Inspiratory muscle training is effective to reduce postoperative pulmonary complications and length of hospital stay: a systematic review and meta-analysis

Kendall, Filipa; Oliveira, José; Peleteiro, Bárbara; Pinho, Paulo; Bastos, Pedro

doi:10.1080/09638288.2016.1277396

Cited by 96 publications

(99 citation statements)

References 36 publications

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“…This training was found to increase strength and endurance of the diaphragm, with improvement in pulmonary function [15]. Kendall et al [16] recommended physiotherapy using maneuvers of sustained maximal inspirations with a linear load Threshold device to treat postoperative pulmonary complications.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the effectiveness of preoperative outpatient pulmonary preparation in patients undergoing esophageal surgery

et al. 2018

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Introduction: Preoperative inspiratory muscle training (IMT) can minimize the occurrence of complications after esophagectomy. Objective: To evaluate the effects of preoperative IMT in patients undergoing esophageal surgery by determining respiratory muscle strength (PImax and PEmax), pulmonary function (FEV1, FVC, FEV1/FVC) and functional capacity by the 6-minute walk test (6MWT). Methods: Twenty-two patients were randomized into two groups: a control group (CG; n = 10) and an intervention group (IG; n = 12). Only IG performed IMT for a minimum period of 2 weeks. The assessments were conducted pre- and post-surgery. Results: An increase of PImax was observed in IG, but not in CG, in the second preoperative assessment (p = 0.014). Assessment on postoperative day 1 showed a reduction in maximal respiratory pressures in the two groups, but the reduction was more marked in IG (p < 0.05). Partial recovery of the variables evaluated was observed at discharge in the two groups. These variables had fully returned to initial values on postoperative day 30. The distance walked in the 6MWT was greater in IG, but the difference was not significant (p = 0.166). There was no difference in the frequency of pulmonary complications between groups. Conclusion: Preoperative IMT performed in our study improved inspiratory muscle strength but did not influence the postoperative pulmonary function or functional capacity of patients undergoing esophagectomy.

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Section: Discussionmentioning

confidence: 99%

Evaluation of the effectiveness of preoperative outpatient pulmonary preparation in patients undergoing esophageal surgery

et al. 2018

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“…Several studies confirm that IMT is effective in increasing respiratory muscle strength [10][11][12] . In this respect, Morano et al 13 also used the Threshold device for IMT.…”

Section: ■ Discussionmentioning

confidence: 99%

Combination of preoperative pulmonary and nutritional preparation for esophagectomy

et al. 2018

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Purpose: To compare pulmonary and nutritional parameters before and after inspiratory muscle training (IMT) and enteral feeding support in patients with esophageal disease undergoing preoperative outpatient follow-up. Methods: Thirty patients with a mean age of 55.83 years, 16 men and 14 women, were included. Pulmonary assessment consisted of the measurement of MIP, MEP, and spirometry. Anthropometric measurements and laboratory tests were performed for nutritional assessment. After preoperative evaluation, inspiratory muscle training and enteral nutrition support were started. A p<0.05 was considered statistically significant. Results: After an outpatient follow-up period of 4 weeks, a significant increase in MIP (-62.20 ± 25.78 to -81.53 ± 23.09), MEP (73.4 ± 31.95 to 90.33 ± 28.39), and FVC (94.86 ± 16.77 to 98.56 ± 17.44) was observed. Regarding the anthropometric variables, a significant increase was also observed in BMI (20.18 ± 5.04 to 20.40 ± 4.69), arm circumference (23.38 ± 3.28 to 25.08 ± 4.55), arm muscle circumference (21.48 ± 3.00 to 22.07 ± 3.36), and triceps skinfold thickness (5.62 ± 2.68 to 8.33 ± 6.59). Conclusion: Pulmonary and nutritional preparation can improve respiratory muscle strength, FVC and anthropometric parameters. However, further studies are needed to confirm the effectiveness of this preoperative preparation.

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“…Future studies might ascertain if daily supervised training is more/as effective as home-based training on changing respiratory muscle function. According to the meta-analysis conducted by Kendall et al [31], there are several issues that might empower inspiratory muscle training, as starting load < 30 % of MIP, with deliberated load increment, session duration > 15 min, training length > 2 weeks, and daily training supervision combined with exercise [31]. Regarding the secondary aims, total PA and light PA increased, and percentage of sedentary time diminished, both in IMT and EMT groups, being the effect size higher in the IMT group.…”

Section: Ucare (N = 19)mentioning

confidence: 99%

Influence of Respiratory Muscle Training on Patients’ Recovery after Lung Resection

et al. 2020

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This prospective experimental study aimed to compare effects of 3 different home-based postoperative respiratory muscle training protocols – inspiratory, expiratory and combined, in the patients’ postoperative recovery, regarding safety and respiratory muscle function, pulmonary function, physical fitness, physical activity (PA), dyspnoea and quality of life (QoL). Patients were divided in four groups Usual Care (UCare), inspiratory (IMT), expiratory (EMT) or combined muscle training (CombT) according to group allocation. Significant treatment*time interactions were found for maximal inspiratory pressure (MIP) (p=0.014), sedentary PA (SEDPA) (p=0.003), light PA (LIGPA) (p=0.045) and total PA (p=0.035). Improvements were observed for MIP in CombT (p=0.001), IMT (p=0.001), EMT (p=0.050). SEDPA reduced in EMT (p=0.001) and IMT (p=0.006), while LIGPA increased in both groups (p=0.001), as well as Total PA (p=0.005 and p=0.001, respectively). In UCare, CombT, and EMT, QoL improved only for Usual Activities. In conclusion, the addition of respiratory muscle training to physiotherapy usual care is safe and effective to increase MIP and contribute to improve physical activity. The CombT showed greater improvement on MIP, while IMT compared to EMT, was more effective to improve physical activity.

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Inspiratory muscle training is effective to reduce postoperative pulmonary complications and length of hospital stay: a systematic review and meta-analysis

Cited by 96 publications

References 36 publications

Evaluation of the effectiveness of preoperative outpatient pulmonary preparation in patients undergoing esophageal surgery

Evaluation of the effectiveness of preoperative outpatient pulmonary preparation in patients undergoing esophageal surgery

Combination of preoperative pulmonary and nutritional preparation for esophagectomy

Influence of Respiratory Muscle Training on Patients’ Recovery after Lung Resection

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