Tran Dat Huu, Le Ha Thi, Chu Tho Thi Quynh, Pham Hung Thi Cam, Le Anh Ngoc Van
Department of Rehabilitation, Vinmec Times City International Hospital, Hanoi, Vietnam.
Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Ann Rehabil Med. 2025 Jun;49(3):152-163. doi: 10.5535/arm.250013. Epub 2025 Jun 17.
The effect of inspiratory muscle training (IMT) on cervical spinal cord injury (SCI) remains controversial. This study aimed to assess the efficacy of IMT in enhancing breathing muscle strength, pulmonary function, and quality of life (QoL) among patients with cervical SCI. A search was performed using the PubMed, Cochrane Library, Scopus, Embase, and Web of Science databases through December 2023. This review was conducted according to PRISMA guidelines and the Cochrane Library Handbook. The meta-analysis used mean differences (MDs) or standardized mean differences to pool the results. The Risk of Bias 2 and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) were used to assess the methodological quality of the included studies. This systematic review included five randomized controlled trials (202 participants). The results of the meta-analysis showed that IMT significantly improved maximal inspiratory pressure (MIP) with MD 12.13 cmH2O (95% confidence interval [CI] 4.22 to 20.03), maximal expiratory pressure (MEP) with MD 8.98 cmH2O (95% CI 6.96 to 11.00), and vital capacity (VC) with MD 0.25 L (95% CI 0.21 to 0.28). There were no significant improvements in forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and QoL. The quality of the evidence ranged from very low to moderate, owing to bias and heterogeneity. Our results showed that IMT may improve MIP, MEP, and VC, but not FEV1, FVC, or QoL, in patients with cervical SCI. Further large-scale studies are required to determine this effect's optimal dosage and duration.
吸气肌训练（IMT）对颈脊髓损伤（SCI）的影响仍存在争议。本研究旨在评估IMT对增强颈SCI患者呼吸肌力量、肺功能和生活质量（QoL）的疗效。通过检索截至2023年12月的PubMed、Cochrane图书馆、Scopus、Embase和Web of Science数据库进行了此项研究。本综述按照PRISMA指南和Cochrane图书馆手册进行。荟萃分析使用均值差异（MDs）或标准化均值差异来汇总结果。使用偏倚风险2和GRADE（推荐分级、评估、制定和评价）来评估纳入研究的方法学质量。本系统综述纳入了五项随机对照试验（202名参与者）。荟萃分析结果显示，IMT显著改善了最大吸气压（MIP），MD为12.13 cmH2O（95%置信区间[CI]为4.22至20.03），最大呼气压（MEP），MD为8.98 cmH2O（95%CI为6.96至11.00），以及肺活量（VC），MD为0.25 L（95%CI为0.21至0.28）。用力肺活量（FVC）、第1秒用力呼气量（FEV1）和生活质量无显著改善。由于存在偏倚和异质性，证据质量从极低到中等不等。我们的结果表明，IMT可能改善颈SCI患者的MIP、MEP和VC，但不能改善FEV1、FVC或生活质量。需要进一步的大规模研究来确定这种效应的最佳剂量和持续时间。
