Summary The purpose of this paper was to review the effectiveness of respiratory
muscle training (RMT) on respiratory muscle strength and endurance, pulmonary
function, quality of life, respiratory complications and exercise performance in
persons with spinal cord injury. A MEDLINE (National Library of Medicine, Bethesda,
MD, USA) database was used for selection of the literature (from 1980 to November
2004), and relevant references from peer-reviewed articles were retrieved as well.
Studies investigating the effects of RMT (i.e. resistive breathing weight lifting or
normocapnic hyperpnea) in persons with spinal cord injury were selected. Two
independent reviewers investigated controlled studies for methodological quality by
using a modification of the framework for methodological quality. Methodological
quality ranged between 15 and 29 (maximal feasible score ¼ 40). Twenty-three
papers were retrieved and six controlled trials were kept for further analysis. A
meta-analysis and calculation of effect-size of each individual study and weighted
summary effect-size was intended. However, unreported data and heterogeneity in
outcome variables did not allow performing a meta-analysis. From the systematic
review it is concluded that RMT tended to improve expiratory muscle strength, vital
capacity and residual volume. Insufficient data was available to make conclusions
concerning the effects on inspiratory muscle strength, respiratory muscle
endurance, quality of life, exercise performance and respiratory complications.
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