Effects of positive expiratory pressure on chest wall volumes in subjects with stroke compared to healthy controls: a case-control study.
Elis E A Cabral, Vanessa R Resqueti, Illia N D F Lima and 3 others
PMID 28736210WHAT IT FOUND
PEP increased tidal volume in both groups, but the effect was significantly smaller in stroke survivors.
In the stroke group, PEP caused lung hyperinflation and did not improve breathing timing, with effects worsening at higher pressures.
Key findings
01Stroke survivors showed a lower increase in chest wall tidal volume during PEP compared to healthy controls.
02PEP caused lung hyperinflation (increased end-expiratory volume) in the stroke group, while controls showed decreased end-expiratory volume.
03PEP did not significantly change inspiratory or expiratory times in the stroke group, unlike in controls.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study did not assess patient symptoms or comfort during the protocol. The sample size was small (16 per group). Stroke patients are heterogeneous in motor impairment, which may affect how they respond to PEP.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume PEP is safe at all intensities for stroke survivors. The study found that pressures above 10 cmH2O caused lung hyperinflation and increased the risk of respiratory discomfort without improving breathing mechanics.