Effect of respiratory physiotherapy on symptom severity in clinical laryngopharyngeal reflux disease: A controlled study

Inspiratory muscle training (IMT) has demonstrated efficacy in improving symptoms and oesophageal sphincter function in patients with gastroesophageal reflux disease (GERD). However, evidence for its use in laryngopharyngeal reflux (LPR), a related but distinct condition, remains limited and inconclusive. We aim to assess the efficacy of an eight-week respiratory physiotherapy program – comprising IMT and diaphragmatic breathing – in reducing symptom severity in patients with clinical LPR. In this prospective, controlled clinical study, 37 patients with clinical LPR were allocated into three groups: a control group receiving dietary and pharmacological treatment and intervention groups receiving the same treatment supplemented with respiratory physiotherapy using either Threshold IMT or Airofit. Maximal inspiratory pressure (PImax) was used to evaluate inspiratory muscle strength. Symptom severity was measured using the Reflux Symptom Index (RSI) and Hull Airway Reflux Questionnaire (HARQ) at baseline and after 8 weeks. Both experimental groups showed a significant increase in inspiratory muscle strength (36.3% for Airofit, p = 0.005; 38.3% for Threshold IMT, p < 0.001), unlike the control group (p = 0.260). RSI scores decreased significantly in all groups but was more pronounced in the intervention groups compared to the control group (p < 0.05). HARQ scores improved across all groups without any significant between-group difference. Standard care supplemented with respiratory physiotherapy integrating IMT significantly reduced symptom severity in LPR. Both the Threshold IMT and Airofit devices proved effective. These findings support respiratory physiotherapy as a feasible, non-pharmacological therapeutic option in LPR management.