The training of muscles that cause the chest to expand in order to take air into the lungs for people with cystic fibrosis

Cystic fibrosis is the most common life-limiting genetic condition in Caucasians. The life-expectancy of newly diagnosed patients is increasing. Inspiratory muscle training may improve quality of life, lung function and exercise tolerance in people with cystic fibrosis, so that these are closer to the levels found in people who do not have cystic fibrosis. It may also boost the clearance of mucus. Inspiratory muscle training can be performed without the help of a carer and wherever the individual feels appropriate. We searched for randomised or quasi-randomised controlled clinical trials to determine the effects of inspiratory muscle training in the treatment of people with cystic fibrosis. We included eight studies with 180 participants in the review, but we could not combine results from these studies to answer our questions, because the studies either did not publish enough details or did not use the same standard measurements. Given this, we cannot recommend the use, or not, of this intervention. We do recommend that future studies make more use of health-related quality of life and exercise tolerance measures. We also suggest there should be agreement upon standard measurements used.

Authors' conclusions: 

We have not found any evidence to suggest that this treatment is either beneficial or not. We would advise that practitioners evaluate on a case-by-case basis whether or not to employ this therapy. We recommend that future studies make more use of health-related quality of life and exercise tolerance measures; and that there is an agreement upon a single standard measure of classifying the clinical status of the participants.

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Background: 

Cystic fibrosis is the most common life-limiting genetic condition in Caucasians and the life-expectancy of those newly diagnosed is increasing. Inspiratory muscle training may be a way of improving the lung function and quality of life of people with cystic fibrosis. Hence there is a need to establish whether this intervention is beneficial.

Objectives: 

To determine the effect of inspiratory muscle training on health-related quality of life, pulmonary function and exercise tolerance.

Search strategy: 

We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group Trials register comprising of references identified from comprehensive electronic database searches and handsearches of relevant journals and abstract books of conference proceedings.

Date of most recent search: 08 July 2013.

Selection criteria: 

Randomised or quasi-randomised clinical controlled trials comparing different inspiratory muscle training regimens with each other or a control in people with cystic fibrosis.

Data collection and analysis: 

Three review authors independently applied the inclusion and exclusion criteria to publications and assessed the quality of the included studies.

Main results: 

Fourteen studies were identified. Of these eight studies with 180 participants met the review inclusion criteria. There was wide variation in the quality of the included studies. Data were not published in sufficient detail or with sufficiently similar outcome measures in these studies to perform meta-analyses.

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