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慢性卒中幸存者的呼吸肌力量及其与6分钟步行试验的关系。

Respiratory Muscle Strength in Chronic Stroke Survivors and Its Relation With the 6-Minute Walk Test.

作者信息

Lista Paz Ana, González Doniz Luz, Ortigueira García Serafín, Saleta Canosa Jesús Luis, Moreno Couto Christian

机构信息

Faculty of Physiotherapy, University of A Coruña, A Coruña, Spain.

Faculty of Physiotherapy, University of A Coruña, A Coruña, Spain.

出版信息

Arch Phys Med Rehabil. 2016 Feb;97(2):266-72. doi: 10.1016/j.apmr.2015.10.089. Epub 2015 Oct 28.

Abstract

OBJECTIVES

To compare respiratory muscle strength in stroke survivors (SS) with that in a control group (CG) of healthy people matched by age and sex, as well as to investigate any relation between respiratory muscle strength and the distance walked during the 6-minute walk test (6MWT).

DESIGN

Cross-sectional study.

SETTING

This study comprised patients from a private neurological rehabilitation center and a public association for patients with acquired brain injury.

PARTICIPANTS

Chronic SS with a diagnosis of hemiplegia/hemiparesis who were able to walk (n=30) and healthy individuals matched by sex and age (n=30) (N=60).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Respiratory muscle strength was assessed using maximal expiratory pressure (MEP) and maximal inspiratory pressure (MIP) with a pressure transducer and a diver nozzle. The distance walked during the 6MWT was also registered for both groups. The motricity index and the Scale Impact of Stroke version 16.0 were also measured in SS.

RESULTS

The Student t test revealed significantly lower values of MIP and MEP in SS than in the CG (MEP, 95.93±43.12cmH2O in SS vs 158.43±41.6cmH2O in the CG; MIP, 58.7±24.67cmH2O in SS vs 105.7±23.14cmH2O in the CG; P<.001). Moreover, these findings were clinically relevant because both MIP and MEP in SS were <60% of the predicted values. A positive correlation between the 6MWT and MIP was found using the Pearson coefficient (r=.43; P<.018).

CONCLUSIONS

Respiratory muscle weakness should be considered in a holistic approach to stroke rehabilitation.

摘要

目的

比较中风幸存者(SS)与年龄和性别相匹配的健康对照组(CG)的呼吸肌力量,并研究呼吸肌力量与6分钟步行试验(6MWT)中行走距离之间的关系。

设计

横断面研究。

地点

本研究包括来自一家私立神经康复中心和一个后天性脑损伤患者公共协会的患者。

参与者

诊断为偏瘫/轻偏瘫且能够行走的慢性SS患者(n = 30)以及年龄和性别相匹配的健康个体(n = 30)(N = 60)。

干预措施

不适用。

主要观察指标

使用压力传感器和潜水喷嘴通过最大呼气压力(MEP)和最大吸气压力(MIP)评估呼吸肌力量。两组均记录6MWT期间的行走距离。还对SS患者测量了运动指数和中风影响量表第16.0版。

结果

Student t检验显示,SS患者的MIP和MEP值显著低于CG(MEP:SS患者为95.93±43.12cmH2O,CG患者为158.43±41.6cmH2O;MIP:SS患者为58.7±24.67cmH2O,CG患者为105.7±23.14cmH2O;P <.001)。此外,这些发现具有临床相关性,因为SS患者的MIP和MEP均<预测值的60%。使用Pearson系数发现6MWT与MIP之间存在正相关(r =.43;P <.018)。

结论

在中风康复的整体方法中应考虑呼吸肌无力。

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