Article

OBJECTIVE: To determine whether two types of exercise--breathing retraining (BRT)
and inspiratory muscle training (IMT)--improve on cardiopulmonary functions and
exercise tolerance in patients with stroke. DESIGN:
A randomized controlled
trial. SETTING: Education and research hospital. SUBJECTS: Forty-five inpatients
with stroke (24 men, 21 women) were recruited for the study. The subjects were
randomized into three groups:
15 assigned to receive inspiratory muscle training
(IMT); 15 assigned to received breathing retraining, diaphragmatic breathing and
pursed-lips breathing (BRT);
15 assigned to a control group. INTERVENTIONS: All
study groups participated in a conventional stroke rehabilitation programme. For
the same period, the IMT and BRT groups trained daily, six times a week, with
each session consisting of one half-hour of training for six weeks. MAIN MEASURES: Each subject underwent pulmonary function and cardiopulmonary exercise
tests. Subjects were also assessed for exertional dyspnoea, stages of motor
recovery, ambulation status, activity of daily living and quality of life.
RESULTS: After the training programme, the IMT group had significantly improved
forced expiratory volume at 1 second (FEV(1)), forced vital capacity (FVC), vital
capacity (VC), forced expiratory flow rate 25-75% (FEF 25-75%) and maximum
voluntary ventilation (MVV) values compared with the BRT and control groups,
although there were no significant differences between the BRT and control groups
(P<0.01). Peak expiratory flow rate (PEF) value was increased significantly in
the BTR group compared with the IMT and control groups. The IMT group also had
significantly higher peak oxygen consumption (Vo(2peak)) than the BRT and control
groups, although there were no significant differences between the BRT and
control groups (P<0.001). There was a statistically significant increase in
maximum inspiratory pressure (PI(max)) and maximum inspiratory and expiratory
pressure (PE(max)) in the BRT group and, PI(max) in the IMT group compared with
baseline and the control group. In the IMT group, this was associated with
improvements in exercise capacity, sensation of dyspnoea and quality of life.
CONCLUSIONS: Significant short-term effects of the respiratory muscle training
programme on respiratory muscle function, exercise capacity and quality of life
were recorded in this study.

Langue : ANGLAIS