Efficacy of Bedside Respiratory Muscle Training in Patients With Stroke: A Randomized Controlled Trial

Abstract

Objective Inspiratory and expiratory muscles are important for effective respiratory function. This study aimed to investigate the efficacy of bedside respiratory muscle training on pulmonary function and stroke-related disabilities in stroke rehabilitation. Design Patients with stroke (N = 40) in a rehabilitation unit were randomly assigned to either the intervention group (n(1) = 20) or the control group (n(2) = 20). Both groups participated in a conventional stroke rehabilitation program. During the study period, the intervention group received bedside respiratory muscle training twice a day for 3 wks. The respiratory muscle training consisted of (1) a breath stacking exercise, (2) inspiratory muscle training, and (3) expiratory muscle training. The primary outcomes were measures of pulmonary function: forced vital capacity, forced expiratory volume in 1 sec, and peak flow. Secondary outcomes were stroke-related disabilities assessed using the National Institutes of Health Stroke Scale, Modified Barthel Index, Berg Balance Scale, Fugl-Meyer Assessment, the Korean Mini-Mental State Examination, and pneumonia incidence. Results Pulmonary function was significantly improved in the intervention group after 3 wks of respiratory muscle training (P < 0.05). This improvement in pulmonary function was independent of the improvement in stroke-related disabilities. Conclusion Three weeks of respiratory muscle training had significant effects on pulmonary function in stroke survivors. To Claim CME Credits Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME Objectives Upon completion of this article, the reader should be able to: (1) Appreciate the respiratory function changes that occur in patients following a stroke; (2) Describe appropriate inspiratory and expiratory muscle training techniques to improve pulmonary function in patients following a stroke; (3) Enhance ability to implement inpatient; and (4) Determine appropriate respiratory training programs for patients following stroke. Level Advanced Accreditation The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.