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Study flow diagram.
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Figure 1

Study flow diagram.

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Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Comparison 1 Respiratory muscle strength tests, Outcome 1 Change in maximal inspiratory pressure (cm H2O).
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Analysis 1.1

Comparison 1 Respiratory muscle strength tests, Outcome 1 Change in maximal inspiratory pressure (cm H2O).

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Comparison 1 Respiratory muscle strength tests, Outcome 2 Change in maximal expiratory pressure (cm H2O).
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Analysis 1.2

Comparison 1 Respiratory muscle strength tests, Outcome 2 Change in maximal expiratory pressure (cm H2O).

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Comparison 2 Spirometry, Outcome 1 Change in FEV1 (L/sec).
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Analysis 2.1

Comparison 2 Spirometry, Outcome 1 Change in FEV1 (L/sec).

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Comparison 2 Spirometry, Outcome 2 Change in FVC (L).
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Analysis 2.2

Comparison 2 Spirometry, Outcome 2 Change in FVC (L).

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Comparison 2 Spirometry, Outcome 3 Change in FEF25‐75% (L).
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Analysis 2.3

Comparison 2 Spirometry, Outcome 3 Change in FEF25‐75% (L).

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Table 1. Glossary

Term

Explanation

cough peak flow

highest expiratory flow generated during a forced cough manoeuvre, measured in litre per second

visual analogue scale

a response scale commonly used in questionnaires, to indicate levels of agreement or disagreement to a statement on a continuous line, e.g. strongly disagree, disagree, agree, strongly agree

Figuras y tablas -
Table 1. Glossary
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Table 2. QoL results

Domain

Time

Treatment group

medians (IQR)

Statistical significance in

change from baseline

Control group

medians (IQR)

Statistical significance in

change from baseline

Physical

baseline

80.50 (54.1 to 88.88)

72.21 (56.94 to 88.80)

post‐intervention

83.30 (62.48 to 93.74)

83.30 (51.39 to 95.46)

follow up

83.30 (70.8 to 95.83)

91.66 (75.00 to 100.00)

Emotional

baseline

81.65 (71.46 to 87.50)

84.97 (60.63 to 92.88)

post‐intervention

83.30 (73.73 to 92.91)

P = 0.031

80.00 (64.58 to 91.65)

follow up

75.00 (66.60 to 91.60)

83.30 (66.66 to 100.00)

Social

baseline

71.42 (57.10 to 79.76)

71.80 (61.90 to 85.70)

post‐intervention

71.81 (62.48 to 83.30)

66.60 (54.50 to 76.17)

P = 0.044

follow up

71.42 (66.6 to 85.71)

72.20 (52.38 to 90.47)

Body image

baseline

83.29 (66.62 to 100.00)

77.77 (69.42 to 100.00)

post‐intervention

94.44 (66.66 to 100.00)

83.25 (66.66 to 97.22)

follow up

100.00 (66.60 to 100.00)

88.80 (77.70 to 100.00)

Eating

baseline

100.00 (55.55 to 100.00)

100.00 (66.62 to 100.00)

post‐intervention

88.88 (66.60 to 100.00)

83.29 (66.62 to 100.00)

follow up

88.88 (66.60 to 100.00)

100.00 (88.80 to 100.00)

Treatment burden

baseline

66.63 (55.50 to 77.77)

61.08 (47.21 to 77.70)

post‐intervention

77.74 (66.62 to 97.20)

P = 0.014

66.60 (44.44 to 94.44)

P = 0.026

follow up

77.70 (55.50 to 100.00)

P = 0.031

66.60 (44.40 to 77.77)

Respiratory symptoms

baseline

66.60 (52.08 to 77.03)

58.30 (50.00 to 2.92)

post‐intervention

80.54 (75.00 to 88.80)

P = 0.001

79.15 (60.38 to 87.43)

P = 0.002

follow up

83.30 (72.20 to 91.66)

P = 0.016

83.30 (66.60 to 88.80)

P = 0.013

Digestion

baseline

83.33 (66.62 to 100.00)

94.40 (66.60 to 100.00)

post‐intervention

100.00 (88.88 to 100.00)

P = 0.024

100.00 (66.62 to 100.00)

follow up

100.00 (88.80 to 100.00)

100.00 (66.66 to 100.00)

Vitality

baseline

45.80 (33.32 to 54.17)

49.95 (33.32 to 64.55)

post‐intervention

41.63 (33.30 to 66.62)

66.65 (45.83 to 91.60)

P = 0.043

follow up

50.00 (41.67 to 58.33)

75.00 (49.95 to 85.40)

Health perception

baseline

61.05 (38.86 to 80.50)

44.42 (30.53 to 80.48)

post‐intervention

61.05 (47.18 to 83.28)

77.70 (61.06 to 100.00)

follow up

55.50 (33.31 to 83.29)

88.80 (58.32 to 94.40)

Role

baseline

58.33 (47.90 to 77.08)

62.47 (54.13 to 87.48)

post‐intervention

58.30 (39.53 to 66.62)

66.63 (58.30 to 77.08)

follow up

75.00 (58.33 to 75.00)

83.30 (49.95 to 95.83)

Weight

baseline

100.00 (0.00 to 100.00)

33.30 (24.98 to 50.00)

post‐intervention

100.00 (24.98 to 100.00)

66.60 (33.32 to 100.00)

follow up

100.00 (0.00 to 100.00)

66.60 (33.31 to 100.00)

IQR: inter‐quartile range
Figuras y tablas -
Table 2. QoL results
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Comparison 1. Respiratory muscle strength tests

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Change in maximal inspiratory pressure (cm H2O) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

1.1 short term (up to 1 month)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 medium term (> 1 month and < 6 months)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Change in maximal expiratory pressure (cm H2O) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2.1 short term (up to 1 month)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 medium term (> 1 month and < 6 months)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 1. Respiratory muscle strength tests
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Comparison 2. Spirometry

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Change in FEV1 (L/sec) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

1.1 short term (up to 1 month)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

1.2 medium term (> 1 month and < 6 months)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2 Change in FVC (L) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2.1 short term (up to 1 month)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

2.2 medium term (> 1 month and < 6 months)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3 Change in FEF25‐75% (L) Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3.1 short term (up to 1 month)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

3.2 medium term (> 1 month and < 6 months)

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 2. Spirometry
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