Exercises to strengthen chest muscles may help improve lung function in MS
But study notes no key gains seen for patients with respiratory muscle training
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A woman sitting outdoors practices breathing exercises with her eyes closed. (Photo from iStock)
- Strengthening the muscles in the chest used for breathing, known as respiratory muscle training, was shown to improve lung function in people with multiple sclerosis.
- However, RMT does not significantly enhance overall exercise capacity in MS, a review study found.
- The researchers suggest RMT be used as an adjunctive therapy in MS, complementing other exercise regimens.
Exercises to strengthen the respiratory muscles — the muscles in the chest needed to move air in and out of the lungs when breathing — can help improve lung function in people with multiple sclerosis (MS), according to a new analysis.
This type of exercise, known as respiratory muscle training (RMT), also was shown to improve physical quality of life in MS patients across several studies. Still, it did not lead to gains in overall exercise capacity, the review found.
Altogether, the data suggest that RMT may provide some benefit for people living with MS, but this therapy, the researchers stressed, is best used in combination with other types of exercise.
“Current evidence does not support an improvement in functional exercise capacity” with RMT, the researchers concluded.
Their study, “Effects of respiratory muscle training on respiratory function, exercise capacity and quality of life in people with multiple sclerosis: a systematic review and meta-analysis,” was published in the journal Multiple Sclerosis and Related Disorders.
MS is a chronic neurological disorder that can cause a range of disabling symptoms, from severe fatigue and mental health issues to incontinence and mobility limitations. These symptoms can take a major toll on patients’ physical capacities and quality of life.
RMT works to strengthen muscles needed to breathe
RMT is a type of exercise therapy that aims to strengthen the muscles needed for breathing, usually by having a person inhale and/or exhale against resistance. That forces these muscles to work harder than they normally would and prompts them to build strength.
Several studies have tested whether RMT can benefit people with MS, but they’ve mostly been small, with variable methods, making it difficult to draw solid conclusions.
Now, seeking to better understand the potential benefits of RMT in MS patients, scientists in China conducted a systematic review and meta-analysis. In other words, they combed through the available scientific literature to identify studies that have tested the effects of RMT in people with MS, then pooled the data from all the studies and analyzed them collectively.
Because this type of analysis draws from data from multiple previous studies, it generally has more statistical power to identify meaningful conclusions.
“This study presents a systematic review and meta-analysis designed to provide a robust and holistic quantitative synthesis of the effects of RMT on the triad of respiratory function, motor performance, and HRQoL [health-related quality of life] in individuals with MS,” the scientists wrote.
The analysis used data from 16 prior studies, most of which were randomized clinical trials, covering more than 500 people with MS. The studies assessed inspiratory muscle training, expiratory muscle training, or a combination of both. Across studies, patients participated in training sessions 2-5 times per week, and interventions lasted four to 12 weeks, or about one to three months.
Scant benefits seen in exercise capacity among patients
The results indicated that RMT significantly improved several measures of lung function. Measures of respiratory muscle strength also showed significant improvements compared with the control interventions.
“The pooled results demonstrated that, compared to control conditions (e.g., sham training, usual care, or no intervention), RMT significantly enhanced respiratory muscle strength and pulmonary function,” the researchers wrote.
Scores on the physical functioning domain of the 36-Item Short Form Survey (SF-36) — a standardized measurement assessing health-related quality of life — also showed significant improvements with RMT. Several other measures of physical quality of life, however, did not show significant improvements.
Measures of exercise capacity — the maximum amount of physical exertion that a person can sustain — and balance ability also generally did not show significant improvements with RMT.
“It is crucial to emphasize that [improvements in lung function measures] did not translate into significant gains in functional exercise capacity, nor into the overall [physical component score] of HRQoL,” the researchers wrote.
[RMT] should be considered as a promising adjunctive therapy for targeted respiratory rehabilitation, rather than a standalone replacement for systemic exercise conditioning.
Based on these data, the scientists suggested that RMT “should be considered as a promising adjunctive therapy for targeted respiratory rehabilitation, rather than a standalone replacement for systemic exercise conditioning.”
The researchers stressed that this meta-analysis was limited by the fact that most studies were small and lasted only a few weeks.
“Future high-quality [clinical trials] with larger sample sizes are needed to confirm these findings and determine the optimal training protocols to maximize clinical efficacy,” the team concluded.
