Coughing is a defensive reflex action of the airway that removes foreign objects and mucus. Here, meta-analysis was performed to review the results of previous studies regarding the effects of coughing exercise and expiratory muscle training (EMT), and to examine the effectiveness of EMT in enhancing cough functions. A systematic literature search was performed using the EBMR, CINAHL, PEDro, MEDLINE, and Ichushi Web (NPO Japan Medical Abstracts Society) databases. Based on a methodological framework, a critical review was performed and summary effect sizes were calculated by applying the random effects model. Both the forced expiration technique (FET) and coughing alone significantly increased mucus clearance. EMT significantly increased expiratory muscle strength, suggesting that it is possible to improve cough effectiveness by EMT. Further studies with larger and more diverse sample groups are necessary to determine the effects of enhancing expiratory muscle strength on cough effectiveness.

The purpose of this study was to clarify the relationship between kyphosis and breathing in elderly people. Hand grip power, pulmonary function, maximal inspiratory mouth pressure (PImax), maximal expiratory mouth pressure (PEmax), and breathing patterns were compared between the kyphosis group and the normal group. In the kyphosis group, hand grip power, PImax, PEmax, peak flow (PEF) and %PEF were significantly lower than in the normal group. During spontaneous breathing, there was a significantly different breathing pattern between the kyphosis group and the normal group. There was more chest movement in the kyphosis group, and more abdomen movement in the normal group. The kyphosis group had significantly decreased volume of abdominal movement during spontaneous breathing and slow vital capacity maneuvers.