Scolaris Content Display Scolaris Content Display

Entrenamiento de los músculos respiratorios para la fibrosis quística

Esta versión no es la más reciente

ver la versión actual 17 diciembre 2020

Appendices

Appendix 1. Search strategy: clinicaltrials.gov

Date of Search

07/05/2018

Years Covered

1920 to 07/05/2018

Complete Strategy

1. inspir*mus*train AND cystic fibrosis

2. resp*mus*train AND cystic fibrosis

3. press*thresh*load AND cystic fibrosis

Language Restrictions

None

Appendix 2. Search strategy: WHO ICTRP

Date of Search

07/05/2018

Years Covered

1920 to 07/05/2018

Complete Strategy

1. inspir*mus*train AND cystic fibrosis

2. resp*mus*train AND cystic fibrosis

3. press*thresh*load AND cystic fibrosis

Language Restrictions

None

Appendix 3. Search strategy: MEDLINE, Embase, CINAHL, AMED, BIOSIS, EMB reviews (OVID‐WEB)

Date of Search

01/08/2013

Years Covered

1966 to present

Complete Strategy

1. randomised controlled trial.pt.
2. controlled clinical trial.pt.
3. randomised controlled trials.sh.
4. random allocation.sh.
5. double blind method.sh.
6. single blind method.sh.
7. or/1‐6
8. (animals not human).sh.
9. 7 not 8
10. clinical trial.pt.
11. exp clinical trials/
12. (clin$ adj25 trial$).ti,ab.
13. ((singl$ or doubl$ or trebl$ or tripl$) adj25 (blind$ or mask$)).ti,ab.
14. placebos.sh.
15. placebo$.ti,ab.
16. random$.ti,ab.
17. research design.sh.
18. or/10‐17
19. 18 not 8
20. 19 not 9
21. comparative study.sh.
22. exp evaluation studies/
23. follow up studies.sh.
24. prospective studies.sh.
25. (control$ or prospectiv$ or volunteer$).ti,ab.
26. or/21‐25
27. 26 not 8
28. 27 not (9 or 20)
29. 9 or 20 or 28
30. exp cystic fibrosis/
31. cystic fibrosis.mp.
32. (fibrocystic adj3 disease adj3 pancreas).tw.
33. mucoviscidos$.mp.
34. (cystic$ adj10 fibros$).tw.
35. (pancreatic adj3 cystic adj3 fibrosis).mp.
36. or/30‐35
37. 29 and 36
38. ((train$ or cond$) adj25 (inspirator$ or ventilator$ or respirator$ or pulmonar$)).mp.
39. (voluntar$ adj3 isocapn$ adj3 hyperpnoe$).tw.
40. (resist$ adj3 load$).tw.
41. (pressu$ adj3 thresh$ adj3 load$).tw.
42. (elas$ adj3 load$).tw.
43. (incre$ adj3 thresh$ adj3 load$).tw.
44. or/38‐43
45. 44 not 8
46. 45 and 37
47. remove duplicates from 46

Summary of Strategy

Lines 1 & 29 are the Cochrane RCT filter.
Lines 30 to 37 are the Cochrane cystic fibrosis filter.
Lines 38 to 45 were to isolate the intervention of interest.
The remainder were to combine these three themes.

Language Restrictions

None

Appendix 4. Search strategy: PEDro

Date of search

01/08/2013

Years covered

1929 to present

Complete strategy

1. inspir* mus* train*
2. resp* mus* train*
3. resp* mus* cond*
4. resist* load*
5. press* thresh* load*
6. incre* thresh* load*
7. cystic fibrosis
8. cyst* fibro*
9. pancreatic cystic fibrosis

Summary of strategy

PEDro is a database of controlled clinical trials, therefore no specific design oriented search terms.
All terms were geared to isolate the condition and the intervention.
The returned citations were then manually combined to be specific to the review question.

