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Functional Inspiratory Muscle Training for Gait Recovery in Patients With Chronic Stroke

2026年7月21日 更新者:Shimaa Taha Mohamed Taha、Cairo University

Effect of Functional Inspiratory Muscle Training on Spatiotemporal Gait Parameters in Patients With Chronic Stroke

The purpose of this randomized controlled trial is to evaluate the effect of functional inspiratory muscle training (F-IMT) on spatiotemporal gait parameters in patients with chronic stroke. Sixty participants with chronic stroke will be randomly assigned to either a functional inspiratory muscle training group or a conventional inspiratory muscle training group. Both groups will receive the same conventional rehabilitation program for 8 weeks. The primary outcome is spatiotemporal gait parameters measured using the STEADYS gait assessment system. Secondary outcomes include exercise capacity assessed by the Six-Minute Walk Test (6MWT) and health-related quality of life assessed using the EuroQol Five-Dimension (EQ-5D) questionnaire.

調査の概要

詳細な説明

Stroke is a leading cause of long-term disability worldwide and is frequently associated with persistent impairments in walking ability. Patients with chronic stroke commonly demonstrate reduced gait speed, shorter stride length, impaired gait symmetry, prolonged double-support time, and decreased functional mobility. These gait abnormalities are associated with impaired trunk control, respiratory muscle weakness, reduced exercise tolerance, and diminished quality of life. Although conventional rehabilitation improves motor function, many patients continue to experience limitations in walking performance.

Inspiratory muscle training (IMT) has been shown to improve inspiratory muscle strength, pulmonary function, exercise capacity, and trunk stability in individuals with neurological disorders. Functional inspiratory muscle training (F-IMT) integrates inspiratory muscle training with functional rehabilitation exercises, allowing simultaneous activation of respiratory and postural muscles during task-oriented activities. This integrated approach may enhance motor control and walking performance beyond conventional IMT alone.

This study is a prospective, single-center, randomized controlled trial involving 60 participants with chronic stroke. Eligible participants will be randomly allocated in a 1:1 ratio to one of two intervention groups. The intervention group will receive functional inspiratory muscle training using a Threshold IMT device integrated with functional rehabilitation exercises at an intensity of 50% of maximal inspiratory pressure (MIP), five sessions per week for 8 weeks. The control group will receive conventional inspiratory muscle training using the same device, training intensity, frequency, and duration without integration into functional activities. Both groups will receive an identical standardized conventional rehabilitation program throughout the intervention period.

The primary outcome will be changes in spatiotemporal gait parameters measured using the STEADYS gait assessment system, including gait speed, cadence, stance time, swing time, double-support time, and stride length. Secondary outcomes will include functional exercise capacity measured using the Six-Minute Walk Test (6MWT) and health-related quality of life measured using the EuroQol Five-Dimension (EQ-5D) questionnaire. Outcome assessments will be performed at baseline and after completion of the 8-week intervention.

The findings of this trial will provide evidence regarding the effectiveness of functional inspiratory muscle training as an adjunct to conventional rehabilitation for improving gait performance, exercise capacity, and quality of life in individuals with chronic stroke.

研究の種類

介入

入学 (推定)

60

段階

  • 適用できない

連絡先と場所

このセクションには、調査を実施する担当者の連絡先の詳細と、この調査が実施されている場所に関する情報が記載されています。

研究連絡先

参加基準

研究者は、適格基準と呼ばれる特定の説明に適合する人を探します。これらの基準のいくつかの例は、人の一般的な健康状態または以前の治療です。

適格基準

就学可能な年齢

  • 大人
  • 高齢者

健康ボランティアの受け入れ

いいえ

説明

Inclusion Criteria:

  • Patients aged between 55 and 65 years.
  • Both male and female participants.
  • Chronic stroke patients (>6 months after stroke onset), including ischemic or hemorrhagic stroke confirmed by neuroimaging.
  • Moderate gait impairment with gait speed ranging from 0.4 to 0.8 m/s.
  • Ability to understand instructions and communicate sufficiently to participate in the study procedures.
  • Breathing spontaneously without ventilatory support.
  • No thoracic or abdominal surgery within the previous 6 months.
  • No facial palsy, or mild facial palsy without limitation of labial occlusion.
  • Ability to walk independently for at least 10 meters with or without an assistive device.
  • Willingness to participate and provide written informed consent.

Exclusion Criteria:

  • Unstable cardiovascular disease (e.g., recent myocardial infarction, uncontrolled hypertension, decompensated heart failure).
  • Uncontrolled metabolic disease or poorly controlled diabetes mellitus.
  • Severe pulmonary disease or respiratory impairment (e.g., severe COPD, hypoxemia, chronic cough, or sputum retention).
  • Active malignancy.
  • Presence of nasal feeding tube, tracheostomy tube, or any condition preventing implementation of the study procedures.
  • Severe musculoskeletal disorders affecting gait performance (e.g., lower limb fracture, severe osteoarthritis, or amputation).
  • Significant cognitive or communication impairment preventing reliable participation.
  • Severe spasticity (Modified Ashworth Scale >3) or fixed contractures.
  • Other neurological disorders affecting gait (e.g., Parkinson's disease, multiple sclerosis, spinal cord injury).
  • Severe obesity (BMI ≥35 kg/m²) that may interfere with gait assessment or exercise performance.
  • Previous participation in inspiratory muscle training programs.

