The Effect of Inspiratory Muscle Training in Patients With Lung Cancer After Surgery: A Systematic Review

Objective: The standard of care treatment of potentially resectable lung cancer (LC) is surgery. However, postoperative pulmonary complications (PPCs) and impairments in physical capacity are common. Recently, the effect of inspiratory muscle training (IMT) in postoperative patients with LC (PWLC) was investigated in these outcomes in different studies. The purpose of this systematic review was to synthesize the effect of postoperative IMT (P-IMT) on PPCs and physical capacity in PWLC.Database: PubMed, EMBASE, Cochrane, and CINAHL were searched.Study Selection: Randomized controlled trials, including control/sham group, IMT as the intervention group, and key measures including PPCs, 6-minute walk test (6MWT), Vo2peak, maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), quality of life (QoL), physical activity level, hospital length of stay, spirometry.Data Synthesis: The quality of the studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. The outcome findings were compared and interpreted.Results: Five studies with 249 patients were analyzed. The PEDro scores of studies ranged from 6 to 8. There is no significant difference in PPCs between the groups. The effects of P-IMT on the 6MWT, Vo2Peak, MIP, MEP, and QoL were ambiguous. No effect of P-IMT on spirometry was reported.Conclusion: No effect of P-IMT in PPCs was reported. The effect of P-IMT on physical capacity and respiratory muscle strength was not observed. The level of the effect of P-IMT on hospital length of stay and postoperative physical activity was low. No optimal setting of P-IMT for PWLC with surgery was found. More studies are needed.