OBJECTIVES: The aim of this meta-analysis was to determine the effects of respiratory muscle training (RMT) on functional ability, pain-related outcomes, and respiratory function in individuals with sub-acute and chronic low back pain (LBP). METHODS: The study selection was as follows: (participants) adult individuals with > 4 weeks of LBP; (intervention) RMT; (comparison) any comparison RMT (inspiratory or expiratory or mixed) versus control; (outcomes) postural control, lumbar disability, pain-related outcomes, pain-related fear-avoidance beliefs, respiratory muscle function, and pulmonary function; and (study design) randomized controlled trials. RESULTS: 11 studies were included in the meta-analysis showing that RMT produces a statistically significant increase in postural control (mean difference (MD) 21.71 (12.22 to 31.21); decrease in lumbar disability (standardized mean difference (SMD) 0.55 (0.001 to 1.09)); decrease in lumbar pain intensity (SMD 0.77 (0.15 to 1.38); increase in expiratory muscle strength (MD 8.05 (5.34 to 10.76)); and increase in forced vital capacity (FVC) (MD 0.30 (0.03 to 0.58)) compared with a control group. However, RMT does not produce an increase in inspiratory muscle strength (MD 18.36 (-1.61 to 38.34)) and in forced expiratory volume at the first second (FEV1) (MD 0.36 (-0.02 to 0.75); and in the FEV1/FVC ratio (MD 1.55 (-5.87 to 8.96)) compared with the control group. CONCLUSIONS: RMT could improve expiratory muscle strength and FVC, with a moderate quality of evidence, whereas a low quality of evidence suggests that RMT could improve postural control, lumbar disability, and pain intensity in individuals with sub-acute and chronic LBP. However, more studies of high methodological quality are needed to strengthen the results of this meta-analysis.

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