Effectiveness of inspiratory muscle training and multicomponent physical training in patients with post-COVID conditions: a systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND: There is evidence that fatigue and dyspnea are among the most frequently reported symptoms of post-COVID condition. Therefore, several studies have investigated respiratory muscle or global peripheral muscle training as strategies to manage those symptoms. Despite evidence of potential benefits, conflicting results persist due to the heterogeneity of rehabilitation protocols and assessment tools. Thereby, the objective of this systematic review was to evaluate the effectiveness of inspiratory muscle training and multicomponent physical training in adults with dyspnea and fatigue for at least 12 weeks after COVID-19. METHOD: A search was conducted in September 2024, in the Cochrane Library (Cochrane Central Register of Controlled Trials), EMBASE, PubMed/MEDLINE, PEDro, Lilacs/BVS, Web of Science, Scopus, and Epistemonikos databases. The inclusion criteria were randomized clinical trials published in any language that evaluated the effectiveness of inspiratory muscle training and multicomponent physical training to improve fatigue, dyspnea, and/or physical function in adults with persistent post-COVID symptoms. The risk of bias of the included studies and the certainty of the evidence were assessed using the RoB 2 and GRADE tools, respectively. RESULTS: ) (MD = 4.49; 95% CI: 3.35 to 5.62). Multicomponent physical training significantly improved the upper and lower body muscle strength through the handgrip strength (MD = 3.05; 95% CI: 1.68 to 4.42), sit-to-stand test (MD = 3.55; 95% CI: 1.61 to 5.49), and timed up and go test (MD = - 1.13; 95% CI: - 1.49 to - 0.77) and the physical functioning were assessed through post-COVID-19 functional scale (MD = - 0.64; 95% CI: - 1.13 to - 0.16) and physical aspects through SF-12 and SF-36 (SMD = 0.72; 95% CI: 0.29 to 1.15). No adverse events were reported among participants in the physical training group, and treatment adherence ranged from 78 to 100%. CONCLUSION: Inspiratory muscle training improved cardiorespiratory outcomes, while multicomponent physical training improved muscle strength, physical functioning, and fatigue. Both types of training improve physical functioning. The certainty of evidence for the outcomes evaluated was low. SYSTEMATIC REVIEW REGISTRATION: PROSPERO (CRD42023451057).
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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 | 0.013 | 0.029 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.024 | 0.041 |
| Bibliometrics | 0.008 | 0.007 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| 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".