Language restrictions

None

Appendix 5. Search strategy: Science Direct

Date of search

01/08/2013

Years covered

1823 to present

Complete strategy

1: (Title‐Abstr‐Key (random*)) OR (Title‐Abstr‐Key (placebo*)) OR (Title‐Abstr‐Key ((singl* or doubl* or trebl* or tripl*) w/25 (blind* or mask*))) OR (Title‐Abstr‐Key (clin* w/25 trial*))
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]
2: ((Title‐Abstr‐Key (random*)) OR (Title‐Abstr‐Key (placebo*)) OR (Title‐Abstr‐Key ((singl* or doubl* or trebl* or tripl*) w/25 (blind* or mask*))) OR (Title‐Abstr‐Key (clin* w/25 trial*))) OR ((Title‐Abstr‐Key (single blind method)) OR (Title‐Abstr‐Key (double blind method)) OR (Title‐Abstr‐Key (random allocation)) OR (Title‐Abstr‐Key (controlled clinical trial)) OR (Title‐Abstr‐Key (randomised controlled trial)))
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]
3: Title‐Abstr‐Key (cystic fibrosis)
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]
4: Title‐Abstr‐Key (fibrocystic w/3 disease w/3 pancreas)
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]
5: Title‐Abstr‐Key (mucoviscidos*)
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]
6: Title‐Abstr‐Key (cystic* w/10 fibros*)
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]
7: Title‐Abstr‐Key (pancreatic w/3 cystic w/3 fibrosis)
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]
8: (Title‐Abstr‐Key (pancreatic w/3 cystic w/3 fibrosis)) OR (Title‐Abstr‐Key (cystic* w/10 fibros*)) OR (Title‐Abstr‐Key (mucoviscidos*)) OR (Title‐Abstr‐Key (fibrocystic w/3 disease w/3 pancreas)) OR (Title‐Abstr‐Key (cystic fibrosis))
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]
9: Title‐Abstr‐Key (train* or cond*) w/3 (inspirator* or ventilator* or respirator* or pulmonar*)
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]
10: Title‐Abstr‐Key (resist* w/3 load*)
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]
11: Title‐Abstr‐Key (inspiratory muscle training)
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]
12: (Title‐Abstr‐Key (inspiratory muscle training)) OR (Title‐Abstr‐Key (resist* w/3 load*)) OR (Title‐Abstr‐Key (train* or cond*) w/3 (inspirator* or ventilator* or respirator* or pulmonar*))
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]
