Efficacy of Interventions to Improve Respiratory Function After Stroke

Menezes, Kênia Kiefer Parreiras de; Nascimento, Lucas Rodrigues; Avelino, Patrick Roberto; Alvarenga, Maria Tereza Mota; Teixeira-Salmela, Luci Fuscaldi

doi:10.4187/respcare.06000

Cited by 37 publications

(32 citation statements)

References 50 publications

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“…Finally, MEP and MIP improved their baseline values in 10.05 and 22.40 cm H 2 0, respectively. These results align with previously published meta-analysis [7][8][9][10].…”

Section: Discussionsupporting

confidence: 93%

“…Regarding the pulmonary function parameters, our results showed positive effectiveness of RMT interventions to improve FEV1, FVC, PEF, MEP, and MIP in patients with stroke. These results are in line with previous systematic reviews and meta-analyses results [7,8]. Patients who have suffered a stroke present abdominal and diaphragm dysfunction, causing a decrease of respiratory muscle strength [2,40,41].…”

Section: Discussionsupporting

confidence: 91%

“…A previously published meta-analysis that included eleven trials also obtained similar results [7]. Nevertheless, the main difference was found in dyspnea.…”

Section: Discussionsupporting

confidence: 61%

“…Previous systematic reviews and meta-analyses have synthesised the available evidence about the effectiveness of RMT exercises on improving respiratory function [3,[7][8][9][10], even exercise tolerance in poststroke patients; however, some weaknesses of these reviews were that they did not only include randomised controlled trials (RCTs) [10], and that they included a limited number of studies [3,8]. Moreover, since the last systematic review and meta-analysis [7], many studies aiming at analysing the effect of RMT on respiratory function and functional capacity have been published.…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of Respiratory Muscle Training for Pulmonary Function and Walking Ability in Patients with Stroke: A Systematic Review with Meta-Analysis

Pozuelo‐Carrascosa

Carmona‐Torres

Laredo-Aguilera

et al. 2020

IJERPH

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Background: Neurological dysfunction due to stroke affects not only the extremities and trunk muscles but also the respiratory muscles. Aim: to synthesise the evidence available about the effectiveness of respiratory muscle training (RMT) to improve respiratory function parameters and functional capacity in poststroke patients. Methods: a systematic electronic search was performed in the MEDLINE, EMBASE, SPORTDiscus, PEDro and Web of Science databases, from inception to May 2020. Study selection and data extraction: randomised controlled trials (RCTs) that examined the effects of RMT versus non-RMT or sham RMT in poststroke patients. We extracted data about respiratory function, respiratory muscle strength and functional capacity (walking ability, dyspnea, balance, activities of daily life), characteristics of studies and features of RMT interventions (a type of RMT exercise, frequency, intensity and duration). Two reviewers performed study selection and data extraction independently. Results: nineteen RCTs met the study criteria. RMT improved the first second forced expiratory volume (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP) and walking ability (6 min walking test), but not Barthel index, Berg balance scale, and dyspnea. Conclusions: RMT interventions are effective to improve respiratory function and walking ability in poststroke patients.

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“…Finally, MEP and MIP improved their baseline values in 10.05 and 22.40 cm H 2 0, respectively. These results align with previously published meta-analysis [7][8][9][10].…”

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 91%

“…A previously published meta-analysis that included eleven trials also obtained similar results [7]. Nevertheless, the main difference was found in dyspnea.…”

Section: Discussionsupporting

confidence: 61%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness of Respiratory Muscle Training for Pulmonary Function and Walking Ability in Patients with Stroke: A Systematic Review with Meta-Analysis

Pozuelo‐Carrascosa

Carmona‐Torres

Laredo-Aguilera

et al. 2020

IJERPH

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“…Respiratory muscle training has been proven to be the best intervention for increasing the strength of respiratory muscles, improving respiratory function, and reducing dyspnea. [9][10][11][12][13] In this type of training, patients perform repetitive breathing exercises against an external load, with a flow-dependent resistance or pressure threshold. 4 Results are achieved when higher training loads (>30%) are applied.…”

mentioning

confidence: 99%

Benefits of Home‐Based Respiratory Muscle Training from the Perspectives of Individuals Who Had a Stroke: Qualitative Study

