Inspiratory Muscle Training in Patients Living With Chronic Kidney Disease and Receiving Hemodialysis: Meta-Analysis of Randomized Controlled Trials (2024)

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Ana Karla Vieira Brüggemann, MSc

Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA)

,

Porto Alegre, Rio Grande do Sul

,

Brazil

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,

Jociane Schardong, PhD

Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA)

,

Porto Alegre, Rio Grande do Sul

,

Brazil

Serviço de Fisioterapia, Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA) hospital

,

Porto Alegre, Rio Grande do Sul

,

Brazil

Address all correspondence to Dr Schardong at: jociane@santacasa.org.br

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Natiele Camponogara Righi, MSc

Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA)

,

Porto Alegre, Rio Grande do Sul

,

Brazil

Serviço de Fisioterapia, Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA) hospital

,

Porto Alegre, Rio Grande do Sul

,

Brazil

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Rodrigo Della Méa Plentz, PhD

Ciências da Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA)

,

Porto Alegre, Rio Grande do Sul

,

Brazil

Serviço de Fisioterapia, Irmandade Santa Casa de Misericórdia de Porto Alegre (ISCMPA) hospital

,

Porto Alegre, Rio Grande do Sul

,

Brazil

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Physical Therapy, Volume 104, Issue 8, August 2024, pzae065, https://doi.org/10.1093/ptj/pzae065

Published:

25 April 2024

Article history

Received:

03 July 2023

Revision received:

15 January 2024

Accepted:

24 April 2024

Published:

25 April 2024

Corrected and typeset:

06 August 2024

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    Ana Karla Vieira Brüggemann, Jociane Schardong, Natiele Camponogara Righi, Rodrigo Della Méa Plentz, Inspiratory Muscle Training in Patients Living With Chronic Kidney Disease and Receiving Hemodialysis: Meta-Analysis of Randomized Controlled Trials, Physical Therapy, Volume 104, Issue 8, August 2024, pzae065, https://doi.org/10.1093/ptj/pzae065

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Abstract

Objective

People living with chronic kidney disease (CKD) and receiving hemodialysis (HD) have impaired respiratory muscle strength and endurance. The objective of this study was to systematically review the effects of inspiratory muscle training (IMT) on respiratory muscle strength, functional capacity, lung function, quality of life, endothelial function, and oxidative stress in people living with CKD and receiving HD.

Methods

An electronic search was conducted from inception to June 2023. Randomized controlled trials that evaluated the effects of IMT on respiratory muscle strength, functional capacity, lung function, endothelial function, quality of life, or oxidative stress in adults living with CKD and receiving HD, compared with control, placebo IMT, or conventional physical therapy, were included.

Results

Eight studies were included, totaling 246 people. The meta-analysis showed that IMT increased the maximum inspiratory pressure (MIP) by 22.53cm H2O, the maximum expiratory pressure (MEP) by 19.54cm H2O, and the distance covered in the 6-minute walk test by 77.63m. Changes in lung function and quality of life were not observed. It was not possible to quantitatively analyze data on endothelial function and oxidative stress.

Conclusion

IMT improves MIP, MEP, and functional capacity in people living with CKD and receiving HD. IMT did not demonstrate significant results for lung function and quality of life. Effects on endothelial function and oxidative capacity remain uncertain.

Impact

Inspiratory muscle training improves MIP, MEP, and functional capacity in people living with CKD and receiving HD, compared with conventional physical therapy or controls or placebo intervention. Increases in functional capacity in this population are extremely important because of the relationship with the survival of these people.

Chronic Renal Failure, Muscle Strength, Renal Dialysis, Respiratory Muscles, Respiratory Training

© The Author(s) 2024. Published by Oxford University Press on behalf of Fellowship of Postgraduate Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)

Subject

Metabolic

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Review

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