13: (Title‐Abstr‐Key (inspiratory muscle training)) OR (Title‐Abstr‐Key (resist* w/3 load*)) OR (Title‐Abstr‐Key (train* or cond*) w/3 (inspirator* or ventilator* or respirator* or pulmonar*))
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]
14: ((Title‐Abstr‐Key (inspiratory muscle training)) OR (Title‐Abstr‐Key (resist* w/3 load*)) OR (Title‐Abstr‐Key (train* or cond*) w/3 (inspirator* or ventilator* or respirator* or pulmonar*))) AND ((Title‐Abstr‐Key (pancreatic w/3 cystic w/3 fibrosis)) OR (Title‐Abstr‐Key (cystic* w/10 fibros*)) OR (Title‐Abstr‐Key (mucoviscidos*)) OR (Title‐Abstr‐Key (fibrocystic w/3 disease w/3 pancreas)) OR (Title‐Abstr‐Key (cystic fibrosis))) AND (((Title‐Abstr‐Key (random*)) OR (Title‐Abstr‐Key (placebo*)) OR (Title‐Abstr‐Key ((singl* or doubl* or trebl* or tripl*) w/25 (blind* or mask*))) OR (Title‐Abstr‐Key (clin* w/25 trial*))) OR ((Title‐Abstr‐Key (single blind method)) OR (Title‐Abstr‐Key (double blind method)) OR (Title‐Abstr‐Key (random allocation)) OR (Title‐Abstr‐Key (controlled clinical trial)) OR (Title‐Abstr‐Key (randomised controlled trial))))
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]
15: ((Title‐Abstr‐Key (pancreatic w/3 cystic w/3 fibrosis)) OR (Title‐Abstr‐Key (cystic* w/10 fibros*)) OR (Title‐Abstr‐Key (mucoviscidos*)) OR (Title‐Abstr‐Key (fibrocystic w/3 disease w/3 pancreas)) OR (Title‐Abstr‐Key (cystic fibrosis))) AND (((Title‐Abstr‐Key (random*)) OR (Title‐Abstr‐Key (placebo*)) OR (Title‐Abstr‐Key ((singl* or doubl* or trebl* or tripl*) w/25 (blind* or mask*))) OR (Title‐Abstr‐Key (clin* w/25 trial*))) OR ((Title‐Abstr‐Key (single blind method)) OR (Title‐Abstr‐Key (double blind method)) OR (Title‐Abstr‐Key (random allocation)) OR (Title‐Abstr‐Key (controlled clinical trial)) OR (Title‐Abstr‐Key (randomised controlled trial))))
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]
16: ((Title‐Abstr‐Key (inspiratory muscle training)) OR (Title‐Abstr‐Key (resist* w/3 load*)) OR (Title‐Abstr‐Key (train* or cond*) w/3 (inspirator* or ventilator* or respirator* or pulmonar*))) AND ((Title‐Abstr‐Key (pancreatic w/3 cystic w/3 fibrosis)) OR (Title‐Abstr‐Key (cystic* w/10 fibros*)) OR (Title‐Abstr‐Key (mucoviscidos*)) OR (Title‐Abstr‐Key (fibrocystic w/3 disease w/3 pancreas)) OR (Title‐Abstr‐Key (cystic fibrosis)))
[All Sources(Medicine and Dentistry,Nursing and Health Professions)]

