Effects of controlled breathing exercises and respiratory muscle training in people with chronic obstructive pulmonary disease: results from evaluating the quality of evidence in systematic reviews

BMC Pulmonary Medicine

Astrid Klopstad Wahl¹  Torbjørn Moum³  Ernst Omenaas²  Anne Marit Mengshoel¹  Kåre Birger Hagen⁴  Christine Råheim Borge⁵ 

[1] Department of Health Sciences, University of Oslo, Oslo, Norway;Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway;Department of Behavioral Sciences in Medicine, University of Oslo, Oslo, Norway;Department of Rheumatology, National Resource Centre for Rehabilitation in Rheumatology, Diakonhjemmet, Oslo, Norway;Department of Medicine, Lovisenberg Diaconal Hospital, Oslo, Norway

关键词: Overview;    Pursed lip breathing;    Diaphragmatic breathing;    Respiratory muscle training;    Controlled breathing;    Chronic obstructive Pulmonary disease;   

Others  :  1091243
DOI  :  10.1186/1471-2466-14-184

 received in 2013-08-30, accepted in 2014-10-27,  发布年份 2014

【 摘 要 】

Background

This paper reviews evidence and quality of Systematic Reviews (SRs) on the effects of breathing control exercises (BCEs) and respiratory muscle training (RMT) on breathlessness/dyspnea and other symptoms, and quality of life (QOL) for individuals with chronic obstructive pulmonary disease (COPD).

Methods

A search for BCE and RMT literature in COPD published between January 1, 2002 and December 31, 2013 was performed in the following databases: PubMed, Ovid, CINAHL, PsycINFO, AMED, Cochrane and PEDro. The AMSTAR criteria were used to evaluate quality.

Results

After reviewing 642 reports, seven SRs were identified on RMT and BCEs. Three SRs were of high quality, three were of moderate quality, and one was of low quality. Two high-quality SRs reported significantly beneficial effects of RMT on dyspnea, and one reported significant effects on disease-specific QOL and fatigue. In these SRs, pooled data analyses were performed with three to fourteen single randomised control trials (RCTs) included in the analysis. In one of the SRs the quality of the single RCTs were rated by the authors to be between 5–7 (with10 best) and in the other one the quality of the single RCTs were rated to be between 30-83% of the maximum score.

One high-quality SR found a significant positive effect of BCE based on pooled data analysis with two single RCTs in regard to pursed-lip breathing (PLB) on breathlessness. In this SR, one single RCT on diaphragmatic breathing (DB) and another one on yoga breathing (YB) showed effect on disease-specific QOL. The single RCTs included in the SR were rated by the authors in the SRs to be of low and moderate quality.

Conclusions

Based on three high-quality SRs performing pooled data analyses, there is evidence that RMT has effect on breathlessness, fatigue and disease-specific QOL and PLB on breathlessness. There is also evidence that single studies on DB and YB has effect on disease-specific QOL. Few RCTs are available and the variable quality of the single RCTs in the SRs, seem to require more RCTs in particular for BCEs, but also RMT before conclusions regarding effects and high quality SRs can be written.

【 授权许可】

   
2014 Borge et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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