Regarding: "Inspiratory muscle training improves performance of a repeated sprints ability test in professional soccer players".

The Journal of Bodywork & Movement Therapies recently published an article by Silva et al., entitled "Inspiratory muscle training improves performance of a repeated sprints ability test in professional soccer players" (Silva et al., 2019). After close reading we find that the new findings of Silva et al., (2019) are relevant and provide a promising indication that IMT can improve the performance of young male soccer players. However, some additional important points must be considered when interpreting these positive findings.

The effects of inspiratory muscle training with linear workload devices on the sports performance and cardiopulmonary function of athletes: A systematic review and meta-analysis.

Inspiratory muscle training (IMT) is considered an ergogenic resource to improve sports performance. The aim of this systematic review is to evaluate the effects of IMT with linear workload devices (IMT-linear) on the sports performance and cardiopulmonary function of athletes. A search was conducted on several databases until July 2018. Eligible studies were independently reviewed by two reviewers. Methodological quality and quality of evidence were assessed with PEDro' score and GRADE, respectively. Statistical analysis was performed using the Review Manager 5.3 software. Twenty-five studies were selected for analysis. A total of 207 athletes were allocated to the IMT group, 143 athletes to the IMT-Sham, and 86 healthy individuals to the control group. The quality of studies was high (6 [3-8] points). IMT-linear improved maximal inspiratory pressure (MD -29.42 cmH2O [-35.65, -23.20]; p < 0.001), independent of sports modality. There was no influence of IMT on the maximal expiratory pressure and pulmonary function markers. It was observed that IMT-linear improves the sports performance (SMD 0.64 [0.35, 0.92]; p < 0.0001) with moderate effect size. The results suggest that IMT-linear represents an effective tool to improve the inspiratory muscle strength of athletes, as well as sports performance. However, IMT-linear did not shown effect on cardiopulmonary function.

Cardiac rehabilitation programme after transcatheter aortic valve implantation versus surgical aortic valve replacement: Systematic review and meta-analysis.

Background Aortic stenosis is a valvular heart disease characterised by fixed obstruction of the left ventricular outflow. It can be managed by surgical aortic valve replacement (sAVR) or transcatheter aortic valve implantation (TAVI). This review aimed to describe the evidence supporting a cardiac rehabilitation programme on functional capacity and quality of life in aortic stenosis patients after sAVR or TAVI. Methods The search was conducted on multiple databases from January to March 2016. All studies were eligible that evaluated the effects of a post-interventional cardiac rehabilitation programme in aortic stenosis patients. The methodological quality was assessed using the PEDro scale. Meta-analysis was performed separately by procedure and between procedures. The walked distance during the six-minute walk test (6MWD) and Barthel index were evaluated. The analysis was conducted in Review Manager. Results Five studies were included (292 TAVI and 570 sAVR patients). The meta-analysis showed that a cardiac rehabilitation programme was associated with a significant improvement in 6MWD (0.69 (0.47, 0.91); P < 0.001) and Barthel index (0.80 (0.29, 1.30); P = 0.002) after TAVI and 6MWD (0.79 (0.43, 1.15); P < 0.001) and Barthel index (0.93 (0.67, 1.18); P < 0.001) after sAVR. In addition, the meta-analysis showed that the cardiac rehabilitation programme promoted a similar gain in 6MWD (4.28% (-12.73, 21.29); P = 0.62) and Barthel index (-1.52 points (-4.81, 1.76); P = 0.36) after sAVR or TAVI. Conclusions The cardiac rehabilitation programme improved the functional capacity and quality of life in aortic stenosis patients. Patients who underwent TAVI benefitted with a cardiac rehabilitation programme similar to sAVR patients.