Effect of respiratory training intervention on rehabilitation of patients with rib fracture: a meta-analysis.

Abstract

Objective: To systematically evaluate the effectiveness of respiratory training interventions in the rehabilitation of patients with rib fractures through a meta-analysis, aiming to provide robust evidence for clinical practice.

Methods: A comprehensive search was conducted in multiple databases (Pubmed, Embase, Web of Science, Cochrane Central, CNKI, Wanfang Data, and CSTJ) up to August 15, 2024, to identify relevant randomized controlled trials (RCTs). Eligible studies were those that compared RTIs plus conventional treatment with conventional treatment alone in patients with rib fractures. Study selection, data extraction, and risk of bias assessment were performed independently by two reviewers. Meta-analysis was conducted using R Studio software, with relative risk (RR) and standardized mean difference (SMD) as effect sizes, accompanied by 95% confidence intervals (95% CI).

Results: Nine RCTs involving 811 patients were included in the meta-analysis. Respiratory training interventions significantly reduced the incidence of atelectasis (RR = 0.23, 95% CI [0.13; 0.38]) and pulmonary infections (RR = 0.24, 95% CI [0.13; 0.44]), without significant heterogeneity between studies. Respiratory training interventions also shortened the length of hospital stay (SMD = -1.37, 95% CI [-1.57; -1.17]) and duration of chest tube drainage (SMD = -1.22, 95% CI [-1.43; -1.00]). Additionally, respiratory training interventions significantly improved arterial partial pressure of oxygen (PaO2) (SMD = 1.77, 95% CI [1.36; 2.18]) and arterial oxygen saturation (SaO2) (SMD = 1.92, 95% CI [1.49; 2.35]), and enhanced pulmonary function (SMD = 1.52, 95% CI [1.19; 1.84]). However, respiratory training interventions did not significantly affect the incidence of pleural effusions (RR = 1.09, 95% CI [0.49; 2.42]).

Conclusion: Respiratory training interventions significantly benefit patients with rib fractures by reducing atelectasis and pulmonary infections, shortening hospital stays and chest tube drainage times, and improving oxygenation and pulmonary function. Further high-quality studies are needed to confirm these findings and refine application strategies.