研究計画

このセクションでは、研究がどのように設計され、研究が何を測定しているかなど、研究計画の詳細を提供します。

研究はどのように設計されていますか?

デザインの詳細

  • 主な目的:処理
  • 割り当て:ランダム化
  • 介入モデル:並列代入
  • マスキング:独身

武器と介入

参加者グループ / アーム
介入・治療
実験的:Functional Inspiratory Muscle Training Group
Participants will receive functional inspiratory muscle training combined with a standardized conventional rehabilitation program. Functional inspiratory muscle training integrates inspiratory muscle loading with functional activities and will be performed using the Threshold IMT device at 50% of maximal inspiratory pressure (MIP), 5 days per week for 8 weeks. Each session will last approximately 30 minutes (3 sets of 10-15 repetitions). Participants will also receive conventional rehabilitation including range of motion exercises, muscle tone management, strengthening and endurance training, transfer training, task-oriented activities, gait training, and activities of daily living training.
Functional inspiratory muscle training combines inspiratory muscle loading with functional activities to improve respiratory muscle performance, trunk stability, and functional mobility. Training will be performed at 50% of maximal inspiratory pressure using a Threshold IMT device for 30 minutes per session, 5 days per week, for 8 weeks.
アクティブコンパレータ:Conventional Inspiratory Muscle Training Group
Participants will receive conventional inspiratory muscle training combined with the same standardized conventional rehabilitation program. Inspiratory muscle training will be performed using the Threshold IMT device at 50% of maximal inspiratory pressure (MIP), 5 days per week for 8 weeks. Each session will last approximately 30 minutes (3 sets of 10-15 repetitions). The conventional rehabilitation program will include range of motion exercises, muscle tone management, strengthening and endurance training, transfer training, task-oriented activities, gait training, and activities of daily living training.
Conventional inspiratory muscle training will be performed using a Threshold IMT device at 50% of maximal inspiratory pressure for 30 minutes per session, 5 days per week, for 8 weeks.

この研究は何を測定していますか?

主要な結果の測定

結果測定
メジャーの説明
時間枠
Change in Gait Speed
時間枠:Time Frame: Baseline (Day 1) and end of Week 8
Gait speed assessed using the STEADYS gait assessment system and reported in meters per second (m/s).
Time Frame: Baseline (Day 1) and end of Week 8
Change in Cadence
時間枠:Baseline (Day 1) and end of Week 8
Cadence assessed using the STEADYS gait assessment system and reported in steps per minute (steps/min).
Baseline (Day 1) and end of Week 8
Change in Stance Time
時間枠:Baseline (Day 1) and end of Week 8
Stance time assessed using the STEADYS gait assessment system and reported as a percentage (%) of the gait cycle.
Baseline (Day 1) and end of Week 8
Change in Swing Time
時間枠:Baseline (Day 1) and end of Week 8
Swing time assessed using the STEADYS gait assessment system and reported as a percentage (%) of the gait cycle.
Baseline (Day 1) and end of Week 8
Change in Double Support Time
時間枠:Baseline (Day 1) and end of Week 8
Double support time assessed using the STEADYS gait assessment system and reported as a percentage (%) of the gait cycle.
Baseline (Day 1) and end of Week 8
Change in Stride Length
時間枠:Baseline (Day 1) and end of Week 8
Stride length assessed using the STEADYS gait assessment system and reported in meters (m).
Baseline (Day 1) and end of Week 8

二次結果の測定

結果測定
メジャーの説明
時間枠
Change in Functional Exercise Capacity
時間枠:Baseline (Day 1) and end of Week 8
Functional exercise capacity assessed using the Six-Minute Walk Test (6MWT). The outcome is the total distance walked during 6 minutes, reported in meters (m). Higher values indicate better functional exercise capacity.
Baseline (Day 1) and end of Week 8
Change in Health-Related Quality of Life
時間枠:Baseline (Day 1) and end of Week 8
Health-related quality of life assessed using the EuroQol Five-Dimension Five-Level Questionnaire (EQ-5D-5L). The EQ-5D-5L Index Score ranges from less than 0 (health states worse than death) to 1.0 (perfect health). Higher scores indicate better health-related quality of life.
Baseline (Day 1) and end of Week 8

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研究記録日

これらの日付は、ClinicalTrials.gov への研究記録と要約結果の提出の進捗状況を追跡します。研究記録と報告された結果は、国立医学図書館 (NLM) によって審査され、公開 Web サイトに掲載される前に、特定の品質管理基準を満たしていることが確認されます。

主要日程の研究

研究開始 (推定)

2026年8月1日

一次修了 (推定)

2026年12月1日

研究の完了 (推定)

2026年12月20日

試験登録日

最初に提出

2026年7月16日

QC基準を満たした最初の提出物

2026年7月21日

最初の投稿 (実際)

2026年7月27日

学習記録の更新

投稿された最後の更新 (実際)

2026年7月27日

QC基準を満たした最後の更新が送信されました

2026年7月21日

最終確認日

2026年7月1日

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