Evidence map›Paper›PMID 42455190›Full record

SynthesisJournal of neurology2026

Effects of respiratory muscle training on respiratory function in patients with amyotrophic lateral sclerosis: a systematic review and meta-analysis.

Yanping Lei, Ju Huang, Min Li, Yan Zhang, Zhi Ye, Xiaoyan He, Zhuojuan Tang, Jun Wei

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Journal of neurology, 2026. 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

8 authors.

Yanping LeiDepartment of Neurology, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, 443000, China.
Ju HuangDepartment of Neurology, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, 443000, China.
Min LiDepartment of Central Lab, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Hubei Province Clinical Medical Research Center for Rare Diseases of Nervous System, Yichang, 443000, China.
Yan ZhangDepartment of Neurology, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, 443000, China.
Zhi YeDepartment of Central Lab, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Hubei Province Clinical Medical Research Center for Rare Diseases of Nervous System, Yichang, 443000, China.
Xiaoyan HeDepartment of Central Lab, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Hubei Province Clinical Medical Research Center for Rare Diseases of Nervous System, Yichang, 443000, China.
Zhuojuan TangDepartment of Neurology, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, 443000, China.
Jun WeiDepartment of Neurology, The First College of Clinical Medical Science, China Three Gorges University, Yichang Central People's Hospital, Yichang, 443000, China. junwei@ctgu.edu.cn.ORCID http://orcid.org/0009-0001-6023-0081

Funding

Department of Science and Technology of Hubei Province No. EWT201947
6 · The paper itself

Abstract

backgroundRespiratory decline is prognostically important in amyotrophic lateral sclerosis (ALS), but the efficacy of respiratory muscle training (RMT) remains uncertain. We synthesized randomized evidence on respiratory and related outcomes.

methodsWe searched databases, specialized registers, and trial registries through June 19, 2025, for randomized RMT trials in ALS. Risk of bias was assessed with the Cochrane tool. Random-effects meta-analyses reported standardized mean differences (SMDs) with 95% confidence intervals (CIs), and certainty was rated with GRADE.

resultsSix studies were included; five concurrently randomized trials contributed quantitative data, whereas Pinto 2013 was retained for qualitative context. RMT improved maximal expiratory pressure (MEP; SMD 0.387, 95% CI 0.192-0.581; P = 0.008) and showed small favorable effects on maximal inspiratory pressure (MIP; SMD 0.156, 95% CI 0.089-0.224; P = 0.005), sniff nasal inspiratory pressure (SNIP; SMD 0.216, 95% CI 0.039-0.392; P = 0.034), peak expiratory flow (PEF; SMD 0.205, 95% CI 0.088-0.323; P = 0.017), and ALSFRS-R (SMD 0.214, 95% CI 0.039-0.388; P = 0.030). Forced vital capacity showed a borderline favorable trend (SMD 0.129, 95% CI - 0.003 to 0.262; P = 0.053). Low heterogeneity estimates were imprecise because most endpoints included only three to four small studies. Certainty was moderate for MIP, low for MEP, FVC, and PEF, and very low for SNIP and ALSFRS-R. Exploratory analyses identified no reliable effect modifiers.

conclusionsRMT was associated with small, directionally consistent improvements mainly in pressure- and flow-based outcomes, whereas effects on FVC and longer-term clinical outcomes remain uncertain. RMT may be considered an individualized adjunct to ALS respiratory care, not a disease-modifying therapy. Larger, longer, standardized trials with patient-important endpoints are needed.

Indexed as

Amyotrophic Lateral SclerosisBreathing ExercisesRespiratory MusclesHumansAmyotrophic lateral sclerosisMeta-analysisPhysical therapyRespiratory muscle trainingSystematic review

Identifiers

PMID42455190

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.