Summary of strategy

Lines 1 & 2 were to isolate studies of appropriate design.
Lines 3 to 8 were to isolate the condition of interest.
Lines 9 to 13 were to isolate the intervention of interest.
The remainder were to combine these three themes.

Language restrictions

None

Appendix 6. Search strategy: SCOPUS

Date of search

01/08/2013

Years covered

1966 to present

Complete strategy

1: TITLE‐ABS‐KEY(randomised controlled trial)
2: TITLE‐ABS‐KEY(controlled clinical trial)
3: TITLE‐ABS‐KEY(random allocation)
4: TITLE‐ABS‐KEY(double blind method)
5: TITLE‐ABS‐KEY(single blind method)
6: TITLE‐ABS‐KEY(clin* W/25 trial*)
7: ((TITLE‐ABS‐KEY(randomised controlled trial)) OR (TITLE‐ABS‐KEY(controlled clinical trial)) OR (TITLE‐ABS‐KEY(random allocation)) OR (TITLE‐ABS‐KEY(double blind method)) OR (TITLE‐ABS‐KEY(single blind method))) OR (TITLE‐ABS‐KEY(clin* W/25 trial*))
8: INDEXTERMS(cystic fibrosis)
9: TITLE‐ABS‐KEY(fibrocystic W/3 disease W/3 pancreas)
10: TITLE‐ABS‐KEY(mucoviscidos*)
11: TITLE‐ABS‐KEY(cystic* W/10 fibros*)
12: TITLE‐ABS‐KEY(pancreatic W/3 cystic W/3 fibrosis)
13: (INDEXTERMS(cystic fibrosis)) OR (TITLE‐ABS‐KEY(fibrocystic W/3 disease W/3 pancreas)) OR (TITLE‐ABS‐KEY(mucoviscidos*)) OR (TITLE‐ABS‐KEY(cystic* W/10 fibros*)) OR (TITLE‐ABS‐KEY(pancreatic W/3 cystic W/3 fibrosis))
14: TITLE‐ABS‐KEY(respiratory muscle training)
15: TITLE‐ABS‐KEY(ventilatory muscle training)
16: TITLE‐ABS‐KEY(pulmonary muscle training)
17: TITLE‐ABS‐KEY(resist* W/3 load*)
18: TITLE‐ABS‐KEY(pressu* W/3 thresh* W/3 load*)
19: TITLE‐ABS‐KEY(elas* W/3 load*)
20: TITLE‐ABS‐KEY(incre* W/3 thresh* W/3 load*)
21: (TITLE‐ABS‐KEY(pressu* W/3 thresh* W/3 load*)) OR (TITLE‐ABS‐KEY(elas* W/3 load*)) OR (TITLE‐ABS‐KEY(incre* W/3 thresh* W/3 load*)) OR ((TITLE‐ABS‐KEY(inspiratory muscle training)) OR (TITLE‐ABS‐KEY(respiratory muscle training)) OR (TITLE‐ABS‐KEY(ventilatory muscle training)) OR (TITLE‐ABS‐KEY(pulmonary muscle training)) OR (TITLE‐ABS‐KEY(resist* W/3 load*)))
22: ((INDEXTERMS(cystic fibrosis)) OR (TITLE‐ABS‐KEY(fibrocystic W/3 disease W/3 pancreas)) OR (TITLE‐ABS‐KEY(mucoviscidos*)) OR (TITLE‐ABS‐KEY(cystic* W/10 fibros*)) OR (TITLE‐ABS‐KEY(pancreatic W/3 cystic W/3 fibrosis))) AND (((TITLE‐ABS‐KEY(randomised controlled trial)) OR (TITLE‐ABS‐KEY(controlled clinical trial)) OR (TITLE‐ABS‐KEY(random allocation)) OR (TITLE‐ABS‐KEY(double blind method)) OR (TITLE‐ABS‐KEY(single blind method))) OR (TITLE‐ABS‐KEY(clin* W/25 trial*))) AND ((TITLE‐ABS‐KEY(pressu* W/3 thresh* W/3 load*)) OR (TITLE‐ABS‐KEY(elas* W/3 load*)) OR (TITLE‐ABS‐KEY(incre* W/3 thresh* W/3 load*)) OR ((TITLE‐ABS‐KEY(inspiratory muscle traning)) OR (TITLE‐ABS‐KEY(respiratory muscle training)) OR (TITLE‐ABS‐KEY(ventilatory muscle training)) OR (TITLE‐ABS‐KEY(pulmonary muscle training)) OR (TITLE‐ABS‐KEY(resist* W/3 load*))))

Summary of strategy

Lines 1 to 7 were to isolate appropriate study design.
Lines 8 to 13 were to isolate the condition.
Lines 14 to 21 were to isolate the intervention.
Line 22: Combines these three themes.

Language restrictions

None

Appendix 7. Search strategy: MEDLINE, CINHAL and AMED (EBSCOHost)