Menezes

Nascimento

Avelino

et al. 2020

PM&R

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Background: Although the significance of respiratory muscle training has been established in the literature, there is a need to understand the participantsʼ perceptions of the benefits of this intervention. Objective: To understand how individuals who had a stroke perceive changes in their body functions and structures, activities, and participation after a high-intensity respiratory muscle training intervention and to understand their perceptions of the benefits and limitations of a home-based intervention. Design: Qualitative study. Setting: Community-dwelling patients. Patients: Fifteen individuals who had a stroke. Methods: For this qualitative study, interviews were conducted using a semistructured questionnaire about topics related to participation in a home-based respiratory muscle training intervention. The interviews were transcribed and analyzed using thematic content analysis. Results: Fifteen participants were interviewed. Most of the participants reported positive perceptions of body functions and structures, grouped into two thematic categories (breathing and speech); activity, also grouped into two thematic categories (walking and domestic activities); and participation, grouped into one thematic category (community-leisure activities). Answers about the benefits of a home-based intervention were grouped into three thematic categories (no need to leave home, commitment to training, and comfort). All participants reported that they would recommend the intervention to other stroke patients and that they were either satisfied or very satisfied with the intervention. Most (80%) participants did not consider the intervention difficult to perform. Conclusion: Individuals who had experienced a stroke perceived the benefits of high-intensity home-based respiratory muscle training in all components of function.

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Clinical characteristics and risk factors for mortality among inpatients with COVID‐19 in Wuhan, China

Chen

Sun

et al. 2020

Clinical & Translational Med

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Coronavirus disease 2019 (COVID-19) has become the worldwide pandemic. Currently, COVID-19, caused by the novel coronavirus, has had outbreaks in more than 213 countries and regions around the world and has caused many deaths. As of 24 April 2020, more than 2.62 million people had been diagnosed worldwide, of whom more than 180 000 died from the virus. 1 This cohort included COVID-19 patients admitted to The Central Hospital of Wuhan on 1 January 2020 to 15 February 2020. Of the 660 participating inpatients with COVID-19, 82 died and 578 were discharged. We comprehensively identified the clinical characteristics at the time of admission in nonsurvivors and patients who recovered from it (Table 1), and we reported several novel risk factors of mortality in COVID-19 patients (Figure 1A). Furthermore, dynamic changes in these major markers during hospitalization and the survival outcomes under different conditions were tracked (Figure 1B-E).Consistent with the previous study, advanced age and high SOFA scores on admission were crucial risk factors for COVID-19 patient mortality. 2 Intriguingly, according to our multivariable logistic regression analysis, we discovered that a history of cerebral infarction, C-reactive protein (CRP) levels >0.6 mg/dL, and lactate dehydrogenase levels >245 U/L on admission significantly elevated the odds of in-hospital death (Figure 1A).Our findings show that the history of cerebral infarction, an independent risk factor for inpatient death, caused a significantly poorer outcome for COVID-19 patients. The possible reasons are as follows. First, cerebral infarction may occur mainly in elderly people, and older age was a crucial predictor for COVID-19 mortality. 2 Second, when cerebral infarction impacts respiratory muscles and respiratory centers or causes hemiplegia, it may cause pulmonary conditions to deteriorate. 3 Third, hypercoagulability is associated with cerebral infarction, and cerebral infarction patients may have preexisting hypercoagulability. 4 Additionally, we observed higher D-dimer in nonsurvivors, suggesting that COVID-19 patients with cerebral infarction may have an aggravatingThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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Efficacy of Interventions to Improve Respiratory Function After Stroke

Cited by 37 publications

References 50 publications

Effectiveness of Respiratory Muscle Training for Pulmonary Function and Walking Ability in Patients with Stroke: A Systematic Review with Meta-Analysis

Effectiveness of Respiratory Muscle Training for Pulmonary Function and Walking Ability in Patients with Stroke: A Systematic Review with Meta-Analysis

Benefits of Home‐Based Respiratory Muscle Training from the Perspectives of Individuals Who Had a Stroke: Qualitative Study

Clinical characteristics and risk factors for mortality among inpatients with COVID‐19 in Wuhan, China

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