Effectiveness of inspiratory muscle training in patients with a chronic respiratory disease: an overview of systematic reviews

Rodrigo Torres-Castro; Saul Caicedo-Trujillo; Elena Gimeno-Santos; Ruvistay Gutiérrez-Arias; Xavier Alsina-Restoy; Luis Vasconcello-Castillo; Pamela Seron; Martijn A Spruit; Isabel Blanco; Jordi Vilaró

doi:10.3389/fspor.2025.1549652

Effectiveness of inspiratory muscle training in patients with a chronic respiratory disease: an overview of systematic reviews

Front Sports Act Living. 2025 May 21:7:1549652. doi: 10.3389/fspor.2025.1549652. eCollection 2025.

Authors

Rodrigo Torres-Castro^{1

2

3}, Saul Caicedo-Trujillo^{4

5}, Elena Gimeno-Santos^{1

2

6

7}, Ruvistay Gutiérrez-Arias^{8

9

10}, Xavier Alsina-Restoy^{1

2}, Luis Vasconcello-Castillo³, Pamela Seron^{11

12}, Martijn A Spruit^{13

14}, Isabel Blanco^{1

2

7

15}, Jordi Vilaró¹⁶

Affiliations

¹ Department of Pulmonary Medicine, Hospital Clínic, University of Barcelona, Barcelona, Spain.
² Fundació de Recerca Clínic Barcelona-Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
³ Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile.
⁴ Centro Médico Familiar Integral y Especialidades Diálisis "LA MARISCAL", Instituto Ecuatoriano de Seguridad Social, Quito, Ecuador.
⁵ Programa de Doctorat-Facultat Ciències de la Salut Blanquerna, Universitat Ramon Llull, Barcelona, Spain.
⁶ Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.
⁷ Biomedical Research Networking Center on Respiratory Diseases, CIBERES, Madrid, Spain.
⁸ Departamento de Apoyo en Rehabilitación Cardiopulmonar Integral, Instituto Nacional del Tórax, Santiago, Chile.
⁹ Exercise and Rehabilitation Sciences Institute, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile.
¹⁰ INTRehab Research Group, Instituto Nacional del Tórax, Santiago, Chile.
¹¹ Departamento de Ciencias de la Rehabilitación, Facultad de Medicina, Universidad de La Frontera, Temuco, Chile.
¹² Centro de Excelencia CIGES, Universidad de La Frontera, Temuco, Chile.
¹³ Department of Research and Development, Ciro, Horn, Netherlands.
¹⁴ Department of Respiratory Medicine, School of Nutrition and Translational Research in Metabolism, Faculty of Health Medicine and Life Sciences, Maastricht University Medical Centre, Maastricht, Netherlands.
¹⁵ ERN-LUNG (European Reference Network on Rare Respiratory Diseases), Spain.
¹⁶ Blanquerna School of Health Sciences, Global Research on Wellbeing (GRoW), Universitat Ramon Llull, Barcelona, Spain.

Abstract

Introduction: There has been inconclusive findings regarding the effectiveness of inspiratory muscle training (IMT) in chronic respiratory diseases (CRDs). Our objective was to determine the effectiveness of IMT on exercise tolerance, maximum respiratory pressure, lung function, symptoms and quality of life in different CRDs.

Methods: We conducted an overview of systematic reviews (SRs) in adults with CRDs who underwent IMT. We reviewed five databases in March 2025. We chose the most comprehensive SRs to report on the analysed outcomes.

Results: Twenty-three SRs were included. In chronic obstructive pulmonary disease (COPD), IMT increased the six-minute walk distance (6MWD) by 35.7 m (95% CI 25.7, 45.7), maximum inspiratory pressure (MIP) by 10.9 cmH₂O (95% CI 8.0, 13.9). In asthma, IMT increased the forced expiratory volume in the first second (FEV₁) by 3.3%pred (95% CI 1.4, 5.1), forced vital capacity (FVC) by 4.1%pred (95% CI 1.0, 7.3), MIP by 21.9 cmH₂O (95% CI 15.0, 28.8), and dyspnoea was reduced (standard mean difference -0.8, 95% CI -1.3,-0.2). In obstructive sleep apnoea (OSA), IMT increased MIP by 29.6 cmH₂O (95% CI 6.0, 53.1). In pulmonary hypertension (PH), IMT increased 6MWD by 39.0 m (95% CI 20.7, 57.4), MIP in 21.2 cmH₂O (95% CI 11.3, 31.1), maximum expiratory pressure by 14.4 cmH₂O (95% CI 6.9, 21.9), and dyspnoea was reduced by 0.5 (95% CI 0.1, 0.9) in modified Medical Research Council scale. In lung resection (LR), IMT increased MIP by 8.1 cmH₂O (95% CI 1.3, 14.9). In bronchiectasis, IMT increased MIP by 6.1 cmH₂O (95% CI 1.4, 10.8). Overall, the most consistent effect of IMT across different CRDs was an increase in MIP.

Conclusion: IMT improved several clinically relevant outcomes, including MIP, exercise capacity, and dyspnoea in different CRDs. However, the limited evidence for certain outcomes and populations highlights the need for further high-quality studies.

Keywords: chronic respiratory diseases; exercise tolerance; inspiratory muscle training; overview; symptoms.

Publication types

Review