This paper reviews the evidence concerning the effectiveness of respiratory muscle training for tetraplegic patients. While respiratory muscle strength/endurance and/or pulmonary function have been shown to improve after inspiratory muscle training, a lack of controlled studies means it is not possible to exclude spontaneous recovery from being responsible for the improvements seen. It is not known if inspiratory muscle training improves quality of life or decreases morbidity. There are limited data which suggest that, for ventilator dependent tetraplegics, strengthening the muscles of the neck and upper thorax may improve vital capacity and allow limited ventilator-free time. The effectiveness of other techniques such as glossopharyngeal breathing, expiratory muscle training and exercise as methods of improving respiratory muscle strength/endurance is unknown.

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