title: Respiratory muscle training for respiratory deficits in neurodegenerative disorders: a systematic review.
abstract: BACKGROUND
  Studies of the impact of respiratory muscle training (RMT) on central neurodegenerative pathologies have been aimed at improving pulmonary function. However, there is no certainty about the effectiveness of RMT in patients affected by these groups of disorders. The purpose of this review was to assess the evidence regarding the efficacy of inspiratory muscle training (IMT) and expiratory muscle training (EMT) on respiratory function in patients with neurodegenerative disorders of the CNS.
  
  
  METHODS
  A comprehensive search from 1990 to September 2012 on MEDLINE, Physiotherapy Evidence Database (PEDro), PubMed, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases was made. Studies reporting on IMT and EMT in patients with neurodegenerative diseases were included. The selected studies were abstracted using a standardized data collection instrument and were assessed by a quality checklist created and adapted from CONSORT (Consolidated Standards for Reporting Trials) and TREND (Transparent Reporting of Evaluation with Nonrandomized Designs).
  
  
  RESULTS
  Twenty-four studies were identified by the search strategy. Only 19 studies met the criteria for full review. Ten studies met all the inclusion criteria and were included in the final analysis. Of the 16 parameters present in the quality assessment checklist, only six were achieved for the studies analyzed.
  
  
  CONCLUSIONS
  There is some evidence that RMT improves a number of respiratory function parameters in patients with Parkinson disease and multiple sclerosis; however, the number of studies and their quality are not sufficient to conclude whether IMT or EMT is effective in improving respiratory function in patients with neurodegenerative disorders of the CNS.
authors.affiliation: School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia. Electronic address: a.reyes@ecu.edu.au.
authors.forename: Alvaro
authors.initials: A
authors.lastname: Reyes
authors.affiliation: School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia.
authors.forename: Mel
authors.initials: M
authors.lastname: Ziman
authors.affiliation: School of Exercise and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.
authors.forename: Ken
authors.initials: K
authors.lastname: Nosaka
mesh_terms: D001945:Breathing Exercises; D002490:Central Nervous System / Q000503:physiopathology; D005260:Female; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D009103:Multiple Sclerosis / Q000503:physiopathology / Q000628:therapy; D019636:Neurodegenerative Diseases / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D010300:Parkinson Disease / Q000503:physiopathology / Q000628:therapy; D012132:Respiratory Muscles / Q000503:physiopathology*; D016896:Treatment Outcome