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Respiratory muscle weakness in obstructive airway diseases, thoracic restrictive diseases, and neuromuscular diseases; understanding possible causes and treatments
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DOI：10.1016/j.rmed.2026.108757.png)
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Abstract
En 中文
Background: Respiratory muscle weakness (RMW) significantly contributes to ventilatory failure and commonly arises from obstructive airway diseases, thoracic restrictive conditions, and neuromuscular disorders. Objective: This narrative review aims to synthesize current literature on the anatomy and physiology of the respiratory musculature, causes of respiratory muscle weakness across disease states, and diagnostic and therapeutic strategies. Methods: This narrative review was conducted through a search of PubMed, Scopus, and Web of Science databases. Priority was given to clinical trials, systematic reviews, and landmark studies focusing on the etiology, diagnostic approaches, and therapeutic interventions for RMW. Results: RMW results from increased respiratory workload, altered lung mechanics, or primary muscular dysfunction. In obstructive and thoracic restrictive diseases, dynamic hyperinflation and reduced compliance worsen muscle fatigue. Neuromuscular disorders lead to progressive muscle degeneration, impaired ventilation, and restrictive patterns. Assessment includes spirometry, inspiratory pressure measurements, electromyography, and imaging. Treatment involves mechanical ventilation, respiratory muscle training, and lung volume reduction. Respiratory muscle training and non-invasive ventilation improve strength, endurance, gas exchange, and quality of life. Conclusion: Respiratory muscle weakness requires early recognition and targeted management. Individualized, evidence-based strategies preventive, therapeutic, or rescue are essential to improve outcomes and reduce the burden of respiratory failure.
Keywords:
Respiratory muscle weakness
Obstructive airway disease
Thoracic restrictive diseases
Neuromuscular disorders
Respiratory muscle training
Mechanical ventilation
Lung volume reduction
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