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Review
. 2025 May 21:7:1549652.
doi: 10.3389/fspor.2025.1549652. eCollection 2025.

Effectiveness of inspiratory muscle training in patients with a chronic respiratory disease: an overview of systematic reviews

Rodrigo Torres-Castro  1   2   3 , Saul Caicedo-Trujillo  4   5 , Elena Gimeno-Santos  1   2   6   7 , Ruvistay Gutiérrez-Arias  8   9   10 , Xavier Alsina-Restoy  1   2 , Luis Vasconcello-Castillo  3 , Pamela Seron  11   12 , Martijn A Spruit  13   14 , Isabel Blanco  1   2   7   15 , Jordi Vilaró  16
Affiliations
Review

Effectiveness of inspiratory muscle training in patients with a chronic respiratory disease: an overview of systematic reviews

Rodrigo Torres-Castro et al. Front Sports Act Living. .

Abstract

Introduction: There has been inconclusive findings regarding the effectiveness of inspiratory muscle training (IMT) in chronic respiratory diseases (CRDs). Our objective was to determine the effectiveness of IMT on exercise tolerance, maximum respiratory pressure, lung function, symptoms and quality of life in different CRDs.

Methods: We conducted an overview of systematic reviews (SRs) in adults with CRDs who underwent IMT. We reviewed five databases in March 2025. We chose the most comprehensive SRs to report on the analysed outcomes.

Results: Twenty-three SRs were included. In chronic obstructive pulmonary disease (COPD), IMT increased the six-minute walk distance (6MWD) by 35.7 m (95% CI 25.7, 45.7), maximum inspiratory pressure (MIP) by 10.9 cmH2O (95% CI 8.0, 13.9). In asthma, IMT increased the forced expiratory volume in the first second (FEV1) by 3.3%pred (95% CI 1.4, 5.1), forced vital capacity (FVC) by 4.1%pred (95% CI 1.0, 7.3), MIP by 21.9 cmH2O (95% CI 15.0, 28.8), and dyspnoea was reduced (standard mean difference -0.8, 95% CI -1.3,-0.2). In obstructive sleep apnoea (OSA), IMT increased MIP by 29.6 cmH2O (95% CI 6.0, 53.1). In pulmonary hypertension (PH), IMT increased 6MWD by 39.0 m (95% CI 20.7, 57.4), MIP in 21.2 cmH2O (95% CI 11.3, 31.1), maximum expiratory pressure by 14.4 cmH2O (95% CI 6.9, 21.9), and dyspnoea was reduced by 0.5 (95% CI 0.1, 0.9) in modified Medical Research Council scale. In lung resection (LR), IMT increased MIP by 8.1 cmH2O (95% CI 1.3, 14.9). In bronchiectasis, IMT increased MIP by 6.1 cmH2O (95% CI 1.4, 10.8). Overall, the most consistent effect of IMT across different CRDs was an increase in MIP.

Conclusion: IMT improved several clinically relevant outcomes, including MIP, exercise capacity, and dyspnoea in different CRDs. However, the limited evidence for certain outcomes and populations highlights the need for further high-quality studies.

Keywords: chronic respiratory diseases; exercise tolerance; inspiratory muscle training; overview; symptoms.

PubMed Disclaimer

Conflict of interest statement

RTC has received educational material from Biolaster, Spain. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the included studies.
Figure 2
Figure 2
Representation of main findings. 6MWD, six-minute walk distance; COPD, chronic obstructive pulmonary disease; CRQ, chronic respiratory disease questionnaire; FEV1, forced expiratory volume in the first second; FVC, forced vital capacity; MEP, maximum expiratory pressure; MIP, maximum inspiratory pressure; mMRC, modified medical research council; SMD, standard mean difference; VAS, visual analogue scale.
See this image and copyright information in PMC

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