Physical Therapy Rehabilitation Science

korean Academy of Physical Therapy Rehabilitation Science (물리치료재활과학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of Inspiratory Training on Respiratory Function and Balance in Stroke Patients: A Randomized Controlled Trial

  • Ku Man (Department of Physical Therapy, Graduate School of Konyang University) ;
  • Park Dae-Sung (Department of Physical Therapy, Konyang University)
  • Received : 2024.01.05
  • Accepted : 2024.03.06
  • Published : 2024.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

Objective: The aim of this study is to explore how using inspiratory training affects the respiratory function and balance of stroke patients. We also plan to compare the results with a control group that does not receive the intervention. Design: A Randomized Controlled Trial Methods: In this study, 27 chronic stroke patients were randomly assigned to either a control group (n=14) or an experimental group (n=13). Both groups underwent six weeks of common interventions involving standard physiotherapy and treadmill training. Additionally, the experimental group received inspiratory training. Respiratory function and balance were evaluated using Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), Maximal Inspiratory Pressure (MIP), Maximal Expiratory Pressure (MEP), Peak Expiratory Flow (PEF), Five times Sit-to-Stand (FTSTS), Seated Center of Pressure (S-COP), and Timed Up and Go (TUG) tests. Results: Respiratory function and balance were compared within each group before and after intervention. The experimental group, which received inspiratory training, showed significant improvements in FVC (0.26±0.18), FEV1 (0.35±0.32), MIP (11.54±12.39), PEF (1.12±1.52), and TUG (-3.39±2.45) compared to pre-intervention values (p<0.05). When comparing changes between groups post-intervention, the experimental group demonstrated significant increases in FVC, FEV1, MIP, PEF, and TUG compared to the control group (p<0.05). However, there were no significant differences in MEP, FTSTS, and S-COP. Conclusions: The results of this study indicate a positive effect of inspiratory training on chronic stroke patients. These findings suggest that with further research involving a larger sample size and enhanced intervention methods, inspiratory training could be employed positively in the rehabilitation of stroke patients.

Keywords

Acknowledgement

본 연구는 보건복지부 국립재활원 재활연구개발용역사업(R&D) 2021년도 재활연구개발지원용역 #NRCRSP-EX21017 호흡재활 기기의 기술 고도화 연구로 수행된 연구임.

