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Effects of Respiratory Muscle Training on Performance in Athletes: A Systematic Review With Meta-Analyses

HajGhanbari, Bahareh1; Yamabayashi, Cristiane1; Buna, Teryn R.1; Coelho, Jonathan D.1; Freedman, Kyle D.1; Morton, Trevor A.1; Palmer, Sheree A.1; Toy, Melissa A.1; Walsh, Cody1; Sheel, A. William2; Reid, W. Darlene1,3,4

The Journal of Strength & Conditioning Research: June 2013 - Volume 27 - Issue 6 - p 1643–1663
doi: 10.1519/JSC.0b013e318269f73f
Original Research

HajGhanbari, B, Yamabayashi, C, Buna, TR, Coelho, JD, Freedman, KD, Morton, TA, Palmer, SA, Toy, MA, Walsh, C, Sheel, AW, and Reid, WD. Effects of respiratory muscle training on performance in athletes: A systematic review with meta-analysis. J Strength Cond Res 27(6): 1643–1663, 2013—The purpose of this study was to perform a systematic review to determine if respiratory muscle training (RMT) improves sport performance and respiratory muscle strength and endurance. Methodology followed the Cochrane Collaboration protocol. MEDLINE, CINAHL, SPORTDiscus, PEDro, EMBASE, EBM reviews, and COCHRANE electronic databases were searched until July 2011. Articles were included if: (a) participants were athletes; (b) RMT was compared with sham or control in a randomized controlled design and included outcomes of respiratory muscle and sport performance; and (d) published in English. Quality assessment using PEDro and data abstraction was performed by 2 authors. Outcomes evaluated were measures of sport performance, exercise capacity, spirometry, and respiratory muscle strength and endurance. Meta-analyses were performed on outcomes reported in 2 or more papers. Results of this systematic review revealed that of the 6,923 citations retrieved from the search strategy, 21 met the inclusion criteria. Meta-analyses demonstrated a significant positive effect of RMT on sport performance outcomes of time trials, exercise endurance time, and repetitions on Yo-Yo tests. Inspiratory muscle strength and endurance improved in most studies, which in part, was dependent on the type of RMT employed. Determination of the type of athlete that may benefit most from RMT was limited by small sample sizes, differing RMT protocols, and differences in outcome measures across studies. In conclusion, RMT can improve sport performance. Closer attention to matching the ventilatory demands of RMT to those required during athletic competition and more aggressive progression of training intensity may show greater improvements in future studies.

1Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada

2School of Human Kinetics, University of British Columbia, Vancouver, British Columbia, Canada

3Muscle Biophysics Laboratory, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada

4Institute for Heart and Lung Health, Vancouver, British Colombia, Canada

Address correspondence to Dr W. Darlene Reid,

Copyright © 2013 by the National Strength & Conditioning Association.