Date of search

01/08/2013

Years covered

1966 to present

Complete strategy

1: TITLE‐ABS‐KEY(randomised controlled trial)
2: TITLE‐ABS‐KEY(controlled clinical trial)
3: TITLE‐ABS‐KEY(random allocation)
4: TITLE‐ABS‐KEY(double blind method)
5: TITLE‐ABS‐KEY(single blind method)
6: TITLE‐ABS‐KEY(clin* W/25 trial*)
7: ((TITLE‐ABS‐KEY(randomised controlled trial)) OR (TITLE‐ABS‐KEY(controlled clinical trial)) OR (TITLE‐ABS‐KEY(random allocation)) OR (TITLE‐ABS‐KEY(double blind method)) OR (TITLE‐ABS‐KEY(single blind method))) OR (TITLE‐ABS‐KEY(clin* W/25 trial*))
8: INDEXTERMS(cystic fibrosis)
9: TITLE‐ABS‐KEY(fibrocystic W/3 disease W/3 pancreas)
10: TITLE‐ABS‐KEY(mucoviscidos*)
11: TITLE‐ABS‐KEY(cystic* W/10 fibros*)
12: TITLE‐ABS‐KEY(pancreatic W/3 cystic W/3 fibrosis)
13: (INDEXTERMS(cystic fibrosis)) OR (TITLE‐ABS‐KEY(fibrocystic W/3 disease W/3 pancreas)) OR (TITLE‐ABS‐KEY(mucoviscidos*)) OR (TITLE‐ABS‐KEY(cystic* W/10 fibros*)) OR (TITLE‐ABS‐KEY(pancreatic W/3 cystic W/3 fibrosis))
14: TITLE‐ABS‐KEY(respiratory muscle training)
15: TITLE‐ABS‐KEY(ventilatory muscle training)
16: TITLE‐ABS‐KEY(pulmonary muscle training)
17: TITLE‐ABS‐KEY(resist* W/3 load*)
18: TITLE‐ABS‐KEY(pressu* W/3 thresh* W/3 load*)
19: TITLE‐ABS‐KEY(elas* W/3 load*)
20: TITLE‐ABS‐KEY(incre* W/3 thresh* W/3 load*)
21: (TITLE‐ABS‐KEY(pressu* W/3 thresh* W/3 load*)) OR (TITLE‐ABS‐KEY(elas* W/3 load*)) OR (TITLE‐ABS‐KEY(incre* W/3 thresh* W/3 load*)) OR ((TITLE‐ABS‐KEY(inspiratory muscle training)) OR (TITLE‐ABS‐KEY(respiratory muscle training)) OR (TITLE‐ABS‐KEY(ventilatory muscle training)) OR (TITLE‐ABS‐KEY(pulmonary muscle training)) OR (TITLE‐ABS‐KEY(resist* W/3 load*)))
22: ((INDEXTERMS(cystic fibrosis)) OR (TITLE‐ABS‐KEY(fibrocystic W/3 disease W/3 pancreas)) OR (TITLE‐ABS‐KEY(mucoviscidos*)) OR (TITLE‐ABS‐KEY(cystic* W/10 fibros*)) OR (TITLE‐ABS‐KEY(pancreatic W/3 cystic W/3 fibrosis))) AND (((TITLE‐ABS‐KEY(randomised controlled trial)) OR (TITLE‐ABS‐KEY(controlled clinical trial)) OR (TITLE‐ABS‐KEY(random allocation)) OR (TITLE‐ABS‐KEY(double blind method)) OR (TITLE‐ABS‐KEY(single blind method))) OR (TITLE‐ABS‐KEY(clin* W/25 trial*))) AND ((TITLE‐ABS‐KEY(pressu* W/3 thresh* W/3 load*)) OR (TITLE‐ABS‐KEY(elas* W/3 load*)) OR (TITLE‐ABS‐KEY(incre* W/3 thresh* W/3 load*)) OR ((TITLE‐ABS‐KEY(inspiratory muscle traning)) OR (TITLE‐ABS‐KEY(respiratory muscle training)) OR (TITLE‐ABS‐KEY(ventilatory muscle training)) OR (TITLE‐ABS‐KEY(pulmonary muscle training)) OR (TITLE‐ABS‐KEY(resist* W/3 load*))))

Summary of strategy

Lines 1 to 7 were to isolate appropriate study design.
Lines 8 to 13 were to isolate the condition.
Lines 14 to 21 were to isolate the intervention.
Line 22: Combines these three themes.

