM response. This review aims to synthesize studies that examine the efficacy of IMT in reducing IMM.
Databases were systematically searched for randomized controlled clinical trials (RCTs) and non-randomized controlled trials evaluating the effect of IMT on the IMM. Searches were performed in MEDLINE/PubMed, SCOPUS, Web of Science and LILACS from inception to December 2023. Assessment of the methodological quality of the included studies was guided by the PEDro scale.
Four studies met the inclusion criteria, two RCTs and two non-randomized controlled trials, collectively including 76 subjects. Three studies included healthy subjects, and one included patients with heart failure. In all studies, IMT demonstrated a significant attenuating effect on the IMM, increasing inspiratory muscle strength and time of exercise tolerance (Tlim).
Current evidence suggests that IMT may provide an effective approach for attenuating the IMM and increasing inspiratory muscle strength and Tlim. However, the small collective sample size and heterogeneity across studies limit current recommendations.
呼吸功增加以及随之而来的呼吸肌疲劳的发展可导致吸气肌代谢反射（IMM）的激活。这种中枢神经系统反应包括将血液从骨骼肌重新分配到呼吸肌，这可能会限制运动能力。因此，开发可能最大限度减少对IMM需求的方法很重要。最近的研究表明，吸气肌训练（IMT）可能会降低IMM反应。本综述旨在综合研究IMT在降低IMM方面的疗效。
系统检索数据库，查找评估IMT对IMM影响的随机对照临床试验（RCT）和非随机对照试验。检索从数据库建库至2023年12月在MEDLINE/PubMed、SCOPUS、科学网和拉丁美洲及加勒比卫生科学数据库中进行。纳入研究的方法学质量评估以PEDro量表为指导。
四项研究符合纳入标准，两项RCT和两项非随机对照试验，共纳入76名受试者。三项研究纳入健康受试者，一项纳入心力衰竭患者。在所有研究中，IMT对IMM均显示出显著的减弱作用，增加了吸气肌力量和运动耐受时间（Tlim）。
目前的证据表明，IMT可能为减弱IMM以及增加吸气肌力量和Tlim提供一种有效方法。然而，总体样本量小以及研究之间的异质性限制了当前的建议。