References

  1. Pozuelo-Carrascosa DP, Carmona-Torres JM, Laredo-Aguilera JA, Latorre-Roman PA, Parraga-Montilla JA, Cobo-Cuenca AI. Effectiveness of respiratory muscle training for pulmonary function and walking ability in patients with stroke: A systematic review with meta-analysis. Int J Environ Res Public Health. 2020;17(15):5356:1-22.  https://doi.org/10.3390/ijerph17155356
  2. Britto RR, Rezende NR, Marinho KC, Torres JL, Parreira VF, Teixeira-Salmela LF. Inspiratory muscular training in chronic stroke survivors: a randomized controlled trial. Arch Phys Med Rehabil. 2011;92(2):184-190.  https://doi.org/10.1016/j.apmr.2010.09.029
  3. Lee K, Park D, Lee G. Progressive respiratory muscle training for improving trunk stability in chronic stroke survivors: a pilot randomized controlled trial. J Stroke Cerebrovasc Dis. 2019;28(5):1200-1211.  https://doi.org/10.1016/j.jstrokecerebrovasdis.2019.01.008
  4. Gelaw AY, Janakiraman B, Teshome A, Ravichandran H. Effectiveness of treadmill assisted gait training in stroke survivors: A systematic review and meta-analysis. Glob Epidemiol. 2019;1:100012:1-9.  https://doi.org/10.1016/j.gloepi.2019.100012
  5. Aydogan Arslan S, Ugurlu K, Sakizli Erdal E, Keskin ED, Demirguc A. Effects of inspiratory muscle training on respiratory muscle strength, trunk control, balance and functional capacity in stroke patients: A single-blinded randomized controlled study. Top Stroke Rehabil. 2022;29(1):40-48.  https://doi.org/10.1080/10749357.2020.1871282
  6. LO Vaz, Almeida JC, Froes KSDSO, Dias C, Pinto EB, Oliveira-Filho J. Effects of inspiratory muscle training on walking capacity of individuals after stroke: A double-blind randomized trial. Clin Rehabil. 2021;35(9):1247-1256.  https://doi.org/10.1177/0269215521999591
  7. Xiao Y, Luo M, Wang J, Luo H. Inspiratory muscle training for the recovery of function after stroke. Cochrane Database Syst Rev. 2012;(5):CD009360: 1-19. 
  8. Sutbeyaz ST, Koseoglu F, Inan L, Coskun O. Respiratory muscle training improves cardiopulmonary function and exercise tolerance in subjects with subacute stroke: a randomized controlled trial. Clin Rehabil. 2010;24(3):240-250.  https://doi.org/10.1177/0269215509358932
  9. Lee K, Cho JE, Hwang DY, Lee W. Decreased respiratory muscle function is associated with impaired trunk balance among chronic stroke patients: A cross-sectional study. Tohoku J Exp Med. 2018;245(2):79-88.  https://doi.org/10.1620/tjem.245.79
  10. Assayag D, Vittinghoff E, Ryerson CJ, Cocconcelli E, Tonelli R, Hu X, Elicker BM, Golden JA, Jones KD, King TE Jr, Koth LL, Lee JS, Ley B, Shum AK, Wolters PJ, Ryu JH, Collard HR. The effect of bronchodilators on forced vital capacity measurement in patients with idiopathic pulmonary fibrosis. Respir Med. 2015;109(8):1058-1062.  https://doi.org/10.1016/j.rmed.2015.06.012
  11. Srivastava A, Taly AB, Gupta A, Kumar S, Murali T. Bodyweight-supported treadmill training for retraining gait among chronic stroke survivors: A randomized controlled study. Ann Phys Rehabil Med. 2016;59(4):235-241.  https://doi.org/10.1016/j.rehab.2016.01.014
  12. Messaggi-Sartor M, Guillen-Sola A, Depolo M, Duarte E, Rodriguez DA, Barrera MC, Barreiro E, Escalada F, Orozco-Levi M, Marco E. Inspiratory and expiratory muscle training in subacute stroke: A randomized clinical trial. Neurology. 2015;85(7):564-72.  https://doi.org/10.1212/WNL.0000000000001827
  13. Kuys SS, Brauer SG, Ada L. Higher-intensity treadmill walking during rehabilitation after stroke in feasible and not detrimental to walking pattern or quality: a pilot randomized trial. Clin Rehabil. 2011;25(4):316-326.  https://doi.org/10.1177/0269215510382928
  14. Chan PP, Si Tou JI, Tse MM, Ng SS. Reliability and validity of the timed up and go test with a motor task in people with chronic stroke. Arch Phys Med Rehabil. 2017;98(11):2213-2220.  https://doi.org/10.1016/j.apmr.2017.03.008
  15. DS Park, DY Lee, SJ Choi, WS Shin. Reliability and validity of the Balancia using Wii balance board for assessment of balance with stroke patients. J Korea Acad Ind Soc. 2013;14(6):2767-2772.  https://doi.org/10.5762/KAIS.2013.14.6.2767
  16. JH Jung, NS Kim. The Effects of breathing retraining on asymmetry of diaphragm thickness in stroke patients. J Korean Soc Phys Med. 2013;8(2):263-269.  https://doi.org/10.13066/kspm.2013.8.2.263
  17. Oh D, Kim G, Lee W, Shin MM. Effects of inspiratory muscle training on balance ability and abdominal muscle thickness in chronic stroke patients. J Phys Ther Sci. 2016;28(1):107-111.  https://doi.org/10.1589/jpts.28.107
  18. Silva P, Franco J, Gusmao A, Moura J, Teixeira-Salmela L, Faria C. Trunk strength is associated with sit-to-stand performance in both stroke and healthy subjects. Eur J Phys Rehabil Med. 2015;51(6):717-724. 
  19. Carral JMC, Rodriguez AL, Cardalda IM, Bezerra JPAG. Muscle strength training program in nonagenarians-a randomized controlled trial. Rev Assoc Med Bras (1992). 2019;65(6):851-856.  https://doi.org/10.1590/1806-9282.65.6.851
  20. Lee DK, Jeong HJ, Lee JS. Effect of respiratory exercise on pulmonary function, balance, and gait in patients with chronic stroke. J Phys Ther Sci. 2018;30(8):984-987. https://doi.org/10.1589/jpts.30.984