Respiratory muscle strength and pulmonary functions in subacute stroke patients during hospitalization on a rehabilitation unit

Yoshino Terui, Eriko Sudo, Satomi Iwasawa, Sachiko Uemura, Masahiro Satake, Takanobu Shioya
Purpose:

To investigate the recovery process of respiratory muscle strength and respiratory functions in subacute stroke patients with mild lower limb impairments during hospitalization in rehabilitation unit.

Methods:

The participants were post-stroke patients with hemiparesis in the subacute phase. Subjects had mild lower-limb motor deficits as per the Stroke Impairment Assessment Set (SIAS) lower-limb motor score (11 – 15 points). Pulmonary function was assessed using the vital capacity (VC), and a forced expiratory flow in 1 s/ forced vital capacity ratio (FEV1 / FVC). The maximal inspiratory mouth pressure (MIP) and the maximal expiratory mouth pressure (MEP) were measured to represent respiratory muscle strength. The VC, MIP and MEP were expressed as percentages of the predicted values derived (%VC, %MIP and %MEP). Pulmonary functions and respiratory muscle strength were compared between the time of admission and discharge.

Results:

Twenty-six patients (14 males; ages 64±10 years) were enrolled in this study. All patients were walking independence at discharge. The mean value (admission / discharge) of pulmonary functions and respiratory muscle strength were %MIP (46.92±19.43 % / 51.53±19.31 %), %MEP (57.31±22.94 % / 72.05±30.56 %), %VC (93.45±15.34 % / 97.12±14.46 %) and FEV1/FVC (87.67±12.51 % / 85.00±8.67 %). There was a significant improvement over time on %MEP (P 0.01). There were no differences on %MIP (P = 0.051), %VC (P = 0.165) and FEV1/FVC (P = 0.263).

Conclusion(s):

Our study confirmed the efficacy to motor rehabilitation after stroke for improvement of expiratory muscle strength during hospitalization. The inspiratory muscle strength, VC and FEV1/FVC were not improved during hospitalization. The patients had lower-than-expected expiratory- and inspiratory- muscle strength when discharged from rehabilitation unit. 

Implications:

The present study shows the change over time of respiratory muscle strength in subacute stroke patients. The meaningful exercises to increase expiratory- and inspiratory- muscle strength should be encouraged for subacute stroke patients with mild lower limb impairments during hospitalization.

Funding acknowledgements:
This study was not funded.
Keywords:
stroke
respiratory muscle
Primary topic:
Neurology: stroke
Second topic:
Other
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
This study was approved by the medical ethical committee of Akita Prefectural Center for Rehabilitation and Psychiatric Medicine.
Provide the ethics approval number:
approval No. 127
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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