Effects of Abdominal Stimulation during Inspiratory Muscle Training on Respiratory Function of Chronic Stroke Patients

Ju-Hyeon Jung, Je-Myung Shim, Hae-Yeon Kwon, Ha-Roo Kim, Bo-In Kim, Ju-Hyeon Jung, Je-Myung Shim, Hae-Yeon Kwon, Ha-Roo Kim, Bo-In Kim

Abstract

[Purpose] The purpose of the present study was to verify a new method for improving respiratory functions by applying both abdominal stimulation and inspiratory muscle training (IMT) to train the inspiratory muscle and the expiratory muscle simultaneously, to improve the efficiency of IMT of chronic stroke patients. [Subjects] Eighteen stroke patients were randomly assigned to an experimental group (n = 9) and a control group (n = 9). [Methods] The experimental group was administered IMT with abdominal stimulation, and the control group was administered only IMT. During the intervention period, the experimental group and control group received training 20 min/day, 3 times/wk, for 4 weeks. To examine the lung functions of the subjects, FVC, FEV1, PEF, and FEF25-75 were measured using an electronic spirometer. The diaphragm thickness ratio was calculated from measurements made with a 7.5-MHz linear probe ultrasonic imaging system. [Result] The experimental group and the control group showed significant increases in diaphragm thickness ratio on the paretic side, but not on the non-paretic side. With regard to lung function, the experimental group showed significant increases in FEV1, PEF, and FEF25-75. The changes between before and after the intervention in the two groups were compared with each other, and the results showed significant differences in FEV1 and PEF. [Conclusion] The present study identified that IMT accompanied by abdominal stimulation improved the pulmonary function of chronic stroke patients.

Keywords: Abdominal stimulation; Inspiratory muscle training; Stroke.

References

    1. Kashihara H, Haruna Y, Suzuki Y, et al. : Effects of mild supine exercise during 20 days bed rest on maximal oxygen uptake rate in young humans. Acta Physiol Scand Suppl, 1994, 616: 19–26
    1. Estenne M, Gevenois PA, Kinnear W, et al. : Lung volume restriction in patients with chronic respiratory muscle weakness: the role of microatelectasis. Thorax, 1993, 48: 698–701
    1. Khedr EM, El Shinawy O, Khedr T, et al. : Assessment of corticodiaphragmatic pathway and pulmonary function in acute ischemic stroke patients. Eur J Neurol, 2000, 7: 509–516
    1. Larson JL, Kim MJ, Sharp JT, et al. : Inspiratory muscle training with a pressure threshold breathing device in patients with chronic obstructive pulmonary disease. Am Rev Respir Dis, 1988, 138: 689–696
    1. Loveridge B, Sanii R, Dubo HI: Breathing pattern adjustments during the first year following cervical spinal cord injury. Paraplegia, 1992, 30: 479–488
    1. Petrovic M, Lahrmann H, Pohl W, et al. : Idiopathic diaphragmatic paralysis-satisfactory improvement of inspiratory muscle function by inspiratory muscle training. Respir Physiol Neurobiol, 2009, 165: 266–267
    1. Sutbeyaz ST, Koseoglu F, Inan L, et al. : Respiratory muscle training improves cardiopulmonary function and exercise tolerance in subjects with subacute stroke: a randomized controlled trial. Clin Rehabil, 2010, 24: 240–250
    1. Britto RR, Rezende NR, Marinho KC, et al. : Inspiratory muscular training in chronic stroke survivors: a randomized controlled trial. Arch Phys Med Rehabil, 2011, 92: 184–190
    1. Gollee H, Hunt KJ, Fraser MH, et al. : Abdominal stimulation for respiratory support in tetraplegia: a tutorial review. J Automatic Contr, 2008, 18: 85–92
    1. Enright SJ, Unnithan VB, Heward C, et al. : Effect of high-intensity inspiratory muscle training on lung volumes, diaphragm thickness, and exercise capacity in subjects who are healthy. Phys Ther, 2006, 86: 345–354
    1. Kandare F, Exner G, Jeraj J, et al. : Breathing induced by abdominal muscle stimulation in individuals without spontaneous ventilation. Neuromodulation, 2002, 5: 180–185
    1. Suzuki J, Tanaka R, Yan S, et al. : Assessment of abdominal muscle contractility, strength, and fatigue. Am J Respir Crit Care Med, 1999, 159: 1052–1060
    1. Kim MH: The effects of respiratory function, trunk control and functional ADL, following respiratory strength training in patients with stroke. Report, University of Sahmyook, Korea, 2012
    1. McKinley WO, Jackson AB, Cardenas DD, et al. : Long-term medical complications after traumatic spinal cord injury: a regional model systems analysis. Arch Phys Med Rehabil, 1999, 80: 1402–1410
    1. Enright S, Chatham K, Ionescu AA, et al. : Inspiratory muscle training improves lung function and exercise capacity in adults with cystic fibrosis. Chest, 2004, 126: 405–411
    1. Fregonezi GA, Resqueti VR, Güell R, et al. : Effects of 8-week, interval-based inspiratory muscle training and breathing retraining in patients with generalized myasthenia gravis. Chest, 2005, 128: 1524–1530
    1. Cheng PT, Chen CL, Wang CM, et al. : Effect of neuromuscular electrical stimulation on cough capacity and pulmonary function in patients with acute cervical cord injury. J Rehabil Med, 2006, 38: 32–36
    1. Lee BB, Boswell-Ruys C, Butler J, et al. : Surface functional electrical stimulation of the abdominal muscles to enhance cough and assist tracheostomy decannulation after high-level spinal cord injury. J Spinal Cord Med, 2008, 31: 78–82

Source: PubMed

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