Abstract
The forward head posture (FHP) of stroke patients has a negative impact on respiratory function. Cervical spine mobilization is a manual therapy technique that used to prevent and treat FHP and respiratory function. This pilot study investigated whether cervical spine mobilization can effectively improve outcomes following FHP and respiratory function of stroke patients. Twenty-four patients participated in our assessor-blinded randomized controlled trial. All the participants received neurodevelopmental treatments (gait training and trunk rehabilitation). The experimental group additionally received 15-min sessions of cervical spine mobilization three times per week for 4 weeks. The control group received cervical spine sham mobilization during the same period. For the cervical angles, the cranial vertebral angle (CVA) and cranial rotation angle (CRA) were measured. A respiratory function test was performed to measure the forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and chest circumferences (upper and lower chest sizes). Except for MIP, there was no significant difference between the experimental group and the control group. The CVA and CRA were significantly increased in the experimental group only. Cervical spine mobilization improved cervical angles and inspiratory function of the stroke patients in this study. However, a comparative study with a larger number of patients is needed to confirm this finding from our pilot study, which had a small sample size.
Highlights
Common stroke has a negative impact on patients’ voluntary respiration [1]
A trunk rehabilitation-based neurodevelopmental treatment (NDT) program is important for cervical alignment and pulmonary function in stroke patients, and cervical mobilization can reinforce that effect
The purpose of this study was to investigate the effect of cervical spine mobilization on inspiratory function and cervical angles of stroke patients
Summary
Common stroke has a negative impact on patients’ voluntary respiration [1]. Muscle weakness is the most evident respiratory problem in stroke patients [2] and is associated with a reduction in pulmonary function, functional outcome, and postural control [3].Altered postural control after a stroke reduces the patient’s ability to maintain postural alignment and results in a forward head posture (FHP). Common stroke has a negative impact on patients’ voluntary respiration [1]. Muscle weakness is the most evident respiratory problem in stroke patients [2] and is associated with a reduction in pulmonary function, functional outcome, and postural control [3]. An FHP causes respiratory muscle weakness [4] and reduces pulmonary function [5]. Improving the FHP of stroke patients can improve their respiratory functions [6]. Voluntary respiration refers to the process of forced inhalation and exhalation, and the smooth movement of the thoracic cage is necessary for deep breathing [7]. The FHP shortens the abdominal muscles, thereby reducing chest motion during breathing [8] and, pulmonary function [9]
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