Abstract
INTRODUCTION: Multiple sclerosis (MS) has a high incidence and can occur at all ages, and respiratory dysfunction is a leading cause of death among the complications of MS. Respiratory muscle training (RMT) is often used to help MS patients improve their respiratory function, but the specific impact of RMT has not been clearly elucidated. The present meta-analysis aims to evaluate the impact of RMT on MS patients. METHODS: We looked up PubMed, Cochrane Library, Embase, Web of Science, and PEDro with the query "respiratory muscle training" AND "multiple sclerosis". The cutoff was January 6, 2026. After screening, eligible randomized controlled clinical trials were analyzed to calculate the standardized mean differences (SMDs) and 95% confidence intervals (CI) of the following metrics regarding RMT intervention: maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), forced vital capacity (FVC), forced expiratory volume in one second (FEV(1)), and the ratio of forced expiratory volume in one second to forced vital capacity (FEV(1)/FVC). RESULTS: A total of 370 articles were retrieved, and eight remained after rigorous screening. The eight trials included a total of 249 patients. Patients undergoing RMT exhibited significant improvements in MEP (SMD = 0.42, 95% CI [0.09-0.76], P = 0.01, I(2) = 24%), MIP (SMD = 0.32, 95% CI [0.02-0.63], P = 0.04, I(2) = 17%), FEV(1) (SMD = 0.41, 95% CI [0.08-0.74], P = 0.01, I(2) =9%), and FEV(1)/FVC (SMD = 0.52, 95% CI [0.15-0.89], P = 0.005, I(2) =0%), but FVC did not benefit from RMT (SMD = 0.28, P = 0.06). CONCLUSIONS: Respiratory muscle training can improve respiratory muscle strength and the lung function in MS patients.