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- W4243582693 abstract "Background Neuromuscular diseases (NMDs) are a heterogeneous group of diseases affecting the anterior horn cell of spinal cord, neuromuscular junction, peripheral nerves and muscles. NMDs cause physical disability usually due to progressive loss of strength in limb muscles, and some NMDs also cause respiratory muscle weakness. Respiratory muscle training (RMT) might be expected to improve respiratory muscle weakness; however, the effects of RMT are still uncertain. This systematic review will synthesize the available trial evidence on the effectiveness and safety of RMT in people with NMD, to inform clinical practice. Objectives To assess the effects of respiratory muscle training (RMT) for neuromuscular disease (NMD) in adults and children, in comparison to sham training, no training, standard treatment, breathing exercises, or other intensities or types of RMT. Search methods On 19 November 2018, we searched the Cochrane Neuromuscular Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and Embase. On 23 December 2018, we searched the US National Institutes for Health Clinical Trials Registry (ClinicalTrials.gov), the World Health Organization International Clinical Trials Registry Platform, and reference lists of the included studies. Selection criteria We included randomized controlled trials (RCTs) and quasi‐RCTs, including cross‐over trials, of RMT in adults and children with a diagnosis of NMD of any degree of severity, who were living in the community, and who did not need mechanical ventilation. We compared trials of RMT (inspiratory muscle training (IMT) or expiratory muscle training (EMT), or both), with sham training, no training, standard treatment, different intensities of RMT, different types of RMT, or breathing exercises. Data collection and analysis We followed standard Cochrane methodological procedures. Main results We included 11 studies involving 250 randomized participants with NMDs: three trials (N = 88) in people with amyotrophic lateral sclerosis (ALS; motor neuron disease), six trials (N = 112) in Duchenne muscular dystrophy (DMD), one trial (N = 23) in people with Becker muscular dystrophy (BMD) or limb‐girdle muscular dystrophy, and one trial (N = 27) in people with myasthenia gravis. Nine of the trials were at high risk of bias in at least one domain and many reported insufficient information for accurate assessment of the risk of bias. Populations, interventions, control interventions, and outcome measures were often different, which largely ruled out meta‐analysis. All included studies assessed lung capacity, our primary outcome, but four did not provide data for analysis (1 in people with ALS and three cross‐over studies in DMD). None provided long‐term data (over a year) and only one trial, in ALS, provided information on adverse events. Unscheduled hospitalisations for chest infection or acute exacerbation of chronic respiratory failure were not reported and physical function and quality of life were reported in one (ALS) trial. Amyotrophic lateral sclerosis (ALS) Three trials compared RMT versus sham training in ALS. Short‐term (8 weeks) effects of RMT on lung capacity in ALS showed no clear difference in the change of the per cent predicted forced vital capacity (FVC%) between EMT and sham EMT groups (mean difference (MD) 0.70, 95% confidence interval (CI) ‐8.48 to 9.88; N = 46; low‐certainty evidence). The mean difference (MD) in FVC% after four months' treatment was 10.86% in favour of IMT (95% CI ‐4.25 to 25.97; 1 trial, N = 24; low‐certainty evidence), which is larger than the minimal clinically important difference (MCID, as estimated in people with idiopathic pulmonary fibrosis). There was no clear difference between IMT and sham IMT groups, measured on the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALFRS; range of possible scores 0 = best to 40 = worst) (MD 0.85, 95% CI ‐2.16 to 3.85; 1 trial, N = 24; low‐certainty evidence) or quality of life, measured on the EuroQol‐5D (0 = worst to 100 = best) (MD 0.77, 95% CI ‐17.09 to 18.62; 1 trial, N = 24; low‐certainty evidence) over the medium term (4 months). One trial report stated that the IMT protocol had no adverse effect (very low‐certainty evidence). Duchenne muscular dystrophy (DMD) Two DMD trials compared RMT versus sham training in young males with DMD. In one study, the mean post‐intervention (6‐week) total lung capacity (TLC) favoured RMT (MD 0.45 L, 95% CI ‐0.24 to 1.14; 1 trial, N = 16; low‐certainty evidence). In the other trial there was no clear difference in post‐intervention (18 days) FVC between RMT and sham RMT (MD 0.16 L, 95% CI ‐0.31 to 0.63; 1 trial, N = 20; low‐certainty evidence). One RCT and three cross‐over trials compared a form of RMT with no training in males with DMD; the cross‐over trials did not provide suitable data. Post‐intervention (6‐month) values showed no clear difference between the RMT and no training groups in per cent predicted vital capacity (VC%) (MD 3.50, 95% CI ‐14.35 to 21.35; 1 trial, N = 30; low‐certainty evidence). Becker or limb‐girdle muscular dystrophy One RCT (N = 21) compared 12 weeks of IMT with breathing exercises in people with Becker or limb‐girdle muscular dystrophy. The evidence was of very low certainty and conclusions could not be drawn. Myasthenia gravis In myasthenia gravis, there may be no clear difference between RMT and breathing exercises on measures of lung capacity, in the short term (TLC MD ‐0.20 L, 95% CI ‐1.07 to 0.67; 1 trial, N = 27; low‐certainty evidence). Effects of RMT on quality of life are uncertain (1 trial; N = 27). Some trials reported effects of RMT on inspiratory and/or expiratory muscle strength; this evidence was also of low or very low certainty. Authors' conclusions RMT may improve lung capacity and respiratory muscle strength in some NMDs. In ALS there may not be any clinically meaningful effect of RMT on physical functioning or quality of life and it is uncertain whether it causes adverse effects. Due to clinical heterogeneity between the trials and the small number of participants included in the analysis, together with the risk of bias, these results must be interpreted very cautiously." @default.
