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Effects of Forced Positive Pressure Breathing Training on Walking Endurance, Exercise-Induced Desaturation, Cognitive Function, and Pulmonary Function in Subacute Stroke Patients

Not Applicable
Completed
Conditions
Diseases of the circulatory system
Registration Number
KCT0009276
Lead Sponsor
Sahmyook University
Brief Summary

In a study focusing on subacute stroke patients, it was found that those who underwent Mechanical Insufflation-Exsufflation (MIE) training showed significant improvements in several key areas compared to a control group. These areas include the distance walked in six minutes, cognitive functions (as measured by the Korean version of the Mini-Mental State Examination, Contrasting Program, and Go-no-go tests), and pulmonary function (including Forced Vital Capacity (FVC), the ratio of FVC to predicted normal values, Forced Expiratory Volume in one second (FEV1), the ratio of FEV1 to predicted normal values, Maximum Inspiratory Pressure (MIP), and Maximum Expiratory Pressure (MEP)). Additionally, the study categorized subgroups based on the presence or absence of Exercise-Induced Desaturation (EID) before treatment, finding that improvements in pulmonary function due to MIE training were consistent across these subgroups, indicating that all patients benefited from the intervention regardless of their initial EID status. However, the impact of pulmonary function improvement on walking endurance was found to be differential, potentially more significant in those with pre-treatment EID. This suggests that measuring EID before treatment could contribute to developing effective intervention plans aimed at improving walking endurance. Cognitive functions in stroke patients are often impaired early on, indicating that early intervention in respiratory function could be effective in improving and protecting cognitive functions. In this study, oxygen saturation was not a primary mediator for cognitive functions, suggesting that the mediating effects of pulmonary function improvement on cognitive functions could extend to mechanisms such as immune-mediated neuroplasticity, the interplay between pulmonary function intervention and systemic immune responses, and sleep disorders. This highlights the need for further research into the complex relationships between pulmonary function, cognitive improvement, and systemic health in subacute stroke patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
Completed
Sex
All
Target Recruitment
49
Inclusion Criteria

a post-stroke duration of more than 3 weeks but less than 6 months, a demonstrable respiratory muscle weakness, as indicated by Maximum Inspiratory Pressure (MIP) and Maximum Expiratory Pressure (MEP) values being less than 70% of the normal range. Additionally, candidates were required to have no thoracic anomalies or deformations, no lung damage or rib fractures, and a score of 18 or above on the Korean Mini-Mental State Examination (K-MMSE), suggesting either normal cognitive function or mild cognitive impairment. Eligibility also depended on the ability to follow instructions, walk independently for at least 6 minutes with or without assistive devices, and a voluntary agreement to participate in the study, understanding its purpose.

Exclusion Criteria

Patients with a history of pulmonary disease, rendering them susceptible to barotrauma, as well as those with a history of stroke or neuromuscular disorders, were excluded from the study.

Study & Design

Study Type
Interventional Study
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
The study variables include pulmonary function (FVC, FEV1, FEV1/FVC, PEF, FEF 25-75%), Exercise-Induced Desaturation (EID), and walking endurance (6MWT).
Secondary Outcome Measures
NameTimeMethod
The study assesses cognitive functions using MMSE-K, Contrasting Program, Go-no-go, and Fist–edge-palm tests, alongside respiratory strength through Maximum Inspiratory Pressure (MIP) and Maximum Expiratory Pressure (MEP).
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