title: Inspiratory muscle training in patients with Amyotrophic Lateral Sclerosis: A systematic review.
abstract: BACKGROUND
  Amyotrophic Lateral Sclerosis is a neurodegenerative disease with rapid involvement of the inspiratory muscles, leading to respiratory insufficiency. Death often occurs by aspiration and pneumonia. Endurance- and strength therapy within ALS are discussed controversially.
  
  
  OBJECTIVE
  To review the current literature to assess the efficacy of inspiratory muscle training for ALS.
  
  
  METHODS
  Systematic review, using databases as PubMed, PEDro, Cochrane and Google Scholar.
  
  
  METHODS
  Inspiratory muscle training vs. sham training or inspiratory muscle training alone.
  
  
  METHODS
  Inspiratory muscle strength, dyspnoea, quality of life and survival time.
  
  
  RESULTS
  Four studies could be included in this review, two RCT's, one pre-experimental study and one with a historical control group. In total 73 patients underwent inspiratory muscle training.
  
  
  CONCLUSIONS
  Studies varied in onset of the training, the training protocol and the outcomes measured. At time, there is limited evidence that inspiratory muscle training leads to strengthening of inspiratory muscles in ALS. Improvements made were minor, in only a few parameters and also in control groups. Survival time was significantly longer in the experimental group in one study. Interesting suppositions (diaphragm training vs. other IM training, improvement of chest wall and lung compliance) need to be examined in robustly designed future trials, defining exact therapeutic windows and interventions.
authors.affiliation: FH Gesundheitsberufe Oberösterreich Studiengang Physiotherapie, Steyr, Austria.
authors.forename: Margit
authors.initials: M
authors.lastname: Eidenberger
authors.affiliation: FH Gesundheitsberufe Oberösterreich Studiengang Physiotherapie, Steyr, Austria.
authors.forename: Silvia
authors.initials: S
authors.lastname: Nowotny
mesh_terms: D000690:Amyotrophic Lateral Sclerosis / Q000503:physiopathology / Q000534:rehabilitation*; D001945:Breathing Exercises / Q000379:methods*; D006801:Humans; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012132:Respiratory Muscles / Q000503:physiopathology*; D016896:Treatment Outcome
keywords: Amyotrophic Lateral Sclerosis; diaphragm; inspiratory muscle strength; training