Background:Signs of respiratory dysfunction can be present already early in the course of Parkinson’s disease (PD). Respiratory training could alleviate this, but its effectiveness is not well understood. Objective:The purpose of this systematic review is to review the efficacy of different respiratory training interventions in PD. Methods:A search strategy was performed in four databases: PubMed, Physiotherapy Evidence Database (PEDro), Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Methodological quality of original full-text articles was assessed using the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and the Risk Of Bias In Non-randomized Studies of Interventions (ROBINS-I) tool for the controlled trials (CTs). Levels of evidence were rated by the Grading of Recommendation Assessment, Development and Evaluation (GRADE) approach. Results:Six papers reporting on four randomized controlled trials and another four controlled trials were included. Positive effects were reported for inspiratory muscle strength training (IMST), expiratory muscle strength training (EMST), air stacking, breath-stacking, incentive spirometry and postural training on respiratory muscle strength, swallowing safety, phonatory aspects and chest wall volumes. Best methodological quality was found for breath-stacking and incentive spirometry. Best levels of evidence were found for EMST, IMST and EMST plus air stacking. Conclusion:Respiratory training shows positive effects and should be considered when people with PD experience respiratory dysfunction. Future studies should focus on standardizing both training devices, instruments to measure outcomes and intervention protocols to further increase the level of evidence.

中文翻译：

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呼吸训练对帕金森病的影响：系统评价

背景：呼吸功能障碍的迹象可能在帕金森病 (PD) 病程的早期就已经存在。呼吸训练可以缓解这种情况，但其有效性尚不清楚。目的：本系统评价的目的是评价不同呼吸训练干预措施对 PD 的疗效。方法：在四个数据库中执行搜索策略：PubMed、物理治疗证据数据库 (PEDro)、Cochrane 图书馆和护理和相关健康文献累积索引 (CINAHL)。使用用于随机对照试验 (RCT) 的 Cochrane 偏倚风险工具和用于对照试验 (CT) 的非随机干预研究中的偏倚风险 (ROBINS-I) 工具评估原始全文文章的方法学质量。证据级别通过推荐评估、制定和评估分级 (GRADE) 方法进行评级。结果：包括六篇报道四项随机对照试验和另外四项对照试验的论文。据报道，吸气肌力量训练 (IMST)、呼气肌力量训练 (EMST)、空气叠加、呼吸叠加、激励肺量测定法和姿势训练对呼吸肌力量、吞咽安全、发声方面和胸壁容积有积极影响。呼吸叠加和激励肺活量测定法的方法学质量最好。发现 EMST、IMST 和 EMST 加空气堆积的最佳证据水平。结论：呼吸训练显示出积极的效果，当 PD 患者出现呼吸功能障碍时应考虑进行呼吸训练。