Effect of respiratory muscle training on expiratory muscle strength and abdominal electrical activity in the acute phase of Stroke

Abstract

Abstract Background: Respiratory muscle function can be compromised during the acute phase and this study aims to assess the effectiveness, feasibility, and safety of short-term expiratory muscle training in acute stroke patients. Additionally, we will assess the effects of expiratory muscular training on the electromyographic activity of the abdominal muscle, vital capacity, stroke severity, hand grip strength, functional independence, autonomy, and quality of life. Methods: This single-center, randomized, single-blind, parallel-group study of 88 patients with stroke will include the following groups: 1) an intervention group that will undergo expiratory muscle training, physical therapy, and standard care (n = 44) and 2) a control group that will only undergo physical therapy and standard care (n = 44). The primary outcome is respiratory muscle strength assessed via inspiratory and expiratory pressures (cmH2O). The secondary outcomes are electromyography activity of the rectus abdominis muscle and abdominal external oblique muscle, vital capacity measured by a ventilometer, handgrip strength, stroke severity and disability [National Institutes of Health Stroke Scale, modified Rankin Scale, and Barthel index], and quality of life. We will assess all variables before and after the intervention. The delta will be compared between the groups (intervention vs. control) using Student t-test for normal distribution and Mann-Whitney test for skewed distribution. The data will be analyzed using SPSS and results with P-values <.05 will be considered statistically significant. Discussion: The ACANTHUS trial has clinical relevance and is necessary since previous studies have revealed that respiratory rehabilitation after stroke improves patients’ functional capacities. Trial Registration: Registro Brasileiro de Ensaios Clínicos (Rebec) - RBR-8w44f6