Zhuo Wang1, Zhi Wang, Qi Fang, Huiling Li, Lulu Zhang, Xueyun Liu. 1. From the School of Nursing, Soochow University/The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (Zhuo Wang); Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China (Zhi Wang, QF, LZ, XL); and School of Nursing, Medical College of Soochow University, Suzhou, Jiangsu, China (HL).
Abstract
OBJECTIVE: The aim of this review was to evaluate and summarize the results of published studies exploring the effects of expiratory muscle strength training on swallowing and cough functions in patients with neurological diseases. DATA SOURCES: The study used Embase, PubMed, and the Cochrane Library as data sources. REVIEW METHODS: Randomized controlled trials or pretest/posttest studies of adults with neurological diseases were included. The data included basic population characteristics, penetration-aspiration scores, peak expiratory flow rate, cough volume acceleration, and maximum expiratory pressure. RESULTS: Ten studies were included in this meta-analysis. Compared with the control groups, expiratory muscle strength training in patients with neurological diseases significantly reduced the penetration-aspiration scores (risk ratio = -0.94, 95% confidence interval = 1.27 to -0.61, P < 0.01) but did not increase the voluntary cough peak expiratory flow rate (risk ratio = 0.57, 95% confidence interval = 0.62 to 1.77, P = 0.35), cough volume acceleration (risk ratio = 33.87, 95% confidence interval = 57.11 to 124.85, P = 0.47), or maximum expiratory pressure (risk ratio = 14.78, 95% confidence interval = 16.98 to 46.54, P = 0.36). CONCLUSIONS: Expiratory muscle strength training might improve swallowing function in patients with neurological diseases. However, conclusive evidence supporting the use of this approach in isolation for improving cough function is unavailable. Additional multicenter, randomized clinical trials performed using reliable and valid cough function outcome measures are required to explore the effects of expiratory muscle strength training on cough function.
OBJECTIVE: The aim of this review was to evaluate and summarize the results of published studies exploring the effects of expiratory muscle strength training on swallowing and cough functions in patients with neurological diseases. DATA SOURCES: The study used Embase, PubMed, and the Cochrane Library as data sources. REVIEW METHODS: Randomized controlled trials or pretest/posttest studies of adults with neurological diseases were included. The data included basic population characteristics, penetration-aspiration scores, peak expiratory flow rate, cough volume acceleration, and maximum expiratory pressure. RESULTS: Ten studies were included in this meta-analysis. Compared with the control groups, expiratory muscle strength training in patients with neurological diseases significantly reduced the penetration-aspiration scores (risk ratio = -0.94, 95% confidence interval = 1.27 to -0.61, P < 0.01) but did not increase the voluntary cough peak expiratory flow rate (risk ratio = 0.57, 95% confidence interval = 0.62 to 1.77, P = 0.35), cough volume acceleration (risk ratio = 33.87, 95% confidence interval = 57.11 to 124.85, P = 0.47), or maximum expiratory pressure (risk ratio = 14.78, 95% confidence interval = 16.98 to 46.54, P = 0.36). CONCLUSIONS: Expiratory muscle strength training might improve swallowing function in patients with neurological diseases. However, conclusive evidence supporting the use of this approach in isolation for improving cough function is unavailable. Additional multicenter, randomized clinical trials performed using reliable and valid cough function outcome measures are required to explore the effects of expiratory muscle strength training on cough function.