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[吸气肌训练对脑卒中幸存者呼吸功能和平衡的影响:一项随机对照试验]

[Effects of inspiratory muscle training on respiratory function and balance in stroke survivors: a randomized controlled trial].

作者信息

Tovar-Alcaraz A, de Oliveira-Sousa S L, León-Garzón M C, González-Carrillo M J

机构信息

Hospital Universitario Virgen del Arrixaca, El Palmar, España.

Universidad Católica de Murcia, Murcia, España.

出版信息

Rev Neurol. 2021 Feb 16;72(4):112-120. doi: 10.33588/rn.7204.2020532.

Abstract

INTRODUCTION

After a stroke, patients with hemiparesis and / or hemiplegia will present a notable asymmetry of the trunk and pelvis, and decreased postural stability and balance, affecting, consequently, respiratory function.

OBJECTIVE

The objective of this study is to analyze the effects of inspiratory muscle training (IMT) on lung function, inspiratory muscle strength, postural and trunk control and balance in stroke survivors in the subacute phase.

MATERIALS AND METHODS

16 survivors of stroke in the subacute phase participated in RCT (experimental = 8; placebo = 8). The experimental group received IMT program, 5 days a week, once a day, for 8 weeks, with a progressive intensity from 15% to 60% of the PImax. The placebo group performed the same program, but with a fixed load of 7cmH20. Inspiratory muscle strength (PImax), lung function (FVC, FEV1, PEF, VMV), trunk control (TCT), and postural control and balance (PASS and Berg Scale) were evaluated.

RESULTS

Experimental and placebo groups showed significant increases in PImax, with a difference between groups. There was a moderate and negative correlation between the initial PImax value and the percentage change (?PImax) (r = -0.572; p = 0.021). Significant increases in VMV (l/m) were observed in the experimental group, and increases in PASS in both groups, but without significant differences between groups.

CONCLUSIONS

Inspiratory muscle training, although low intensity, is effective in improving inspiratory muscle strength in stroke survivors. However, the effects on postural control and balance remain uncertain.

摘要

引言

中风后,偏瘫和/或半身不遂的患者会出现明显的躯干和骨盆不对称,姿势稳定性和平衡能力下降,从而影响呼吸功能。

目的

本研究的目的是分析吸气肌训练(IMT)对亚急性期中风幸存者的肺功能、吸气肌力量、姿势和躯干控制以及平衡的影响。

材料与方法

16名亚急性期中风幸存者参与了随机对照试验(实验组=8;安慰剂组=8)。实验组接受IMT计划,每周5天,每天1次,共8周,强度从最大吸气压(PImax)的15%逐渐增加到60%。安慰剂组执行相同的计划,但负荷固定为7cmH20。评估吸气肌力量(PImax)、肺功能(用力肺活量FVC、第1秒用力呼气量FEV1、呼气峰值流速PEF、每分钟通气量VMV)、躯干控制(TCT)以及姿势控制和平衡(姿势评估量表PASS和伯格平衡量表)。

结果

实验组和安慰剂组的PImax均显著增加,两组之间存在差异。初始PImax值与变化百分比(ΔPImax)之间存在中度负相关(r=-0.572;p=0.021)。实验组的VMV(升/分钟)显著增加,两组的PASS均增加,但两组之间无显著差异。

结论

吸气肌训练虽然强度较低,但对改善中风幸存者的吸气肌力量有效。然而,对姿势控制和平衡的影响仍不确定。

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