Table 1 Characteristics of included studies
ID | Design | Participants | Interventions | Outcomes reported | |
|---|---|---|---|---|---|
Experimental | Control | ||||
Albinni 2004 [24] | RCT (conference proceedings) | n = 16 (gender not specified) Age range: 6–18 FEV1 > 30% pred | n = 11 (gender not specified) Age range: 6–18 FEV1 > 30% pred | Experimental: IMT(Respifit 1000) and CET Resistance = NR Dosage = daily × 12 week Setting = NR Progression = NR Supervision = NR Control: CET | Lung function = FEV1 ↔ ,FVC ↔ ,MEF 50%VC↑, MEF 25%VC↑ Inspiratory muscle strength = Pimax↑ Inspiratory muscle endurance = maximal sustained ventilatory capacity↑ Maximal exercise capacity = Vo2 max↑ Timing = 0, 12 wk PS: reduction of antibiotic use, markedly improved expectoration and reduced sensation of breathlessness |
Emirza 2021 [25] (NCT03873688) | RCT | n = 15 allocated, 14 analysed (64.3% female) Age (year):12.97 (2.76) FEV1: 79.64 ± 27.69% pred | n = 15 allocated, 14 analysed (50% female) Age (year):12.13 (3.44) FEV1: 82.00 ± 22.49% pred | Experimental: RMT(respiratory muscle exercise device threshold PEP) and routine therapy and rehabilitation Resistance = 30% of MEP ( 5-20cmH2O) Dosage = 10 min × 2/day × 5/wk × 6 wk Setting = NR Progression = 2wkly MIP, MEP Supervision = check daily exercise records Control: shame RMT ( 5 cmH2O) + routine therapy and rehabilitation | PCF↑ Respiratory muscle strength = MIP↑, MEP↑ Lung function ↔  = FEV1, FVC, FEV1/FVC Exercise capacity = 6MWD↑ QoL = The Turkish version of the CFQ-R (vitality, treatment, and digestive domains of QoL in the parent↑ + physical and health domains ↑) Global rating of change score (GRoC): All patients in the groups assessed their changes as unchanged or better Timing = 0, 6 wk (The GRoC was assessed after the training was finished) PS: In comparing the two groups, changes in PCF and MEP were significantly higher in the training group. During the training, no adverse effect related to the study was experienced |
Zeren 2019 [26] (NCT03375684) | RCT | n = 18( 50% female) Age (year):11.66 (2.42) Baseline of FEV1 > 70% of the predicted value FEV1: 79.36 ± 13.67% pred | n = 18( 56% female) Age (year):10.47 (2.03) Baseline of FEV1 > 70% of the predicted value FEV1: 78.69 ± 15.91% pred | Experimental: IMT( Threshold Inspiratory Muscle Trainer) + PT ( rest for at least 1 h between training) Resistance = 30% of MIP Dosage = 15 min × 2/day × 8 wk Setting = hospital, home Progression = weekly MIP Supervision = check daily exercise records Control: PT | Postural stability = BBS( static postural stability = PST; dynamic postural stability = LOST↑) Lung function = FVC↑, FEV1↑, PEF↑( expressed as percentages of the predicted values) MIP↑, MEP↑ Exercise capacity = 6MWD↑ PS: 14 patients in PT + IMT group (78%) and 15 patients in PT group (83%) completed all training sessions as planned. Adherence to the training program averaged 97.9% ± 4.2% in PT + IMT group and 97.5% ± 5.7% in PT group. In comparing the two groups, changes in MIP were significantly higher in the training group. No adverse effects were reported during the program |
Sawyer 1993 [27] | RCT | n = 10( 40% female) Age (year): 11.46(2.45) FEV1: 89 ± 20% pred | n = 10( 50% female) Age (year): 9.76 (2.57) FEV1: 92 ± 29% pred | Experimental: IMT(threshold loading device) Resistance = 60% Plmax ( Starting from -7cmH2O) Dosage = 30 min/ day x 7 days/ wk x 10wk Setting = home Progression = weekly MIP Supervision = 3 home visits per week by a nurse + diary Control: 10% Pimax | Inspiratory muscle strength = Pimax↑ Maximal exercise testing = Exercise time on the treadmill↑ Lung function = Improvement in lung function outcomes required in systematic reviews was not reported |
Bieli 2014 [28] | RCT (conference proceedings) | n = 16 (gender not specified) Age range: 6–18 FEV1: 87.0 ± 25.8% pred | A Group: RMET( SpiroTiger®) x 8wk + chest physiotherapy x 8wk B Group: chest physiotherapy x 8wk + RMET x 8wk | Respiratory endurance↑ Exercise endurance↑ QoL ↔  Lung function ↔  Clinical score ↔  | |
Bieli 2017 [29] | RCT(two-sequence, two-period crossover design) | intervention/control( IC): n = 11( 54.5% female) Age (year): 15.4( 12.0; 16.6) FEV1 > 40% pred | control/intervention( CI): n = 11( 54.5% female) Age (year): 13.2( 11.9; 17.8) FEV1 > 40% pred | Intervention period: RMET by voluntary eucapnic hyperventilation( SpiroTiger®) Resistance = The initial training conditions were defined by breathing performance representing 50% MVV Dosage = 5–10 min × 2/day × 5/wk x 8wk ( two periods separated by a 1-week washout) Setting = home Progression = NR Supervision = supervised by a physiotherapist weekly Control period: standard chest physiotherapy | RME test: time to exhaustion↑ Exercise testing ↔ : time to exhaustion( perform on a cycle ergometer in the sitting position) Lung function( expressed as z-scores) ↔ : FEV1, FVC, MEF 75/25 QoL: CFQ ↔  CFCS ↔  Timing = 0, 9, 17wk |