Evidence map›Paper›PMID 41603003›Full record

SynthesisFrontiers in neurology2025

Effectiveness of respiratory rehabilitation in cervicothoracic spinal cord injury: a systematic review and network meta-analysis.

Zhixiang Liu, Jiejun Tan, Xiaodong Song, Ziyi Zhang, Yajie Wang, Yating Tao, Simeng Chen, Fanxing Zhuo, Zhuang Wu, Zerong Zhang and 1 more

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in neurology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Zhixiang Liu *The Third People's Hospital of Bengbu, Bengbu, China.
Jiejun Tan *The Third People's Hospital of Bengbu, Bengbu, China.
Xiaodong Song *The Third People's Hospital of Bengbu, Bengbu, China.
Ziyi ZhangSchool of Sport Science, Beijing Sport University, Beijing, China.
Yajie WangSchool of Healthy of Science, Universiti Kebangsaan Malaysia, Bangi, Malaysia.
Yating TaoThe Third People's Hospital of Bengbu, Bengbu, China.
Simeng ChenThe Third People's Hospital of Bengbu, Bengbu, China.
Fanxing ZhuoThe Third People's Hospital of Bengbu, Bengbu, China.
Zhuang WuThe Third People's Hospital of Bengbu, Bengbu, China.
Zerong Zhang *The Third People's Hospital of Bengbu, Bengbu, China.
HongPeng Li *School of Sport Science, Beijing Sport University, Beijing, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Objective: Respiratory dysfunction is a major contributor to morbidity and mortality in patients with cervicothoracic spinal cord injury (SCI). This dysfunction primarily arises from diaphragmatic paralysis, impaired neural control of respiratory muscles, and autonomic dysregulation, leading to reduced ventilatory capacity and compromised respiratory performance. Although various respiratory rehabilitation strategies are widely used, their comparative effectiveness remains unclear. This study aimed to evaluate and rank non-pharmacological respiratory rehabilitation interventions for improving pulmonary function, respiratory muscle strength, and dyspnea in individuals with cervicothoracic SCI. Review methods: A systematic review and Bayesian network meta-analysis were conducted in accordance with PRISMA 2020 guidelines. Eight databases were searched from inception to July 2025 for randomized controlled trials (RCTs) evaluating non-pharmacological respiratory rehabilitation interventions in cervicothoracic SCI. Primary outcomes included forced vital capacity (FVC, L), forced expiratory volume in one second (FEV₁, L), maximal inspiratory pressure (MIP, cmH₂O), and Borg dyspnea score. Network meta-analyses were performed using the gemtc and multinma packages in R. Results: Forty RCTs involving 1,878 participants were included. Liuzijue demonstrated the greatest improvement in FVC (MD = 0.97, 95% CrI 0.57-1.37), abdominal compression training showed the largest effect on FEV₁ (MD = 0.68, 95% CrI 0.36-1.00), progressive resistance breathing training achieved the highest gain in MIP (MD = 13.95, 95% CrI 9.08-18.82), and normocapnic hyperpnoea produced the greatest reduction in dyspnea severity (MD = -3.00, 95% CrI - 4.50 to -1.50). No significant inconsistency or publication bias was detected across the outcome networks. Conclusion: Distinct respiratory rehabilitation modalities confer domain-specific benefits in patients with cervicothoracic SCI. Liuzijue and abdominal compression training primarily improve ventilatory function, progressive resistance breathing training enhances inspiratory muscle strength, and normocapnic hyperpnoea effectively alleviates dyspnea. These findings support a multimodal, individualized rehabilitation approach tailored to specific respiratory deficits in clinical practice. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/search, identifier CRD42024554608.

Indexed as

network meta-analysispulmonary functionrespiratory dysfunctionrespiratory rehabilitationspinal cord injury

Identifiers

PMID41603003
PMCPMC12834050

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.