Respiratory function and functional capacity in chronic stroke patients 1

Anna Cláudia Martinez Machado,Bruno Porto Pessoa,Gisele Do Carmo Leite Diniz,Paula Luciana Scalzo,Nathália Grasielle Marinho Silva

doi:10.1590/0103-5150.029.001.ao10

Abstract

Abstract Introduction: Cerebrovascular accident (CVA) or stroke results in weakness of the trunk muscles and physical unfitness. Objectives: To evaluate respiratory changes caused by stroke and correlate them with the functional capacity of chronic stroke patients who were treated at the Clinical Center of Physical Therapy of the Pontifical Catholic University of Minas Gerais, Betim. Methods: Fifteen patients were recruited for assessment of respiratory function and functional capacity. We measured maximum inspiratory pressure (MIP), maximal expiratory pressure (MEP), peak expiratory flow (PEF), vital capacity (VC), and functional capacity using the six-minute walk test (6MWT). Test results were compared with reference values using an unpaired Student's t-test or the Mann-Whitney test. Respiratory variables were correlated with the distance walked in the 6MWT using Spearman's correlation test. Results: The sample had a mean age of 58.2 ± 13.4 years, and most patients had a diagnosis of ischemic stroke and left hemiparesis. The following values were obtained: MIP (47.7 ± 22.2 cmH2O); MEP (47.5 ± 20.3 cmH2O); PEF (351.3 ± 90.8 L/min); VC (3.0 ± 0.91 L); and 6MWT (222.4 ± 101.6 m). The MIP, MEP, PEF, and 6MWT values measured in this study were statistically significantly lower (p < 0.001) than the reference values. There was no statistically significant correlation between the distance walked in the 6 MWT and respiratory variables (p > 0.005). Conclusion: Our results suggest that, despite the decrease in respiratory muscle strength, PEF, and VC, these variables did not correlate with the functional capacity of the chronic stroke patients assessed in this study.

Highlights

Cerebrovascular accident (CVA) or stroke results in weakness of the trunk muscles and physical unfitness
The sample had a mean age of 58.2 ± 13.4 years, and most patients had a diagnosis of ischemic stroke and left hemiparesis
Our results suggest that, despite the decrease in respiratory muscle strength, peak expiratory flow (PEF), and vital capacity (VC), these variables did not correlate with the functional capacity of the chronic stroke patients assessed in this study

Summary

Introduction

Cerebrovascular accident (CVA) or stroke results in weakness of the trunk muscles and physical unfitness. Conclusion: Our results suggest that, despite the decrease in respiratory muscle strength, PEF, and VC, these variables did not correlate with the functional capacity of the chronic stroke patients assessed in this study. Automatic control is mediated by neuronal groups in the brainstem, while voluntary control is mediated by cortical centers that are located in the contralateral motor cortex [1]. This neural control allows the coordinated activity of the respiratory muscles [1, 2]. The diaphragm stands out among the respiratory muscles whose primary function is to allow the rhythmic and continuous movement of the chest wall and abdomen [2]. The clinical picture of post-stroke individuals can be quite diverse depending on the location and extent of the vascular injury, and may contribute to the development of respiratory insufficiency or failure [3,4,5]

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