Ezeugwu Victor Emeka, Olaogun Matthew, Mbada Chidozie Emmanuel, Adedoyin Rufus
University of Abuja Teaching Hospital - Physiotherapy, Phase 3 Gwagwalada, Abuja, Federal Capital Territory, 900001, Nigeria.
Physiother Res Int. 2013 Dec;18(4):212-9. doi: 10.1002/pri.1547. Epub 2013 Jan 29.
Reduced endurance and excessive fatigue in stroke survivors (SS) during exercise may be linked to impairment of lung function and breathing mechanics, but little is known about lung function of SS. The purpose of this study is to determine lung function (forced expiratory volume in 1 second [FEV1], forced vital capacity [FVC], FEV1 /FVC ratio and peak expiratory flow [PEF]) and influence of anthropometrics on lung function in SS compared with healthy controls (CG).
In this case-control, cross-sectional study, we recruited 70 participants (42 males, 28 females), comprising 35 SS and 35 CG (range 34-73 years). Anthropometrics were measured using standard instruments and procedure. Chest excursion was measured at the axilla, xiphoid and lower costal levels. Lung function indices were measured using a micro-computerized spirometer. Ethical approval was obtained from the Ethics and Research Committee of Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria.
RESULTS/FINDINGS: Compared with the CG, the SS had significantly lower values for FEV1 (1.99 ± 0.66 vs. 2.36 ± 0.45 L, p = 0.004), FVC (2.55 ± 0.70 vs. 2.90 ± 0.54 L, p = 0.014), PEF (3.88 ± 1.38 vs. 5.24 ± 1.30 L second(-1) , p = 0.001) and chest excursion (3.0 ± 0.71 vs. 3.5 ± 0.91 cm, p = 0.018). Correlations between chest excursion, FEV1 , FVC and PEF were not significant (p > 0.05).
The weakness of respiratory muscles associated with stroke may have contributed to decreases in lung function observed. There was a significant reduction in chest excursion of SS compared with CG. Chest excursion has been used as an indicator of respiratory muscle function because the range of motion of the thorax serves the respiration. Movements of the thorax influence the content of the thorax cavity, leading to alterations in lung volumes.
Stroke survivors have lower lung function when compared with CG; this has implications for clinicians in stroke rehabilitation, underscoring the importance for inclusion of interventions to improve lung function.
中风幸存者（SS）在运动过程中耐力下降和过度疲劳可能与肺功能和呼吸力学受损有关，但对SS的肺功能了解甚少。本研究的目的是确定SS与健康对照组（CG）相比的肺功能（一秒用力呼气量[FEV1]、用力肺活量[FVC]、FEV1/FVC比值和呼气峰值流速[PEF]）以及人体测量学对肺功能的影响。
在这项病例对照横断面研究中，我们招募了70名参与者（42名男性，28名女性），包括35名SS和35名CG（年龄范围34 - 73岁）。使用标准仪器和程序测量人体测量学指标。在腋窝、剑突和肋下缘水平测量胸廓活动度。使用微型计算机化肺活量计测量肺功能指标。获得了尼日利亚伊费奥巴费米·阿沃洛沃大学教学医院伦理与研究委员会的伦理批准。
结果/发现：与CG相比，SS的FEV1（1.99±0.66 vs. 2.36±0.45 L，p = 0.004）、FVC（2.55±0.70 vs. 2.90±0.54 L，p = 0.014）、PEF（3.88±1.38 vs. 5.24±1.30 L·秒⁻¹，p = 0.001）和胸廓活动度（3.0±0.71 vs. 3.5±0.91 cm，p = 0.018）值显著更低。胸廓活动度、FEV1、FVC和PEF之间的相关性不显著（p > 0.05）。
与中风相关的呼吸肌无力可能导致了所观察到的肺功能下降。与CG相比，SS的胸廓活动度显著降低。胸廓活动度已被用作呼吸肌功能的指标，因为胸廓的运动范围服务于呼吸。胸廓的运动影响胸腔内容物，导致肺容量改变。
对物理治疗实践 的启示：与CG相比，中风幸存者的肺功能较低；这对中风康复临床医生有启示意义，强调了纳入改善肺功能干预措施的重要性。
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