Neuroanesthesia & neurocritical care
Effects of different respiratory training methods on respiratory function in patients with spinal cord injury: a network meta-analysis of randomized controlled trials
Authors' conclusion
tSCS_RRMT appears to be the most effective for improving MIP, rFMS_NMES_RBT for enhancing FEV1, and IS_ADIM for improving FVC based on SUCRA rankings. Due to irreconcilable heterogeneity, indirectness, imprecision, and incoherence, the reliability of the evidence is limited.
Study context
- Population
- Patients with spinal cord injury (SCI)
- Participants
- 625 patients · 17 randomized controlled trials (RCTs)
- Comparison
- Eight respiratory training interventions vs control intervention
- Outcome
- Maximal inspiratory pressure (MIP), FEV1 and forced vital capacity (FVC)
Methodological detailsBayesian network meta-analysis (NMA), Confidence in Network Meta-Analysis (CINeMA) evidence quality assessment, prospectively registered
- Bayesian NMA
- CINeMA evidence quality assessment
- Prospectively registered
Pooled result
As reported in the abstract
MIP, FEV1, FVC (SUCRA rankings and league table)
tSCS_resistance respiratory muscle training (RRMT)
86.32%
SUCRA maximal inspiratory pressure (MIP)
RRMT
84.09%
SUCRA MIP
rFMS_NMES_routine breathing training (RBT)
89.41%
SUCRA FEV1
IS_ADIM
- SUCRA FEV1
- 70.05%
- SUCRA forced vital capacity (FVC)
- 76.25%
RBT
65.40%
SUCRA FVC
Each group vs controlEstimate (95% CrI)
RRMT
MD (MIP) 13.25(7.51–18.92)
IS_ADIM
MD (FVC) 0.58(0.31–0.85)
RBT
MD (FVC) 0.49(0.29–0.69)
Original publication
Effects of different respiratory training methods on respiratory function in patients with spinal cord injury: a network meta-analysis of randomized controlled trials. Crit Care. Published 7 July 2025. doi:10.
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