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

Abstract

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.

Efficacy of diaphragmatic breathing exercise on respiratory, cognitive, and motor function outcomes in patients with stroke: a systematic review and meta-analysis

“…In total, there were 3,088 hits from the literature. Out of these hits, only six studies were eligible for inclusion in the review (40)(41)(42)(43)(44)(45). However, two other potential eligible studies were excluded for being a non-randomized trial and having multiple interventions including two different breathing exercises in the experimental group, respectively (16,46).…”

“…However, the information was provided by only three studies, wherein 55 and 31 of the participants had ischemic and hemorrahgic strokes, respectviely (40, 43, 45). Similarly, only five studies provided information on the side affected, 68 on the right side and 49 on the left side (40,41,(43)(44)(45).…”

“…However, in all the studies, only participants with no significant cognitive impairment were included (40-45). In addition, only four studies provided information on the severity of the disability the included participants had, which was moderate as indicated by the participants' ability to stand independently (40, 41,43,45).…”

“…For the exclusion criteria, some of the studies excluded participants with musculoskeletal disorders (40-42, 44); previous neurological disorders (40, 43); previous pulmonary disorders (41,45); cardiac problems (44,45); pain (40); visual problem (40); and hemineglect (40).…”

“…For the differences in the protocols of the included studies, participants performed only diaphragmatic breathing exercise without any additional intervention aside from conventional therapy or usual care in only two studies (40, 43). In the remaining studies, other interventions were added to diaphragmatic breathing exercise (41,42,44,45).…”