Effect of inspiratory muscle training associated or not to physical rehabilitation in preoperative anatomic pulmonary resection: a systematic review and meta-analysis

• Published in: Supportive care in cancer Vol. 30; no. 2; pp. 1079 - 1092
• Main Authors: de Oliveira Vacchi, Cindy, Martha, Bianca Andrade, Macagnan, Fabrício Edler
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-02-2022; Springer; Springer Nature B.V
• Subjects: Adult; Analysis; Breathing Exercises; Cancer surgery; Health aspects; Humans; Length of Stay; Lung cancer; Lung Neoplasms; Medicine; Medicine & Public Health; Meta-analysis; Muscles; Nursing; Nursing Research; Oncology; Pain Medicine; Palliative care; Physical therapy; Pneumonia; Pulmonary Atelectasis; Rehabilitation; Rehabilitation Medicine; Respiration; Respiratory therapy; Review Article; Surgery; Surgical outcomes; Ventilation; Respiratory muscles; Breathing exercises; Randomized controlled trial; Lung neoplasms
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-021-06467-4

Objective
The aim of this study is to systematically review the effect of inspiratory muscle training (IMT) associated or not with physical rehabilitation in the preoperative period of anatomical pulmonary resection.
Methods
Search in the databases: MEDLINE, Cochrane CENTRAL, EMBASE, LILACS and PEDro up to November 2019. Randomized clinical trials (RCTs) were included in adults in the preoperative period of pulmonary resection. The selection of studies and data extraction was performed by two independent reviewers. The risk of bias assessed with RoB 2.0 and the quality of evidence with GRADE. PROSPERO: CRD42018105859.
Results
Six RCTs were included; patients who underwent IMT in the preoperative period showed a significant improvement in functional capacity assessed by the 6-min walk test (6WT) (MD 28,93 [IC 95% 0,28; 57,58],
p =
 0,04,
I
2
 = 0%) and significantly reduced the length of hospital stay (MD –3,63 [IC 95% −4,96; −2,29],
p =
 0,00,
I
2
 = 0%). There was no significant difference between groups regarding pulmonary function, in postoperative complications such as pneumonia (RR 0,56 [IC 95% 0,29; 1,10],
p =
 0,09,
I
2
 = 0%), atelectasis (RR 0,81 [IC 95% 0,24; 2,69],
p =
 0,72,
I
2
 = 0%), mechanical ventilation > 48 h (RR 0,43 [IC 95% 0,12; 1,58],
p =
 0,20,
I
2
 = 0%), in mortality (RR 0,33 [IC 95% 0,04; 3,12],
p =
 0,33,
I
2
 = 0%), and quality of life.
Conclusion
IMT associated with physical exercise in the preoperative period of pulmonary resection improves functional capacity and reduces the length of hospital stay in the postoperative period.