The Effects of Respiratory Muscle Strengthening Training on Pulmonary Function and Gait Ability in Subacute Stroke Patients

The relationship of respiratory functions and respiratory muscle strength with trunk control, functional capacity, and functional independence in post‐stroke hemiplegic patients

BACKGROUND

Cardiorespiratory system involvement and early fatigue observed in stroke patients complicate the rehabilitation process and affect their ability to perform daily activities and functional independence.

AIM

It was aimed to determine the relationship between respiratory functions and respiratory muscle strength with trunk control, functional capacity, and functional independence in hemiplegic patients after stroke.

MATERIALS AND METHODS

Twenty-five volunteers who were diagnosed with post-stroke hemiplegia were included in the study. Sociodemographic and physical characteristics were recorded. Pulmonary function test (PFT), respiratory muscle strength, Trunk Impairment Scale (TIS), Timed-Up and Go Test (TUG), and Barthel Index (BI) were applied.

RESULTS

There was a moderate negative correlation between TUG scores and PFT results (r = 0.413-0.502; p = 0.011-0.04), except for PEF (%) and FEV1/FVC. Also, there were statistically significant correlation between TIS scores and FEV1(%) (r = 0.505; p = 0.012), FVC(%) (r = 0.449; p = 0.024). On the other hand, there was no statistically significant relationship between BI results and any parameter of the PFT (p > 0.05). There was no statistically significant correlation between respiratory muscle strength and TUG, TIS, BI (p > 0.05).

CONCLUSION

It has been shown that respiratory functions are associated with functional capacity and trunk control. However, it was found that there was no relationship between respiratory muscle strength and functional capacity, trunk control, and functional independence. It is thought that considering these parameters in the assessment of patients will contribute to the creation of individual and effective rehabilitation programs. The respiratory system should be systematically assessed in stroke rehabilitation and considered as part of a holistic approach.

CLINICAL TRIAL REGISTRATION

NCT05290649 (retrospectively registered) (clinicaltrials.gov).

Effects of diaphragmatic breathing and pursed lip breathing exercises on the pulmonary function and walking endurance in patients with chronic stroke: a randomised controlled trial

Background/Aims

Neurological dysfunction from stroke affects not only the muscles of the extremities and trunk, but also the respiratory function, so it is important to improve the respiratory function of patients with stroke is recognised as an important part. The aim of this study was to investigate the effects of diaphragmatic and pursed lip breathing exercises on pulmonary function, chest expansion and walking endurance in older patients with chronic stroke.

Methods

The participants were 32 older patients with chronic stroke, randomly assigned to two groups. The study group (n=16) performed diaphragmatic breathing exercises in combination with pursed lip breathing exercises, while the control group (n=16) performed non-resistant cycle ergometer exercises. Forced vital capacity, forced expiratory volume in 1 second, the ratio of forced expiratory volume in 1 second FEV1 to forced vital capacity, peak expiratory flow, chest expansion and 6-Minute Walk Test measurements were taken before and 4 weeks after treatment.

Results

The breathing exercise group exhibited a significant increase in chest expansion and 6-Minute Walk Test outcome measurements (P<0.05). There was a significant difference in forced vital capacity, forced expiratory volume in 1 second and peak expiratory flow between the two groups (P<0.05).

Conclusions

Diaphragmatic breathing and pursed lip breathing exercises were effective in improving pulmonary function in older patients with chronic stroke.

Effects of diaphragm and deep abdominal muscle exercise on walking and balance ability in patients with hemiplegia due to stroke

The aim of this study was to investigate the effects of diaphragm and deep abdominal muscle exercise (DDAME) on walking ability (WA) and balance ability (BA) in subjects with hemiplegia due to stroke. Study subjects consisted of twenty patients diagnosed with hemiplegia due to stroke. They were randomized into a control group (CG) (n=10) that performed traditional exercise and an experimental group (EG) (n=10) that performed DDAME. The WA was measured using the 10-m walking test (10MWT) and 6-min walk test (6MWT). The BA was measured using the Timed Up and Go test (TUG) and Berg’s balance scale (BBS). Paired t-test was performed to compare differences within the groups before and after intervention. The analysis of covariance was performed to compare the differences between the EG and CG. The level of significance was set at α=0.05. Within-group changes in 10MWT and 6MWT were significantly different in both the EG (P<0.05) and CG (P<0.05). There was significantly more improvement in the 10MWT and 6MWT in the EG than in the CG (P<0.05). Within-group changes in TUG and BBS were significantly different in both the EG (P<0.05) and the CG (P<0.05). There was significantly more improvement in TUG and BBS in the EG than in the CG (P<0.05). DDAME program, with diaphragm and inspiratory muscle strengthening exercises, is needed for patients experiencing difficulty in WA, BA, trunk asymmetry, abnormal alignment, mobility of trunk muscles, power, or endurance decline.

Effect of respiratory exercise on pulmonary function, balance, and gait in patients with chronic stroke

[Purpose] This study investigated the effect of respiratory exercise on pulmonary function, balance, and gait in chronic stroke patients. [Participants and Methods] Twenty patients with chronic stroke were randomly assigned to experimental and control groups (n=10 each). The patients in both groups underwent neurodevelopmental treatment. Moreover, the experimental group performed respiratory exercise. Pulmonary function was measured using a pneumatometer. Balance was measured using a Berg Balance Scale and Functional Reach Test. Gait was measured with a 10-m walk test and Timed Up-and-Go Test. [Results] Intragroup comparison showed significant differences in forced vital capacity, forced expiratory volume in one second, Berg Balance Scale, Functional Reach Test, 10-meter walk test, and Timed Up-and-Go Test. Intergroup comparison showed that the differences in forced vital capacity, forced expiratory volume in one second, Berg Balance Scale, Functional Reach Test, 10-meter walk test, and Timed Up-and-Go Test for the experimental group were significantly related to those for the control group. [Conclusion] Based on these results it was concluded that respiratory exercise effectively improves the pulmonary function, balance, and gait in patients with chronic stroke.