Objective  To systematically evaluate the effect of threshold-pressure inspiratory muscle training on the rehabilitation efficacy of stroke patients through a Meta-analysis.

Methods  The Cochrane Library, PubMed, Embase, Web of Science, CNKI, WanFang Data, VIP and CBM were searched for all published randomized controlled trials related to the effect of threshold-pressure inspiratory muscle training on the rehabilitation efficacy of stroke patients from the establishment of the databases to November 13, 2024. The selection and quality evaluation of included literature were conducted independently by two researchers. Meta-analysis was performed using RevMan 5.3 and Stata 14 softwares.

Results  A total of 13 randomized controlled trials were included, including 516 stroke patients. The results of Meta-analysis showed that the maximum inspiratory pressure (MIP) [weighted mean difference (WMD)=11.17, 95% confidence interval (CI) (7.58, 14.76), P<0.001], peak inspiratory flow (PIF) [WMD=1.18, 95%CI (0.79, 1.57), P<0.001], forced vital capacity (FVC) [WMD=0.50, 95%CI (0.19, 0.81), P=0.002], forced expiratory volume in one second (FEV1) [WMD=0.60, 95%CI (0.24, 0.95), P=0.001], 6-minute walking test (6MWT) [WMD=26.88, 95%CI (1.05, 52.71), P=0.041], Berg Balance Scale (BBS) score [WMD=6.61, 95%CI (3.78, 9.44), P<0.001], modified barthel index (MBI) [WMD=7.86, 95%CI (2.20, 13.53), P=0.007] of the threshold-pressure inspiratory muscle training group were significantly higher than those of the control group.

Conclusion  The threshold-pressure inspiratory muscle training combined with routine rehabilitation can enhance the MIP and PIF of inspiratory muscle function index, improve the FVC and FEV1 of pulmonary function index, and improve the exercise endurance, balance function and activities of daily living ability of stroke patients. However, the specific effects of threshold-pressure inspiratory muscle training were influenced by the parameter model of different threshold load prescriptions and the duration of the intervention. The above conclusion requires more high-quality studies to verify in the future.

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