Article

OBJECTIVE: To determine the effect of expiratory muscle strength training (EMST)
on both cough and swallow function in stroke patients. DESIGN: Prospective
pre-post intervention trial with 1 participant group.
SETTING: Two outpatient
rehabilitation clinics. PARTICIPANTS: Adults (N=14) with a history of ischemic
stroke in the preceding 3 to 24 months. INTERVENTION:
EMST. The training program
was completed at home and consisted of 25 repetitions per day, 5 days per week,
for 5 weeks. MAIN OUTCOME MEASURES: Baseline and posttraining measures were
maximum expiratory pressure, voluntary cough airflows, reflex cough challenge to
200mumol/L of capsaicin, sensory perception of urge to cough, and fluoroscopic
swallow evaluation. Repeated measures and 1-way analyses of variance were used to
determine significant differences pre- and posttraining. RESULTS: Maximum
expiratory pressure increased in all participants by an average of 30cmH2O
posttraining. At baseline, all participants demonstrated a blunted reflex cough
response to 200mumol/L of capsaicin. After 5 weeks of training, measures of urge
to cough and cough effectiveness increased for reflex cough; however, voluntary
cough effectiveness did not increase. Swallow function was minimally impaired at
baseline, and there were no significant changes in the measures of swallow
function posttraining. CONCLUSIONS: EMST improves expiratory muscle strength,
reflex cough strength, and urge to cough. Voluntary cough and swallow measures
were not significantly different posttraining. It may be that stroke patients
benefit from the training for upregulation of reflex cough and thus improved
airway protection.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS