Alvarenga Maria Tereza M, Menezes Kênia K P, Nascimento Lucas R, Avelino Patrick R, Almeida Tályta L S, Teixeira-Salmela Luci F
NeuroGroup, Department of Physiotherapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte.
Department of Physiotherapy, Fundação Comunitária de Ensino Superior de Itabira (FUNCESI), Itabira, Minas Gerais.
Int J Rehabil Res. 2020 Jun;43(2):135-140. doi: 10.1097/MRR.0000000000000395.
The objective of the present study was to investigate if different levels of inspiratory muscle strength would be associated with dyspnea, walking capacity, and quality of life after stroke. For this exploratory study, the dependent outcome was strength of the inspiratory muscles, measured by maximal inspiratory pressure. Individuals with maximal inspiratory pressure ≥80 cmH2O were classified as non-weak, those with maximal inspiratory pressure between 45 and 80 cmH2O were classified as weak, and those with maximal inspiratory pressure ≤45 cmH2O were classified as very weak. Related outcomes included dyspnea, measured by the modified Medical Research Council scale; walking capacity, measured by the 6-minute walk test; and quality of life, measured by the Stroke-Specific Quality of Life scale. Fifty-three participants, who had a mean age of 62 years (SD 12) and a mean time since the onset of the stroke of 20 (SD 17) months were included. Significant differences were found only between the weak/very weak and non-weak groups. The mean differences between the non-weak and weak/very weak participants were -1.8 points (95% confidence interval -2.7 to -0.9) for dyspnea and 55 points (95% confidence interval 22-88) for quality of life. Significant correlations were found between measures of inspiratory strength and dyspnea (r = -0.54; P < 0.01) and quality of life (r = 0.56; P < 0.01). There were not found any significant differences or correlations regarding walking capacity. The findings demonstrated that individuals with stroke, who had weakness of the inspiratory muscles, reported greater dyspnea and worse quality of life, compared with those, who did not have weakness. The results regarding walking capacity remain unclear.
本研究的目的是调查不同水平的吸气肌力量是否与中风后的呼吸困难、步行能力和生活质量相关。在这项探索性研究中，因变量是吸气肌力量，通过最大吸气压力来测量。最大吸气压力≥80 cmH2O的个体被归类为非虚弱，最大吸气压力在45至80 cmH2O之间的个体被归类为虚弱，最大吸气压力≤45 cmH2O的个体被归类为非常虚弱。相关结果包括通过改良的医学研究委员会量表测量的呼吸困难、通过6分钟步行试验测量的步行能力以及通过卒中特异性生活质量量表测量的生活质量。纳入了53名参与者，他们的平均年龄为62岁（标准差12），中风发作后的平均时间为20（标准差17）个月。仅在虚弱/非常虚弱组和非虚弱组之间发现了显著差异。非虚弱参与者与虚弱/非常虚弱参与者之间的平均差异在呼吸困难方面为-1.8分（95%置信区间-2.7至-0.9），在生活质量方面为55分（95%置信区间22 - 88）。在吸气力量测量与呼吸困难（r = -0.54；P < 0.01）和生活质量（r = 0.56；P < 0.01）之间发现了显著相关性。在步行能力方面未发现任何显著差异或相关性。研究结果表明，与没有吸气肌无力的中风患者相比，有吸气肌无力的中风患者报告的呼吸困难更严重，生活质量更差。关于步行能力的结果仍不明确。
