PDF(Pubmed)
Abstract：
Objectives: The aim of this meta-analysis was to determine the effects of respiratory muscle training (RMT) on functional ability, pain-related outcomes, and respiratory function in individuals with sub-acute and chronic low back pain (LBP). Methods: The study selection was as follows: (participants) adult individuals with >4 weeks of LBP; (intervention) RMT; (comparison) any comparison RMT (inspiratory or expiratory or mixed) versus control; (outcomes) postural control, lumbar disability, pain-related outcomes, pain-related fear-avoidance beliefs, respiratory muscle function, and pulmonary function; and (study design) randomized controlled trials. Results: 11 studies were included in the meta-analysis showing that RMT produces a statistically significant increase in postural control (mean difference (MD) = 21.71 [12.22; 31.21]; decrease in lumbar disability (standardized mean difference (SMD) = 0.55 [0.001; 1.09]); decrease in lumbar pain intensity (SMD = 0.77 [0.15; 1.38]; increase in expiratory muscle strength (MD = 8.05 [5.34; 10.76]); and increase in forced vital capacity (FVC) (MD = 0.30 [0.03; 0.58]) compared with a control group. However, RMT does not produce an increase in inspiratory muscle strength (MD = 18.36 [-1.61; 38.34]) and in forced expiratory volume at the first second (FEV1) (MD = 0.36 [-0.02; 0.75]; and in the FEV1/FVC ratio (MD = 1.55 [-5.87; 8.96]) compared with the control group. Conclusions: RMT could improve expiratory muscle strength and FVC, with a moderate quality of evidence, whereas a low quality of evidence suggests that RMT could improve postural control, lumbar disability, and pain intensity in individuals with sub-acute and chronic LBP. However, more studies of high methodological quality are needed to strengthen the results of this meta-analysis.
摘要：
目的：本荟萃分析的目的是确定呼吸肌训练（RMT）对功能能力的影响，疼痛相关结果，亚急性和慢性下腰痛（LBP）患者的呼吸功能。方法：研究选择如下：（参与者）LBP>4周的成年人；（干预）RMT；（比较）任何比较RMT（吸气或呼气或混合）与对照；（结果）姿势控制，腰椎残疾,疼痛相关结果，与疼痛相关的恐惧回避信念，呼吸肌功能，和肺功能；和（研究设计）随机对照试验。结果：11项研究纳入荟萃分析，显示RMT在姿势控制方面产生统计学上的显着增加（平均差异（MD）=21.71[12.22;31.21]；腰椎残疾减少（标准化平均差异（SMD）=0.55[0.001;1.09]）；腰椎疼痛强度降低（SMD=0.77[0.15;1.38]；与对照组相比，呼气肌力增加（MD=8.05）[5.58;10.76]然而,与对照组相比，RMT不会增加吸气肌力（MD=18.36[-1.61;38.34]）和第一秒用力呼气量（FEV1）（MD=0.36[-0.02;0.75]；以及FEV1/FVC比率（MD=1.55[-5.87;8.96]）。结论:RMT能提高呼气肌力和FVC,有中等质量的证据,而低质量的证据表明RMT可以改善姿势控制，腰椎残疾,亚急性和慢性LBP患者的疼痛强度。然而,需要更多的方法质量高的研究来加强这项荟萃分析的结果.
