Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2022; 10(13): 4119-4130
Published online May 6, 2022. doi: 10.12998/wjcc.v10.i13.4119
Perioperative respiratory muscle training improves respiratory muscle strength and physical activity of patients receiving lung surgery: A meta-analysis
Meng-Xuan Yang, Jiao Wang, Xiu Zhang, Ze-Ruxin Luo, Peng-Ming Yu
Meng-Xuan Yang, Jiao Wang, Xiu Zhang, Ze-Ruxin Luo, Peng-Ming Yu, Rehabilitation Medicine Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
Author contributions: Yu PM made the substantial contributions to the conception and design of the work; Yang MX and Wang J searched, selected materials and extracted data; Yang MX wrote this manuscript; Yang MX, Wang J, Zhang X and Luo ZR revised the paper carefully and also contributed to the statistical analysis. All authors have read and approved the final manuscript.
Conflict-of-interest statement: None declared.
PRISMA 2009 Checklist statement: We performed this systematic review and meta-analysis according to the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines[16]. Meanwhile, it has been registered with PROSPERO (ID: CRD42020214940).
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peng-Ming Yu, PhD, Associate Professor, Rehabilitation Medicine Center, West China Hospital, Sichuan University, No. 37 Guoxuexiang, Chengdu 610041, Sichuan Province, China. 13438201451@126.com
Received: December 8, 2021
Peer-review started: December 8, 2021
First decision: January 25, 2022
Revised: February 7, 2022
Accepted: March 16, 2022
Article in press: March 16, 2022
Published online: May 6, 2022
Processing time: 142 Days and 23.9 Hours
Abstract
BACKGROUND

The clinical role of perioperative respiratory muscle training (RMT), including inspiratory muscle training (IMT) and expiratory muscle training (EMT) in patients undergoing pulmonary surgery remains unclear up to now.

AIM

To evaluate whether perioperative RMT is effective in improving postoperative outcomes such as the respiratory muscle strength and physical activity level of patients receiving lung surgery.

METHODS

The PubMed, EMBASE (via OVID), Web of Science, Cochrane Library and Physiotherapy Evidence Database (PEDro) were systematically searched to obtain eligible randomized controlled trials (RCTs). Primary outcome was postoperative respiratory muscle strength expressed as the maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). Secondary outcomes were physical activity, exercise capacity, including the 6-min walking distance and peak oxygen consumption during the cardio-pulmonary exercise test, pulmonary function and the quality of life.

RESULTS

Seven studies involving 240 participants were included in this systematic review and meta-analysis. Among them, four studies focused on IMT and the other three studies focused on RMT, one of which included IMT, EMT and also combined RMT (IMT-EMT-RMT). Three studies applied the intervention postoperative, one study preoperative and the other three studies included both pre- and postoperative training. For primary outcomes, the pooled results indicated that perioperative RMT improved the postoperative MIP (mean = 8.13 cmH2O, 95%CI: 1.31 to 14.95, P = 0.02) and tended to increase MEP (mean = 13.51 cmH2O, 95%CI: -4.47 to 31.48, P = 0.14). For secondary outcomes, perioperative RMT enhanced postoperative physical activity significantly (P = 0.006) and a trend of improved postoperative pulmonary function was observed.

CONCLUSION

Perioperative RMT enhanced postoperative respiratory muscle strength and physical activity level of patients receiving lung surgery. However, RCTs with large samples are needed to evaluate effects of perioperative RMT on postoperative outcomes in patients undergoing lung surgery.

Keywords: Respiratory muscle training, Respiratory muscle strength, Physical activity, Lung surgery, Systematic review and meta-analysis

Core Tip: Our study indicated that perioperative respiratory muscle training (RMT) improved the postoperative maximal inspiratory pressure (P = 0.02) and tended to increase maximal expiratory pressure (P = 0.14). For secondary outcomes, perioperative RMT enhanced postoperative physical activity significantly (P = 0.006) and a trend of improved postoperative pulmonary function was observed. Perioperative RMT enhanced postoperative respiratory muscle strength and physical activity level of patients receiving lung surgery.