Language restrictions

None

Comparison 1 RMT (80% of maximal effort) versus control, Outcome 1 Forced expiratory volume at one second (L).
Figuras y tablas -
Analysis 1.1

Comparison 1 RMT (80% of maximal effort) versus control, Outcome 1 Forced expiratory volume at one second (L).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 RMT (80% of maximal effort) versus control, Outcome 2 Forced vital capacity (L).
Figuras y tablas -
Analysis 1.2

Comparison 1 RMT (80% of maximal effort) versus control, Outcome 2 Forced vital capacity (L).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 RMT (80% of maximal effort) versus control, Outcome 3 Chronic Respiratory Disease Questionnaire (mastery).
Figuras y tablas -
Analysis 1.3

Comparison 1 RMT (80% of maximal effort) versus control, Outcome 3 Chronic Respiratory Disease Questionnaire (mastery).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 RMT (80% of maximal effort) versus control, Outcome 4 Chronic Respiratory Disease Questionnaire (emotion).
Figuras y tablas -
Analysis 1.4

Comparison 1 RMT (80% of maximal effort) versus control, Outcome 4 Chronic Respiratory Disease Questionnaire (emotion).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2 RMT (60% of maximal effort) versus control, Outcome 1 Forced expiratory volume at one second (L).
Figuras y tablas -
Analysis 2.1

Comparison 2 RMT (60% of maximal effort) versus control, Outcome 1 Forced expiratory volume at one second (L).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 2 RMT (60% of maximal effort) versus control, Outcome 2 PImax (cm H₂O).
Figuras y tablas -
Analysis 2.2

Comparison 2 RMT (60% of maximal effort) versus control, Outcome 2 PImax (cm H₂O).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 3 RMT (40% of maximal effort) versus control, Outcome 1 Forced expiratory volume at one second (L).
Figuras y tablas -
Analysis 3.1

Comparison 3 RMT (40% of maximal effort) versus control, Outcome 1 Forced expiratory volume at one second (L).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 3 RMT (40% of maximal effort) versus control, Outcome 2 Forced expiratory volume at one second (% predicted).
Figuras y tablas -
Analysis 3.2

Comparison 3 RMT (40% of maximal effort) versus control, Outcome 2 Forced expiratory volume at one second (% predicted).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 3 RMT (40% of maximal effort) versus control, Outcome 3 Forced vital capacity (L).
Figuras y tablas -
Analysis 3.3

Comparison 3 RMT (40% of maximal effort) versus control, Outcome 3 Forced vital capacity (L).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 3 RMT (40% of maximal effort) versus control, Outcome 4 Forced vital capacity (% predicted).
Figuras y tablas -
Analysis 3.4

Comparison 3 RMT (40% of maximal effort) versus control, Outcome 4 Forced vital capacity (% predicted).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 3 RMT (40% of maximal effort) versus control, Outcome 5 Inspiratory muscle endurance (% PImax).
Figuras y tablas -
Analysis 3.5

Comparison 3 RMT (40% of maximal effort) versus control, Outcome 5 Inspiratory muscle endurance (% PImax).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 4 RMT (20% of maximal effort) versus control, Outcome 1 Forced expiratory volume at one second (L).
Figuras y tablas -
Analysis 4.1

Comparison 4 RMT (20% of maximal effort) versus control, Outcome 1 Forced expiratory volume at one second (L).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 4 RMT (20% of maximal effort) versus control, Outcome 2 Forced vital capacity (L).
Figuras y tablas -
Analysis 4.2

Comparison 4 RMT (20% of maximal effort) versus control, Outcome 2 Forced vital capacity (L).

Ir a la figura de la revisiónAbrir en una pestaña nueva

Respiratory muscle training compared with control for cystic fibrosis

Patient or population: adults and children with cystic fibrosis

Settings: outpatients

Intervention: respiratory muscle trainingₑ

Comparison: controlₑ

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Controlₑ

Respiratory muscle trainingₑ

FEV1: % predicted

Follow‐up: 6‐12 weeks

No significant differences between the respiratory muscle training group and the control group were reported in any study.

NA

145

(7 studies including 2 cross‐over studies)

⊕⊝⊝⊝
very low2,3

Studies reported FEV1 as % predicted, litres or z score.

One study with respiratory muscle training level 30% of maximal effort reported a significant improvement within the training group.

FVC: % predicted

Follow‐up: 6‐12 weeks

No significant differences between the respiratory muscle training group and the control group were reported in any study.

