Inspiratory muscle training in stroke patients with congestive heart failure

Abstract

BackgroundCardiopulmonary function can be adversely affected after a cerebrovascular accident in patients with congestive heart failure (CHF). The aim of this study was to investigate the efficacy and feasibility of inspiratory muscle training (IMT) for stroke patients with CHF.MethodsA prospective randomized single-blind controlled trial was conducted in a single tertiary medical center in southern Taiwan between May 2011 and July 2015. Forty-one patients were enrolled, of whom 21 completed the study (IMT group n = 11 and control group n = 10). Both groups participated in a conventional stroke rehabilitation program. Patients in the IMT group received an additional IMT program beginning with an intensity of 30% maximal inspiratory pressure (MIP), then increased by 2cmH2O each week for 30 minutes daily for at least 5 days a week for 10 weeks. MIP, maximal expiratory pressure, spirometry, resting oxyhemoglobin saturation, modified Borg Scale, Fatigue Assessment Scale, and Barthel Index were assessed in each patient.ResultsThere were significant differences from baseline in MIP (P = 0.008), percent predicted forced vital capacity (P = 0.033), forced expiratory volume in 1 second (FEV1) (P = 0.008), percent predicted FEV1 (P = 0.008), and Barthel Index (P = 0.012) in the IMT group, and Barthel Index (P = 0.027) in the control group. There were significant differences between groups in MIP (20.91 ± 19.73 vs −9.00 ± 26.01, adjusted P value = 0.023) and Barthel Index (24.55 ± 22.30 vs 7.50 ± 8.25, adjusted P value = 0.044).ConclusionThe 10-week IMT was feasible and effective in improving inspiratory force and activities of daily living for the stroke patients with CHF.

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

“…Of these, 754 were excluded by irrelevancy and 46 were full-text revised. Finally, nineteen studies aimed to assess the effectiveness of RMT on pulmonary function and functional capacity variables in patients with stroke were included in the meta-analysis [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. Figure 1 shows the flow of study selection.…”

“…Table 1 depicts the characteristics of the included studies and the participants. Studies were conducted in Korea [20,[22][23][24][25][26][27]33,34,36], Turkey, Spain [28,30], Brazil [21,35], Germany [32], United Kingdom [31] and Taiwan [19,29].…”

“…All included studies performed RMT; nevertheless, ten studies carried out IMT and EMT [19][20][21]23,28,[30][31][32][33]36], and nine studies only performed IMT [22,[24][25][26][27]29,34,35,37]. Regarding the threshold devices used in the RMT interventions, they were very varied: Respironics, Respifit-S, Orygen Dual Valve, SpiroTiger, Threshold, PowerBreath, tri-ball incentive spirometer and Dofin Breathing ( Table 1).…”

Effect of inspiratory muscle training on respiratory capacity and walking ability with subacute stroke patients: a randomized controlled pilot trial

“…Impaired respiratory fucntion may be a consequence of weakness of the respiratory muscles and postural trunk dysfunction. Several studies consistently reported highter positioning of the paretic hemidiaphragm associated with decreases in diaphragmatic excursion during spontaneous breathing and hyperventilation 3 ) . Previous studies 1 , 2 , 3 ) suggested that inspiratory muscle are critical factor to solve this problems.…”

Inspiratory muscle training in stroke patients with congestive heart failure

“…In the article “Inspiratory muscle training in stroke patients with congestive heart failure: A CONSORT-compliant prospective randomized single-blind controlled trial”, [ 1 ] which appeared in Volume 95, Issue 37 of Medicine , a footnote should have been included noting that Mei-Yun Liaw is the co-first author of the article.…”