- W4243582693 created "2022-05-12" @default.
- W4243582693 creator A5008212948 @default.
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- W4243582693 date "2019-09-05" @default.
- W4243582693 modified "2023-10-10" @default.
- W4243582693 title "Respiratory muscle training in children and adults with neuromuscular disease" @default.
- W4243582693 cites W128546466 @default.
- W4243582693 cites W1485248089 @default.
- W4243582693 cites W1505689017 @default.
- W4243582693 cites W1575692552 @default.
- W4243582693 cites W1585284281 @default.
- W4243582693 cites W1873179464 @default.
- W4243582693 cites W189368282 @default.
- W4243582693 cites W1939799638 @default.
- W4243582693 cites W1954728404 @default.
- W4243582693 cites W1966458990 @default.
- W4243582693 cites W1967017542 @default.
- W4243582693 cites W1973819173 @default.
- W4243582693 cites W1974350845 @default.
- W4243582693 cites W1975211751 @default.
- W4243582693 cites W1975847221 @default.
- W4243582693 cites W1984100750 @default.
- W4243582693 cites W1993368001 @default.
- W4243582693 cites W1999113624 @default.
- W4243582693 cites W2007810250 @default.
- W4243582693 cites W2018380714 @default.
- W4243582693 cites W2022382208 @default.
- W4243582693 cites W2031253609 @default.
- W4243582693 cites W2033676880 @default.
- W4243582693 cites W2035222887 @default.
- W4243582693 cites W2035500734 @default.
- W4243582693 cites W2037377025 @default.
- W4243582693 cites W2040862163 @default.
- W4243582693 cites W2044303655 @default.
- W4243582693 cites W2046943947 @default.
- W4243582693 cites W2052977441 @default.
- W4243582693 cites W2054232593 @default.
- W4243582693 cites W2055745123 @default.
- W4243582693 cites W2058179257 @default.
- W4243582693 cites W2060108082 @default.
- W4243582693 cites W2060737725 @default.
- W4243582693 cites W2065384164 @default.
- W4243582693 cites W2065826225 @default.
- W4243582693 cites W2072106463 @default.
- W4243582693 cites W2072562340 @default.
- W4243582693 cites W2083436606 @default.
- W4243582693 cites W2084628187 @default.
- W4243582693 cites W2085382464 @default.
- W4243582693 cites W2086113479 @default.
- W4243582693 cites W2086666224 @default.
- W4243582693 cites W2088007520 @default.
- W4243582693 cites W2088205751 @default.
- W4243582693 cites W2093256418 @default.
- W4243582693 cites W2098456188 @default.
- W4243582693 cites W2101952378 @default.
- W4243582693 cites W2102541936 @default.
- W4243582693 cites W2105506496 @default.
- W4243582693 cites W2105815730 @default.
- W4243582693 cites W2108381339 @default.
- W4243582693 cites W2112433656 @default.
- W4243582693 cites W21141899 @default.
- W4243582693 cites W2116506535 @default.
- W4243582693 cites W2119614758 @default.
- W4243582693 cites W2122901895 @default.
- W4243582693 cites W2124879124 @default.
- W4243582693 cites W2126280897 @default.
- W4243582693 cites W2127203224 @default.
- W4243582693 cites W2127803048 @default.
- W4243582693 cites W2132981406 @default.
- W4243582693 cites W2134371576 @default.
- W4243582693 cites W2138904037 @default.
- W4243582693 cites W2139862170 @default.
- W4243582693 cites W2140863437 @default.
- W4243582693 cites W2141588819 @default.
- W4243582693 cites W2141887601 @default.
- W4243582693 cites W2148324198 @default.
- W4243582693 cites W2149098090 @default.
- W4243582693 cites W2149296107 @default.
- W4243582693 cites W2151607652 @default.
- W4243582693 cites W2151903784 @default.
- W4243582693 cites W2152482086 @default.
- W4243582693 cites W2153836018 @default.
- W4243582693 cites W2154300777 @default.
- W4243582693 cites W2155992212 @default.
- W4243582693 cites W2156098321 @default.
- W4243582693 cites W2161257635 @default.
- W4243582693 cites W2161371756 @default.
- W4243582693 cites W2161938104 @default.
- W4243582693 cites W2162212422 @default.
- W4243582693 cites W2165804548 @default.
- W4243582693 cites W2167290287 @default.
- W4243582693 cites W2170178370 @default.
- W4243582693 cites W2179546122 @default.