Efficacy of inspiratory muscle training on respiratory muscle strength in hematopoietic stem cell recipients: a systematic review and meta-analysis

Abstract

Objective: To investigate whether inspiratory muscle training improves respiratory muscle strength and function and reduces dyspnea and fatigue in hematopoietic stem cell recipients. Design: A systematic review and meta-analysis of randomized controlled trials. Participants: People with hematological neoplasms who underwent hematopoietic stem cell transplantation. Intervention: Inspiratory muscle training with POWER breath Plus, POWERbreathe, Classic, and Threshold devices, with a load of 40% of the maximum inspiratory pressure. Outcome Measures: The primary outcomes were maximal inspiratory pressure, maximal expiratory pressure, forced expiratory volume in the first second of expiration (FEV1 ), forced vital capacity (FVC), and the FEV1 /FVC ratio. Secondary outcomes were dyspnea, fatigue, respiratory rate, peripheral O2 saturation, quality of life, and functional capacity. Results: The search identified 3 eligible studies with a sample of 108 participants. Maximal inspiratory pressure was higher in the intervention group in the 3 studies reviewed, with an average difference of −9.3 cm H2 O, −31.94 cm H2 O, and −16 cm H2 O in relation to the control group after inspiratory muscle training. One study found an improvement in the distance covered in the 6-minute walk test (34.22 m) and in the distance covered in the modified incremental shuttle walking test (66.43 m) in the intervention group. Limitation: This systematic review includes only 3 randomized controlled clinical trials. Conclusion: Inspiratory muscle training is effective in increasing inspiratory muscle strength and functional capacity in bone marrow transplant recipients. However, its effects on fatigue and dyspnea remain uncertain. (Rehab Oncol 2022;40:96–104) Key words: bone marrow transplant, breathing exercises, hematological neoplasms, hematopoietic stem cell transplantation, inspiratory muscle training, maximum respiratory pressures, specialty in physiotherapy