Effects of pulmonary rehabilitation combined with inspiratory muscle training on lung function and exercise capacity in older patients with COPD: a systematic review and meta-analysis.

However, the observed effect did not reach statistical significance, likely attributable to substantial heterogeneity among studies (I 2 = 72.9%, p = 0.025, 95% CI: −0.37–1.36) ( Figure 5 ). 3.4.4 Effect of PR combined with IMT on FEV 1 % in older COPD patients The meta-analysis of four RCTs demonstrated a moderate effect size (SMD = 0.58) for improvement in FEV 1 % with PR combined with IMT compared to PR alone in older COPD patients.

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Although our study observed a positive trend for PR combined with IMT on FEV 1 and FEV 1 %, the small number of included studies and high heterogeneity undermined the reliability of these results.

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