TY - JOUR
T1 - High-Intensity Respiratory Muscle Training Improves Strength and Dyspnea Poststroke
T2 - A Double-Blind Randomized Trial
AU - Parreiras de Menezes, Kênia Kiefer
AU - Nascimento, Lucas Rodrigues
AU - Ada, Louise
AU - Avelino, Patrick Roberto
AU - Polese, Janaine Cunha
AU - Mota Alvarenga, Maria Tereza
AU - Barbosa, Mariana Hoffman
AU - Teixeira-Salmela, Luci Fuscaldi
N1 - Funding Information:
Supported by Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES, grant code 001), Conselho Nacional de Desenvolvimento Cient?fico e Tecnol?gico (CNPq, grant no. 304434/2014-0), and Funda??o de Amparo ? Pesquisa de Minas Gerais (FAPEMIG, grant no. PPM 00082-16).
Publisher Copyright:
© 2018 American Congress of Rehabilitation Medicine
PY - 2019/2
Y1 - 2019/2
N2 - Objective: To examine whether high-intensity home-based respiratory muscle training, that is, with higher loads, delivered more frequently and for longer duration, than previously applied, would increase the strength and endurance of the respiratory muscles, reduce dyspnea and respiratory complications, and improve walking capacity post-stroke. Design: Randomized trial with concealed allocation, blinded participants and assessors, and intention-to-treat analysis. Setting: Community-dwelling patients. Participants: Patients with stroke, who had respiratory muscle weakness (N=38). Interventions: The experimental group received 40-minute high-intensity home-based respiratory muscle training, 7 days per week, for 8 weeks, progressed weekly. The control group received a sham intervention of similar dose. Main Outcome Measures: Primary outcome was inspiratory muscle strength (via maximal inspiratory pressure), whereas secondary outcomes were expiratory muscle strength (maximal expiratory pressure), inspiratory muscle endurance, dyspnea (Medical Research Council score), respiratory complications (hospitalizations), and walking capacity (6-minute walk test). Outcomes were measured at baseline, after intervention, and 1 month beyond intervention. Results: Compared to the control, the experimental group increased inspiratory (27cmH2O; 95% confidence interval [95% CI], 15 to 40) and expiratory (42cmH2O; 95% CI, 25 to 59) strength, inspiratory endurance (33 breaths; 95% CI, 20 to 47), and reduced dyspnea (-1.3 out of 5.0; 95% CI, -2.1 to -0.6), and the benefits were maintained at 1 month beyond training. There was no significant between-group difference for walking capacity or respiratory complications. Conclusion: High-intensity home-based respiratory muscle training was effective in increasing strength and endurance of the respiratory muscles and reducing dyspnea for people with respiratory muscle weakness post-stroke, and the magnitude of the effect was higher, than that previously reported in studies, which applied standard protocols.
AB - Objective: To examine whether high-intensity home-based respiratory muscle training, that is, with higher loads, delivered more frequently and for longer duration, than previously applied, would increase the strength and endurance of the respiratory muscles, reduce dyspnea and respiratory complications, and improve walking capacity post-stroke. Design: Randomized trial with concealed allocation, blinded participants and assessors, and intention-to-treat analysis. Setting: Community-dwelling patients. Participants: Patients with stroke, who had respiratory muscle weakness (N=38). Interventions: The experimental group received 40-minute high-intensity home-based respiratory muscle training, 7 days per week, for 8 weeks, progressed weekly. The control group received a sham intervention of similar dose. Main Outcome Measures: Primary outcome was inspiratory muscle strength (via maximal inspiratory pressure), whereas secondary outcomes were expiratory muscle strength (maximal expiratory pressure), inspiratory muscle endurance, dyspnea (Medical Research Council score), respiratory complications (hospitalizations), and walking capacity (6-minute walk test). Outcomes were measured at baseline, after intervention, and 1 month beyond intervention. Results: Compared to the control, the experimental group increased inspiratory (27cmH2O; 95% confidence interval [95% CI], 15 to 40) and expiratory (42cmH2O; 95% CI, 25 to 59) strength, inspiratory endurance (33 breaths; 95% CI, 20 to 47), and reduced dyspnea (-1.3 out of 5.0; 95% CI, -2.1 to -0.6), and the benefits were maintained at 1 month beyond training. There was no significant between-group difference for walking capacity or respiratory complications. Conclusion: High-intensity home-based respiratory muscle training was effective in increasing strength and endurance of the respiratory muscles and reducing dyspnea for people with respiratory muscle weakness post-stroke, and the magnitude of the effect was higher, than that previously reported in studies, which applied standard protocols.
KW - Breathing exercises
KW - Cerebrovascular disease
KW - Clinical trial
KW - Dyspnea
KW - Exercise
KW - Muscle strength
KW - Rehabilitation
KW - Stroke
UR - http://www.scopus.com/inward/record.url?scp=85057218138&partnerID=8YFLogxK
U2 - 10.1016/j.apmr.2018.09.115
DO - 10.1016/j.apmr.2018.09.115
M3 - Article
C2 - 30316960
AN - SCOPUS:85057218138
SN - 0003-9993
VL - 100
SP - 205
EP - 212
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 2
ER -