吸气肌训练对慢性肾病血液透析患者呼吸困难和肺活量的影响：一项系统回顾和荟萃分析

IF 1.5 4区医学 Q2 REHABILITATION

Physiotherapy Theory and Practice Pub Date : 2025-10-01 Epub Date: 2025-04-21 DOI:10.1080/09593985.2025.2495129

Juliana Rodrigues da Silva, Júlio Henrique Policarpo, Diego Dantas, Patrícia Érika de Melo Marinho

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引用次数: 0

摘要

简介：吸气肌训练（IMT）是改善血液透析（HD）患者呼吸条件的一种替代方法。目的：探讨IMT对透析患者呼吸困难及肺活量的影响。方法：采用随机对照试验（rct）评价IMT对透析患者呼吸困难、肺活量、呼吸肌力量及透析效果指数（Kt/V）的影响。检索于2025年2月进行，在Medline/PubMed、Cochrane Library、LILACS、CINAHL、PEDro、Web of Science、Embase和谷歌Scholar数据库中进行。使用Cochrane RoB2工具评估研究质量。结果：共分析了6项研究（n = 210）。一项研究显示呼吸困难改善[4.17±0.58；95%可信区间(0.0073 - -0.884);p =。[022]， meta分析发现平均差异为0.34 L/min [95%CI (0.08-0.61)；p =。010]和25.15 cmH2O [95%CI (17.05-33.24)；结论：CKD合并HD患者的IMT治疗可改善呼吸困难、FVC和MIP。考虑到研究的低质量，需要新的方法更严格的随机对照试验。

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Effects of inspiratory muscle training on dyspnea and lung capacity in patients with chronic kidney disease on hemodialysis: a systematic review and meta-analysis.

Introduction: Inspiratory muscle training (IMT) is an alternative to improve the respiratory condition of hemodialysis (HD) patients with respiratory muscle weakness.

Objective: To evaluate the effect of IMT on dyspnea and lung capacity in dialysis patients.

Method: A systematic review of randomized controlled trials (RCTs) which evaluated the effects of IMT in dialysis patients on the outcomes of dyspnea, lung capacity, respiratory muscle strength and dialysis effectiveness index (Kt/V) was conducted. The searches were conducted in February 2025 and were performed in the Medline/PubMed, Cochrane Library, LILACS, CINAHL, PEDro, Web of Science, Embase and Google Scholar databases. Study quality was assessed using the Cochrane RoB2 tool.

Results: Six studies were analyzed (n = 210). One study showed an improvement in dyspnea [4.17 ± 0.58; 95%CI (0.0073-0.884); p = .022], and the meta-analyses found a mean difference of 0.34 L/min [95%CI (0.08-0.61); p = .010] in forced vital capacity (FVC) and 25.15 cmH₂O [95%CI (17.05-33.24); p < .001] in maximum inspiratory pressure (MIP) in the IMT groups. There was no difference in Kt/V. Only one study showed a low risk of bias.

Conclusion: IMT in patients with CKD on HD improved dyspnea, FVC and MIP. Considering the low quality of the studies, new RCTs with greater methodological rigor are needed.

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来源期刊

Physiotherapy Theory and Practice REHABILITATION-

CiteScore

3.40

自引率

10.00%

发文量

300

期刊介绍： The aim of Physiotherapy Theory and Practice is to provide an international, peer-reviewed forum for the publication, dissemination, and discussion of recent developments and current research in physiotherapy/physical therapy. The journal accepts original quantitative and qualitative research reports, theoretical papers, systematic literature reviews, clinical case reports, and technical clinical notes. Physiotherapy Theory and Practice; promotes post-basic education through reports, reviews, and updates on all aspects of physiotherapy and specialties relating to clinical physiotherapy.