Fourth Physical Medicine & Rehabilitation Clinic, Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey.
Clin Rehabil. 2010 Mar;24(3):240-50. doi: 10.1177/0269215509358932. Epub 2010 Feb 15.
OBJECTIVE: To determine whether two types of exercise--breathing retraining (BRT) and inspiratory muscle training (IMT)--improve on cardiopulmonary functions and exercise tolerance in patients with stroke. DESIGN: A randomized controlled trial. SETTING: Education and research hospital. SUBJECTS: Forty-five inpatients with stroke (24 men, 21 women) were recruited for the study. The subjects were randomized into three groups: 15 assigned to receive inspiratory muscle training (IMT); 15 assigned to received breathing retraining, diaphragmatic breathing and pursed-lips breathing (BRT); 15 assigned to a control group. INTERVENTIONS: All study groups participated in a conventional stroke rehabilitation programme. For the same period, the IMT and BRT groups trained daily, six times a week, with each session consisting of one half-hour of training for six weeks. MAIN MEASURES: Each subject underwent pulmonary function and cardiopulmonary exercise tests. Subjects were also assessed for exertional dyspnoea, stages of motor recovery, ambulation status, activity of daily living and quality of life. RESULTS: After the training programme, the IMT group had significantly improved forced expiratory volume at 1 second (FEV(1)), forced vital capacity (FVC), vital capacity (VC), forced expiratory flow rate 25-75% (FEF 25-75%) and maximum voluntary ventilation (MVV) values compared with the BRT and control groups, although there were no significant differences between the BRT and control groups (P<0.01). Peak expiratory flow rate (PEF) value was increased significantly in the BTR group compared with the IMT and control groups. The IMT group also had significantly higher peak oxygen consumption (Vo(2peak)) than the BRT and control groups, although there were no significant differences between the BRT and control groups (P<0.001). There was a statistically significant increase in maximum inspiratory pressure (PI(max)) and maximum inspiratory and expiratory pressure (PE(max)) in the BRT group and, PI(max) in the IMT group compared with baseline and the control group. In the IMT group, this was associated with improvements in exercise capacity, sensation of dyspnoea and quality of life. CONCLUSIONS: Significant short-term effects of the respiratory muscle training programme on respiratory muscle function, exercise capacity and quality of life were recorded in this study.
目的：确定两种类型的运动——呼吸训练（BRT）和吸气肌训练（IMT）是否能改善中风患者的心肺功能和运动耐量。
设计：随机对照试验。
地点：教育和研究医院。
对象：45 名住院中风患者（24 名男性，21 名女性）被纳入研究。这些患者被随机分为三组：15 名接受吸气肌训练（IMT）；15 名接受呼吸训练、膈式呼吸和缩唇呼吸（BRT）；15 名对照组。
干预措施：所有研究组均参加常规中风康复计划。同时，IMT 和 BRT 组每周训练 6 次，每次训练 6 周，每次训练 30 分钟。
主要测量指标：每位患者均进行肺功能和心肺运动试验。患者还进行运动性呼吸困难、运动恢复阶段、步行状态、日常生活活动和生活质量评估。
结果：经过培训计划，与 BRT 和对照组相比，IMT 组的 1 秒用力呼气量（FEV1）、用力肺活量（FVC）、肺活量（VC）、25-75%用力呼气流量（FEF25-75%）和最大自主通气量（MVV）值显著提高，尽管 BRT 组和对照组之间没有显著差异（P<0.01）。与 IMT 和对照组相比，BRT 组的呼气峰流速（PEF）值显著增加。与 BRT 和对照组相比，IMT 组的峰值摄氧量（Vo2peak）也显著升高，尽管 BRT 组和对照组之间没有显著差异（P<0.001）。与基线和对照组相比，BRT 组的最大吸气压力（PI(max)）和最大吸气和呼气压力（PE(max)）显著增加，IMT 组的 PI(max)也显著增加。在 IMT 组中，这与运动能力、呼吸困难感和生活质量的改善有关。
结论：本研究记录了呼吸肌训练方案对呼吸肌功能、运动能力和生活质量的短期显著影响。
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