Effect of inspiratory and expiratory muscle training on respiratory function and decannulation outcome in patients with tracheostomy after stroke: a randomized controlled trial.

IF 2.2 4区医学 Q1 REHABILITATION Topics in Stroke Rehabilitation Pub Date : 2024-12-09 DOI:10.1080/10749357.2024.2437328

Lei Li, Rui Liu, Zhonghua Yu, Jing He, Quan Wei

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Abstract

Background: This study aimed to evaluate the clinical efficacy and safety of inspiratory and expiratory muscle training (IEMT) for patients who underwent tracheostomy after stroke.

Methods: The study was an investigator-initiated, single-center, two-arm, evaluator-blinded, randomized clinical trial conducted at West China Hospital of Sichuan University, China, from January 2022 to June 2022. The patients were randomly divided into the intervention group and control group. Patients in both groups received conventional clinical, rehabilitation treatment and usual care. The intervention group also received IEMT for three weeks. There were three primary outcomes including maximal inspiratory pressure (MIP, cmH₂O), maximal expiratory pressure (MEP, cmH2O) and decannulation outcome after intervention (n, %). The secondary outcomes were other respiratory function outcomes, motor function, activities of daily living (ADL), quality of life (QoL) and the new pulmonary infection rate after the intervention at three weeks.

Results: A total of 50 participants were enrolled [25 in each group; 39 (78%) were men; mean (SD) age, 55.94 (11.97) years]. At three weeks, significant differences were found in the MIP [control vs IEMT: 39.04 (6.21) vs 56.28 (10.41), p < 0.001]; MEP [43.48 (5.36) vs 62.16 (10.18), p < 0.001], and tracheal tube extraction success rate [2 (8%) vs 9 (36%), p = 0.019] between the two groups. In addition, the new pulmonary infection rate in the intervention groups were significantly different (all p < 0.05) from those in the control group.

Conclusions: IEMT can improve respiratory function, decannulation outcome, among patients with tracheostomy after stroke.

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吸气和呼气肌肉训练对中风后气管切开患者呼吸功能和拔管效果的影响：随机对照试验。

背景：本研究旨在评价吸气和呼气肌训练（IEMT）对脑卒中后气管切开术患者的临床疗效和安全性。方法：该研究是一项研究者发起的、单中心、双臂、评估者盲法、随机临床试验，于2022年1月至2022年6月在中国四川大学华西医院进行。将患者随机分为干预组和对照组。两组患者均接受常规临床、康复治疗及日常护理。干预组也接受三周的IEMT治疗。三个主要结局包括最大吸气压（MIP, cmH2O），最大呼气压（MEP, cmH2O）和干预后的脱管结局（n, %）。次要指标为其他呼吸功能指标、运动功能、日常生活活动（ADL）、生活质量（QoL）和干预后3周肺部新感染率。结果：共入组50例[每组25例；男性39例（78%）；平均（SD）年龄55.94（11.97）岁]。三周时，两组间MIP差异显著[对照组与IEMT: 39.04 (6.21) vs 56.28 (10.41), p p p = 0.019]。结论：IEMT可改善脑卒中气管切开术患者的呼吸功能和脱管结局。

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来源期刊

Topics in Stroke Rehabilitation 医学-康复医学

CiteScore

5.10

自引率

4.50%

发文量

审稿时长

6-12 weeks

期刊介绍： Topics in Stroke Rehabilitation is the leading journal devoted to the study and dissemination of interdisciplinary, evidence-based, clinical information related to stroke rehabilitation. The journal’s scope covers physical medicine and rehabilitation, neurology, neurorehabilitation, neural engineering and therapeutics, neuropsychology and cognition, optimization of the rehabilitation system, robotics and biomechanics, pain management, nursing, physical therapy, cardiopulmonary fitness, mobility, occupational therapy, speech pathology and communication. There is a particular focus on stroke recovery, improving rehabilitation outcomes, quality of life, activities of daily living, motor control, family and care givers, and community issues. The journal reviews and reports clinical practices, clinical trials, state-of-the-art concepts, and new developments in stroke research and patient care. Both primary research papers, reviews of existing literature, and invited editorials, are included. Sharply-focused, single-issue topics, and the latest in clinical research, provide in-depth knowledge.