Current Insights of Inspiratory Muscle Training on the Cardiovascular System: An Update of the Systematic Review with Meta-Analysis

Authors

  • Rafael Pena Graduate Program in Human Movement and Rehabilitation, Evangelical University of Goias, Brazil.
  • Francisco V. Santos Cancer Institute of São Paulo, Intensive Care Unit, São Paulo, Brazil.
  • Graziella F. B. Cipriano Physical Therapy Department, University of Brasilia, Brasilia, Brazil.
  • Gerson Cipriano Jr. Physical Therapy Department, University of Brasilia, Brasilia, Brazil.
  • Adriana M. Güntzel Chiappa Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil.
  • Lawrence Patrick Cahalin Department of Physical Therapy, University of Miami Miller School of Medicine, Coral Gables, Florida, USA.
  • Gaspar R. Chiappa Graduate Program in Human Movement and Rehabilitation, Evangelical University of Goias, Brazil.

DOI:

https://doi.org/10.9734/bpi/anums/v1/6977E

Keywords:

Breathing exercises, respiratory muscle training, cardiovascular system

Abstract

Background: Cardiorespiratory limitation is a common hallmark of cardiovascular disease which is a key component of pharmacological and exercise treatments. More recently, inspiratory muscle training (IMT) has become an effective complementary treatment with positive effects on muscle strength and exercise capacity.

Aim: We assessed the effectiveness of IMT on the cardiovascular system through autonomic function modulation via heart rate variability and arterial blood pressure.

Methods: Randomized controlled trials (RCTs) were identified from searches of The Cochrane Library, MEDLINE, and EMBASE to November 2023. We included studies examining a program of IMT (\(\ge\)) one-week treatment) offered as a sole intervention or as an adjuvant to another form of exercise. Citations, conference proceedings, and previous reviews were included without population restriction, comparing IMT intervention to no treatment, placebo, or active control.

Results: We identified 20 RCTs involving 521 subjects (mean age range 21-71 years). IMT programs targeted maximum inspiratory pressure (MIP) and cardiovascular outcomes, using low (n=11) and moderate to high intensity (n=9) protocols, but the protocols varied considerably (duration: 1-12 weeks, frequency: 3-14 times/week, time: 10-30 mins). An overall increase of the MIP (cmH2O) was observed (23.66 95% CI 15.95 to 31.37, I2=77%), according to weighted mean difference (95%CI) and was accompanied by a reduction of the low to high-frequency ratio (-0.70 95% CI -1.34 to -0.05, I2=42%). In a subgroup analysis, low- and moderate-intensity IMT treatment was associated with a reduction of the systolic blood pressure (SBP) (-5.08 95% CI -9.11 to -1.06 mmHg, I2=0%), heart rate (HR) (-3.58 95% CI -5.94 to -1.21 bpm, I2=63.4%) and diastolic blood pressure (DBP) (-11.25 95% CI -16.46 to -6.05 mmHg, I2=0%), respectively.

Conclusion: IMT is an effective treatment for inspiratory muscle weakness in several populations and could be considered a complementary treatment to improve the cardiovascular system, mainly SBP, HR, and DBP. Further research is required to understand the above findings better. More studies are needed to better understand the role of IMT as a component or alternative to regular exercise protocols for treating individuals with increased blood pressure response.

Downloads

Published

2024-01-08

How to Cite

Rafael Pena, Francisco V. Santos, Graziella F. B. Cipriano, Gerson Cipriano Jr., Adriana M. Güntzel Chiappa, Lawrence Patrick Cahalin, & Gaspar R. Chiappa. (2024). Current Insights of Inspiratory Muscle Training on the Cardiovascular System: An Update of the Systematic Review with Meta-Analysis. Advancement and New Understanding in Medical Science Vol. 1, 63–86. https://doi.org/10.9734/bpi/anums/v1/6977E

Issue

Advancement and New Understanding in Medical Science Vol. 1

Section

Chapters