Efficacy of chest expansion resistance exercise on respiratory function, trunk control and dynamic balance in patients with chronic stroke: A Comparative study.

Shruti Prabhakaran Nair,Rukaiya Mithaiwala,Shailesh Satyanarayana Gardas

doi:10.1186/s43161-021-00041-z

Shruti Prabhakaran Nair, Rukaiya Mithaiwala + Show 1 more

Open Access

https://doi.org/10.1186/s43161-021-00041-z

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Abstract

BackgroundMotor impairments caused by stroke result in impaired diaphragmatic and respiratory muscle function, changes in thoracic biomechanics on the hemiparetic side ultimately resulting in decreased efficiency of lung ventilation. This study aimed to examine the efficacy of chest expansion resistance exercise (CERE) on respiratory function, trunk control ability, and balance in patients with chronic stoke. Following a purposive sampling, thirty-five patients with chronic stroke were randomly allocated into two groups, i.e., the experimental group receiving CERE with conventional therapy and the control group receiving conventional therapy alone. Both the groups received therapy four times per week for a period of four weeks (total 16 sessions). Following assessments were done before and after treatment in both the groups: chest expansion ( axillary, nipple, xiphisternal levels) using measure tape, respiratory muscle strength using micro-respiratory pressure meter, trunk control using the Trunk Impairment Scale, and balance using mini-Balance Evaluation Systems Test.ResultsBoth groups had 17 participants each (n = 34, drop-outs = 1) consisting of 12 males and 5 females having a mean age of 56.5 ± 12.98 years and 59.7 ± 10.2 years, respectively. Intra-group analysis showed a statistically significant increase in mean values of chest expansion, respiratory muscle strength, trunk control ability, and balance in the experimental group whereas the control group showed improvement only in trunk control ability and balance. Inter-group comparison revealed a better improvement in all the outcome variables in experimental group compared to the control group.ConclusionsBased on these results, this study proved that CERE was more effective in improving respiratory function, trunk control, and balance in patients with chronic stroke.

Highlights

Motor impairments caused by stroke result in impaired diaphragmatic and respiratory muscle function, changes in thoracic biomechanics on the hemiparetic side resulting in decreased efficiency of lung ventilation
According to World Health Organization, stroke is defined as a clinical syndrome consisting of rapidly developing clinical signs of focal disturbance of cerebral function lasting more than 24 h or leading to death with no apparent cause other than a vascular origin [1]
One participant from experimental group dropped out in the second week because he discontinued coming for therapy to the outpatient department (OPD) and had to be excluded from the study

Summary

Introduction

Motor impairments caused by stroke result in impaired diaphragmatic and respiratory muscle function, changes in thoracic biomechanics on the hemiparetic side resulting in decreased efficiency of lung ventilation. Decreased maximal inspiratory pressures [8], muscle disuse of the hemiparetic side including the diaphragm, impaired rib cage mobility [6], along with impaired postural control, and truncal mal-alignment [9, 10] are commonly seen in chronic stroke patients. These impairments result in activity limitation thereby affecting their cardiopulmonary function and reducing the energy efficiency of the body [11]

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