The Effect of Inspiratory Muscle Training on Gastroesophageal Reflux Disease Characteristics: A Systematic Review
Bibliographic record
Abstract
Background/Objective: Gastroesophageal reflux disease (GERD) is multifactorial and affects an increasing number of people. It is a common condition in which the stomach contents move up into the esophagus; thus, its main cause is found in the antireflux valve mechanism of the gastroesophageal junction. This consists of two sphincters, the lower oesophageal and the diaphragmatic. The disease has been related to diaphragm dysfunction, either due to the de-coordination of the diaphragms’ contractility or due to decreased strength. Breathing exercises seem to have a positive effect in this population. The aim of this study was to systematically examine the effects of inspiratory muscle training (IMT) on GERD characteristics. Methods: We conducted a systematic review of research up to April 2024 in Scopus, PubMed, and Science Direct. We included randomized controlled trials (RCTs) and clinical trials assessing the effects of IMT on GERD characteristics. Methodological quality was assessed with the PEDro scale (Physiotherapy Evidence Database) and the Newcastle Ottawa scale (NOC). Results: Among the 1984 studies identified from the search, only three studies (one study with a post-COVID-19 population and two with GERD and healthy subjects) were included in this study, as they presented a fair to high methodological quality. Significant improvements in maximal inspiratory pressure (p < 0.001) and diaphragmatic excursion (p < 0.001) were revealed in one study. No significant differences between groups were mentioned for the reflux symptoms and for LES–EGJ pressure in the studies included. Conclusions: IMT seems to provide promising effects in strengthening the antireflux valve mechanism, as it increases MIP and diaphragmatic excursion. This systematic review established a bibliographic gap for the contribution of IMT in the antireflux valve mechanism. More evidence is needed to support the importance of IMT as a non-pharmacological intervention for GERD patients.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.033 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.011 | 0.008 |
| Bibliometrics | 0.009 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".