Abstract

Background: Neurological dysfunction due to stroke affects not only the extremities and trunk muscles but also the respiratory muscles. Aim: to synthesise the evidence available about the effectiveness of respiratory muscle training (RMT) to improve respiratory function parameters and functional capacity in poststroke patients. Methods: a systematic electronic search was performed in the MEDLINE, EMBASE, SPORTDiscus, PEDro and Web of Science databases, from inception to May 2020. Study selection and data extraction: randomised controlled trials (RCTs) that examined the effects of RMT versus non-RMT or sham RMT in poststroke patients. We extracted data about respiratory function, respiratory muscle strength and functional capacity (walking ability, dyspnea, balance, activities of daily life), characteristics of studies and features of RMT interventions (a type of RMT exercise, frequency, intensity and duration). Two reviewers performed study selection and data extraction independently. Results: nineteen RCTs met the study criteria. RMT improved the first second forced expiratory volume (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF), maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP) and walking ability (6 min walking test), but not Barthel index, Berg balance scale, and dyspnea. Conclusions: RMT interventions are effective to improve respiratory function and walking ability in poststroke patients.

Highlights

  • Stroke is a loss of focal neurological function due to infarction or haemorrhage in an essential part of the brain [1]

  • (via Scopus), SPORTDiscus, PEDro and Web of Science databases from inception to May 2020; disagreements were solved by consensus or involving a third researcher (JAL-A)

  • The electronic search retrieved 826 studies, and we identified two new studies through manual search

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Summary

Introduction

Stroke is a loss of focal neurological function due to infarction or haemorrhage in an essential part of the brain [1] This neurological damage affects peripheral and respiratory muscles, causing respiratory weakness, changes in the respiratory pattern and decreases in respiratory volumes and flows [2,3]. These breathing alterations are related to a decrease in physical activity and to a reduction in the ability to carry out the activities of daily life [4]. We extracted data about respiratory function, respiratory muscle strength and functional capacity (walking ability, dyspnea, balance, activities of daily life), characteristics of studies and features of RMT interventions (a type of RMT exercise, frequency, intensity and duration). Conclusions: RMT interventions are effective to improve respiratory function and walking ability in poststroke patients

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