Combined respiratory muscle training facilitates expiratory muscle activity in stroke patients.
Myeong-Rae Jo, Nan-Soo Kim
PMID 29200637WHAT IT FOUND
Stroke patients who added inspiratory and expiratory muscle training to usual rehabilitation showed greater increases in abdominal muscle activity, breathing pressures and cough peak flow than usual rehabilitation alone.
The training used inspiratory and expiratory devices plus usual rehabilitation, so component effects cannot be separated.
Key findings
01Combined respiratory muscle training was added to usual stroke rehabilitation and used both a threshold inspiratory device and a threshold expiratory device.
02In the training group, expiratory muscle activity of the rectus abdominis, internal oblique and external oblique increased after the 8-week program.
03Peak expiratory flow, measured as cough capacity, increased in the training group.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for SLPs
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What it does not show
The study included only 25 participants, and the paper does not report how they were assigned to the intervention or control group. No blinding of participants or assessors is described. The intervention group received usual stroke rehabilitation plus inspiratory and expiratory training, so the contribution of any single component cannot be separated. Participants were at least 6 months after stroke and able to walk independently, so the results may not apply to acute stroke patients or those who cannot walk. The paper reports measurements immediately before and after the 8-week program, but no later follow-up is described. The supplied text does not clearly report between-group statistical results, so the size of the difference compared with control is uncertain.
The easy way to misread this
Do not conclude that combined respiratory muscle training alone improves cough or aspiration risk in all stroke patients. The sample was small, allocation and blinding were not described, and the training group also received usual stroke rehabilitation; the study measured cough peak flow, not swallowing or aspiration.