PURPOSE: To examine the effects of inspiratory muscle training (IMT) on pulmonary and diaphragmatic function, exercise capacity, balance and quality of life (QOL), in post-stroke individuals. METHODS: A literature search was conducted using MEDLINE, CINAHL, EMBASE, PubMed, PEDro, Web of Science and China Biological Medicine databases. Randomized controlled trials (RCTs) with a PEDro score >= 6 focusing on the effects of IMT were included. The GRADE system was used to determine the certainty of evidence for each outcome. RESULTS: Nine studies (255 participants) were included. IMT significantly increased forced expiratory volume in one second (FEV1) (4 studies, 112 participants, mean difference (MD) 0.18 litre, 95% confidence interval (CI) 0.14 to 0.23); maximal inspiratory pressure (MIP) (8 studies, 226 participants, MD 6.37 cm H2O, 95% CI 1.26 to 11.49); and diaphragm thickness fraction (DTf) on both sides (MD of affected side versus unaffected side: 51 versus 37%). The evidence certainty for diaphragmatic function was moderate. No significant change was observed in forced vital capacity (FVC), balance function, exercise capacity and QOL. CONCLUSION: This review reveals moderate evidence certainty in support of IMT improving diaphragmatic function. It appears that a training intensity between 30 and 50% MIP results in a significantly improved MIP.

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