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Review
. 2024 May 23;13(11):3053.
doi: 10.3390/jcm13113053.

Effects of Respiratory Muscle Training on Functional Ability, Pain-Related Outcomes, and Respiratory Function in Individuals with Low Back Pain: Systematic Review and Meta-Analysis

Raúl Fabero-Garrido  1 , Iván Rodríguez-Marcos  1 , Tamara Del Corral  1   2 , Gustavo Plaza-Manzano  1   2 , Ibai López-de-Uralde-Villanueva  1   2
Affiliations
Review

Effects of Respiratory Muscle Training on Functional Ability, Pain-Related Outcomes, and Respiratory Function in Individuals with Low Back Pain: Systematic Review and Meta-Analysis

Raúl Fabero-Garrido et al. J Clin Med. .

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.

Keywords: disability; low back pain; pain threshold; postural balance; respiratory function tests; respiratory muscle training.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram.
Figure 2
Figure 2
Synthesis forest plot for postural control and lumbar disability for respiratory muscle training versus control group [16,38,39,40,42,43,45].
Figure 3
Figure 3
Synthesis forest plot for pain intensity and pain-related fear-avoidance beliefs for respiratory muscle training versus control group [14,15,16,38,39,40,42,43,45].
Figure 4
Figure 4
Synthesis forest plot for respiratory muscle strength and pulmonary function for respiratory muscle training versus control group [14,16,38,39,41,42,43,44].
See this image and copyright information in PMC

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