Ubaid Ansari, BS
Medical Student
California Northstate University College of Medicine
Elk Grove, California, United States
Jimmy Wen, BA
Medical Student
California Northstate University College of Medicine
Elk Grove, California, United States
Muhammad Karabala, BS
Medical Student
California Northstate University College of Medicine
Elk Grove, California, United States
Burhaan Syed, BS
Medical Student
California Northstate University College of Medicine
Elk Grove, California, United States
Ihab Abed, BS
Medical Student
California Northstate University College of Medicine
Elk Grove, California, United States
Forshing Lui, MD
Professor of Clinical Neurology
California Northstate University College of Medicine
Elk Grove, California, United States
Respiratory muscle weakness is a significant contributor to morbidity and mortality in Amyotrophic Lateral Sclerosis (ALS) patients. Respiratory Muscle Strength Training (RMST) has emerged as a potential therapeutic approach to mitigate respiratory muscle weakness in ALS, but its efficacy and safety remain unclear due to conflicting evidence and methodological heterogeneity in existing studies. Despite positive findings on respiratory muscle strength, RMST's efficacy in ALS management remains inconclusive. Challenges include methodological heterogeneity, limited sample sizes, and inadequate reporting of complications. Future research should focus on standardized protocols, larger sample sizes, longer follow-ups, and comprehensive assessment of adverse effects to clarify the role of RMST in ALS treatment.
Design: A systematic review was conducted across three databases (PubMed, Embase, and Cochrane Library) following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to assess the effectiveness of RMST in ALS patients. Eligible studies included comparative studies for RMST, focusing on outcomes such as maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP), forced vital capacity (FVC), and ALS Functional Rating Scale (ALSFRS-R). Quality assessment was performed using the Cochrane Risk of Bias tool.
Results: Six studies, including 183 patients with a mean age of 58.0 years (49.6 to 63.2) and mean follow-up time of 21.2 weeks (8 to 52) were included in this study. The average mean difference for ALSFRS-R (3 studies), MIP (3 studies), MEP (3 studies), and FVC (2 studies) were 2.062 (0.04 - 5.3), 2.285 (-8.145 - 10.8), 19.435 (10.86 - 21.7), and 7.23 (3.6 - 10.86), respectively. Complications related to RMST were poorly reported across studies. Secondary outcomes such as depression scores, blood oxygen levels, and heart rate variability showed promising trends but lacked consistency.
Conclusions:
