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Effects of Inspiratory Muscle Training on Stroke Rehabilitation Outcomes

Not Applicable
Recruiting
Conditions
Stroke
Registration Number
NCT06640101
Lead Sponsor
Hong Kong Metropolitan University
Brief Summary

This study is designed to explore the effects of a 4-week protocol of inspiratory muscle training (IMT) at 50% maximum inspiratory pressure (MIP) on respiratory function, diaphragm thickness, balance control, exercise capacity, and quality of life in people after stroke. To ascertain the effect of IMT on the relationship between diaphragm muscle contraction and activation of other trunk muscles, this study also explores whether any effect of the 4-week IMT protocol on balance control is associated with changes in the anticipatory posture adjustments (APAs) time - the onset time of postural muscles during a required task (e.g., the rapid shoulder flexion test).

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
84
Inclusion Criteria
  • Age ≥ 40 years and < 80 years;
  • breathing spontaneously;
  • clinically diagnosed with ischemic and/or haemorrhagic stroke;
  • duration of stroke from onset falls within 1 month to 12 months after diagnosis;
  • no thoracic or abdominal surgery within the last 6 months;
  • able to understand and follow verbal instructions;
  • no facial palsy, or mild facial palsy without limitation of labial occlusion;
  • able to maintain a resting sitting posture without feet support for at least 30 seconds;
  • no cognitive impairment (Montreal Cognitive Assessment (MoCA) score ≥ 26);
  • able to independently walk at least 10 meters with or without an assistive device.
Exclusion Criteria
  • acute myocardial infarction or acute heart failure;
  • acute pain in any part of the body;
  • with respiratory illness or positive clinical signs of impaired respiratory function (such as shortness of breath, hypoxemia, chronic cough and sputum retention);
  • with chronic cardiovascular dysfunction;
  • Trunk Impairment Scale (TIS) score ≥ 20.
  • patient with a nasal feeding tube, tracheal tube and/or any condition that prevents the measurement or the implementation of the study procedure.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Primary Outcome Measures
NameTimeMethod
Diaphragmatic thicknessbaseline, after 4 weeks of intervention

The diaphragmatic thickness of both the left and right diaphragms will be measured by ultrasound. (Mindray M9, Shenzhen, China).

Secondary Outcome Measures
NameTimeMethod
Maximum Inspiratory Pressure (MIP)baseline, after 4 weeks of intervention

Maximum Inspiratory Pressure (MIP) is a measure used in pulmonary function testing to assess the strength of the respiratory muscles, particularly the muscles used for inhalation. It will be measured using the spirometer.

Forced Vital Capacity (FVC)baseline, after 4 weeks of intervention

Forced Vital Capacity (FVC) is a measurement used in pulmonary function tests to assess lung function. It refers to the total volume of air that a person can forcibly exhale from their lungs after taking the deepest breath possible. It will be measured using the spirometer.

Forced Expiratory Volume in one second (FEV1)baseline, after 4 weeks of intervention

Forced Expiratory Volume in one second (FEV1) measures the volume of air a person can forcibly exhale in the first second of a forced breath. It will be measured using the spirometer.

Sitting Balancebaseline, after 4 weeks of intervention

A force plate will be used to measure changes in the center of pressure during the performance of various tasks in sitting positions.

Trunk Impairment Scale (TIS)baseline, after 4 weeks of intervention, 12-week follow-up after the end of intervention

The TIS is a rating scale used to measure static sitting balance, dynamic sitting balance, and trunk coordination. The total TIS score ranges from 0 to 23 points, with a higher score indicating better trunk function.

Timed Up and Go Test (TUG)baseline, after 4 weeks of intervention, 12-week follow-up after the end of intervention

TUG is a test to measure the time that a participant needs to stand up from a standard armchair, walk a short distance of about 3 meters, turn around, walk back to the chair, and sit down again.

Falls efficacy scale internationalbaseline, after 4 weeks of intervention, 12-week follow-up after the end of intervention

The Falls Efficacy Scale-International (FES-I) is a questionnaire measuring fear of falling in older adults. It has 16 items, scored from 1 to 4, with higher scores indicating greater fear. It's used in clinical settings to assess fall risk and tailor interventions.

6-Minute Walk Testbaseline, after 4 weeks of intervention

The 6-Minute Walk Test (6MWT) measures how far someone can walk in six minutes. It assesses exercise capacity and mobility.

Stroke Impact Scalebaseline, after 4 weeks of intervention, 12-week follow-up after the end of intervention

The Chinese version of the Stroke Impact Scale 3.0 (SIS) will be used to measure the quality of life. A higher overall score suggests better physical, emotional, and social functioning, while a lower score may indicate more significant impairment or limitations.

Trunk muscle activitybaseline, after 4 weeks of intervention

Surface electromyography (sEMG) (Noraxon USA, Inc., Scottsdale, AZ, USA) will be used to measure the bilateral muscle activity of the erector spinae, rectus abdominis, external oblique muscle, internal oblique muscle, and transversus abdominis during sitting balance tests on the force plate.

Anticipatory posture adjustments (APAs) time of trunk musclesbaseline, after 4 weeks of intervention

Participants will be requested to perform a rapid shoulder flexion test on the force plate. Surface electromyography (sEMG) (Noraxon USA, Inc., Scottsdale, AZ, USA) will be used to measure Anticipatory posture adjustments (APAs) time of trunk muscles.

Trial Locations

Locations (1)

Shenzhen Second People's Hospital

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Shenzhen, None Selected, China

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