Meta-analysis finds respiratory muscle training improves some lung function measures in multiple sclerosis

This publication is a systematic review and meta-analysis that evaluates the effects of respiratory muscle training on respiratory function in patients with multiple sclerosis. It synthesizes data from studies involving 249 patients, focusing on outcomes such as maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), forced vital capacity (FVC), forced expiratory volume in one second (FEV), and the FEV/FVC ratio. The comparator and follow-up duration are not reported, and the analysis does not specify primary or secondary outcomes beyond these measures.

The meta-analysis found significant improvements in several respiratory parameters. For maximal expiratory pressure, the standardized mean difference (SMD) was 0.42 (95% CI [0.09-0.76], p = 0.01). Maximal inspiratory pressure showed an SMD of 0.32 (95% CI [0.02-0.63], p = 0.04). Forced expiratory volume in one second had an SMD of 0.41 (95% CI [0.08-0.74], p = 0.01), and the FEV/FVC ratio had an SMD of 0.52 (95% CI [0.15-0.89], p = 0.005). However, forced vital capacity did not show a significant benefit, with an SMD of 0.28 (p = 0.06).

Limitations include a small total sample size of 249 patients, which may reduce the generalizability and precision of the findings. Adverse events, serious adverse events, discontinuations, and tolerability are not reported, limiting safety assessments. The authors do not provide details on funding or conflicts of interest, and the practice relevance is unspecified, suggesting cautious interpretation.

In practice, these results indicate that respiratory muscle training may modestly improve certain lung function measures in multiple sclerosis, but the evidence is based on pooled data with methodological gaps. Clinicians should consider the unreported safety profile and the lack of long-term follow-up when applying these findings. Further research is needed to confirm benefits and assess clinical outcomes beyond respiratory parameters.