OBJECTIVE: The objective of this systematic review and meta-analysis was to assess the effectiveness of TIMT on pulmonary function in children and adolescents with asthma. METHODS: Randomized controlled clinical trials were searched in MEDLINE, Embase, the Cochrane Library, Web of Science, CINAHL, Sino Med, Wan Fang, CNKI, and VIP until March 2024. References from included studies and relevant systematic reviews were manually screened to ensure inclusion of all pertinent literature. Trials comparing TIMT against blank TIMT and conventional care were included. Risk of bias and quality of evidence were assessed using the RoB II tool. Where feasible, data were pooled and analyzed using fixed or random effect models. Mean difference (MD) and 95% confidence intervals (CI) were reported. RESULTS: Six studies involving 337 children and adolescents aged 4 to 18 years were included. TIMT significantly improved lung function compared to control groups. Improvements were noted in FEV1 (MD 4.63 mL, 95% CI 2.64 to 6.62 mL, I2 4%), FVC (MD 7.46 mL, 95% CI 5.09 to 9.82 mL, I2 0%), FEV1/FVC (MD 7.33%, 95% CI 5.01 to 9.65%), and ACT (MD 1.86, 95% CI 0.96 to 2.75, I2 12%). No significant heterogeneity was observed across the included meta-analyses. CONCLUSIONS: TIMT is effective in improving lung function and alleviating asthma symptoms in children and adolescents with asthma. Further high-quality randomized controlled trials with larger sample sizes are needed to confirm these findings.

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