NA

114

(5 studies including 1 cross‐over study)

⊕⊝⊝⊝
very low2,3

Studies reported FVC as % predicted, litres or z score.

One study with respiratory muscle training level 30% of maximal effort reported a significant improvement within the training group.

Exercise capacity: VO2max (mL/kg/min)

Follow‐up: 6‐12 weeks

No significant differences between the respiratory muscle training group and the control group were reported in any study.

NA

54

(3 studies including 1 cross‐over study)

⊕⊝⊝⊝
very low2,3

One study with an unspecified level of resistance reported a significant improvement within the respiratory muscle training group.

HRQoL: total score

Follow‐up: 8 weeks

Two studies reported no significant differences between the respiratory muscle training group and the control group.

One study reported significant improvements in the parameters of mastery and emotion in the respiratory muscle training group compared to the control group.

NA

69

(3 studies including 1 cross‐over study)

⊕⊝⊝⊝
very low2,3

Two studies used the Chronic Respiratory Disease Questionnaire (CRDQ) and one study used the cystic fibrosis questionnaire (CFQ).

Respiratory muscle function: maximal inspiratory pressure (PImax)

Follow‐up: 6‐10 weeks

Significant improvements were observed in all respiratory muscle training groups.

Two studies reported no significant differences between the respiratory muscle training group and the control group.

NA

51

(3 studies including 1 cross‐over study)

⊕⊕⊝⊝
low2

Respiratory muscle function: inspiratory capacity

Follow‐up: NA

NA

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: confidence interval; FEV1: forced expiratory volume in 1 second; FVC: forced vital capacity; HRQoL: health related quality of life;NA: not applicable; VO₂max: maximal oxygen uptake.

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1. The resistance level of the respiratory muscle training intervention was variable; three studies used 80% of maximal effort, one study used 60% of maximal effort, one study used 40% of maximal effort, one study used 30% of maximal effort and three studies did not specify the level of resistance. Control groups were also variable; cycle ergometer, H20, treatment as usual, standard chest physiotherapy, low resistance threshold loading device, no training or sham training.

2. Downgraded twice due to serious risk of bias: the included studies lacked methodological detail relating to methods of randomisation, allocation concealment and blinding. Most of the studies were at high risk of bias due to lack of blinding, incomplete outcome data or selective reporting, or both.

3. Downgraded due to imprecision: studies included a small number of participants and numerical results were not available for some of the studies.

Figuras y tablas -
Ir a la tabla de la revisión
Comparison 1. RMT (80% of maximal effort) versus control

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Forced expiratory volume at one second (L) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

1.1 Two to six months

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Forced vital capacity (L) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2.1 Two to six months

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Chronic Respiratory Disease Questionnaire (mastery) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4 Chronic Respiratory Disease Questionnaire (emotion) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 1. RMT (80% of maximal effort) versus control
Ir a la tabla de la revisión
Comparison 2. RMT (60% of maximal effort) versus control

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Forced expiratory volume at one second (L) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

1.1 Two to six months

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 PImax (cm H₂O) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2.1 Two to six months

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 2. RMT (60% of maximal effort) versus control
Ir a la tabla de la revisión
Comparison 3. RMT (40% of maximal effort) versus control

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Forced expiratory volume at one second (L) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

1.1 Less than two months

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Forced expiratory volume at one second (% predicted) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2.1 Less than two months

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Forced vital capacity (L) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3.1 Less than two months

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

4 Forced vital capacity (% predicted) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4.1 Less than two months

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5 Inspiratory muscle endurance (% PImax) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5.1 Less than two months

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 3. RMT (40% of maximal effort) versus control
Ir a la tabla de la revisión
Comparison 4. RMT (20% of maximal effort) versus control

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Forced expiratory volume at one second (L) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

1.1 Two to six months

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Forced vital capacity (L) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2.1 Two to six months

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 4. RMT (20% of maximal effort) versus control
Ir a la tabla de la revisión