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呼吸训练联合膈神经电刺激对近期脑卒中患者肺功能和躯干功能的影响

Impact of respiratory training combined with electrical phrenic nerve stimulation on pulmonary and trunk function in individuals who have recently experienced a stroke.

作者信息

Sui Yan-Fang, Song Zhen-Hua, Shi Jing-Qin, Wang Shan-Shan, Li Bin-Bin, Tong Liang-Qian

机构信息

Department of Rehabilitation Medicine, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China.

Department of Nuclear Medicine, Affiliated Haikou Hospital of Xiangya Medical College, Central South University, Haikou, China.

出版信息

Front Neurol. 2025 Jun 17;16:1579421. doi: 10.3389/fneur.2025.1579421. eCollection 2025.

Abstract

OBJECTIVE

This study aims to explore the effects of combining phrenic nerve electrical stimulation with respiratory training on pulmonary and trunk function in post-stroke individuals. Rationale for combining these interventions stems from the diaphragm's dual role in respiration and postural control, as well as the limitations of conventional respiratory training in addressing phrenic nerve dysfunction and impaired diaphragm coordination after stroke.

METHODS

In this single-blinded randomized controlled trial, 160 early stroke patients were randomly assigned via computer-generated random number tables with allocation concealment using sealed opaque envelopes to a control group receiving standard therapy and an experimental group receiving additional phrenic nerve stimulation and breathing training. Each group comprised 80 patients. To evaluate the trunk function and balance before and after the treatment, the Sheikh Trunk Control Scale, Berg Balance Scale (BBS), and Balance Feedback Training Device were utilized. Additionally, pulmonary function was assessed using a pulmonary function measuring instrument.

RESULTS

Following 4 weeks of treatment, there was a statistically significant enhancement in the Sheikh Trunk Control Scale and BBS scores, respiratory muscle strength index, and peak inspiratory flow rate for patients in both groups ( < 0.05). Additionally, there were significant reductions in measures related to balance, including movement length, movement area, as well as mean anterior-posterior and left-right movement speeds ( < 0.05). Consequently, after the 4-week treatment period, the trunk function and balance, pulmonary function all improved in the experimental group.

CONCLUSION

Combining phrenic nerve stimulation with respiratory training can effectively improve lung and core functions during post-stroke rehabilitation. However, generalizability is limited by the short follow-up period and strict exclusion criteria. Future research should explore long-term outcomes and compare combined interventions with standalone therapies.

摘要

目的

本研究旨在探讨膈神经电刺激联合呼吸训练对脑卒中患者肺功能和躯干功能的影响。将这些干预措施相结合的理论依据源于膈肌在呼吸和姿势控制中的双重作用,以及传统呼吸训练在解决脑卒中后膈神经功能障碍和膈肌协调受损方面的局限性。

方法

在这项单盲随机对照试验中,160例早期脑卒中患者通过计算机生成的随机数字表随机分配,使用密封不透明信封进行分配隐藏,分为接受标准治疗的对照组和接受额外膈神经刺激及呼吸训练的实验组。每组包括80例患者。为了评估治疗前后的躯干功能和平衡,使用了谢赫躯干控制量表、伯格平衡量表(BBS)和平衡反馈训练装置。此外,使用肺功能测量仪器评估肺功能。

结果

治疗4周后,两组患者的谢赫躯干控制量表和BBS评分、呼吸肌力量指数以及吸气峰值流速均有统计学意义的提高(<0.05)。此外,与平衡相关的指标,包括移动长度、移动面积以及前后和左右平均移动速度均有显著降低(<0.05)。因此,在4周治疗期后,实验组的躯干功能和平衡、肺功能均得到改善。

结论

膈神经刺激联合呼吸训练可有效改善脑卒中后康复期间的肺功能和核心功能。然而,随访期短和严格的排除标准限制了研究结果的普遍性。未来的研究应探索长期结果,并将联合干预与单一疗法进行比较。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c13/12209256/c4c541e50bd7/fneur-16-1579421-g001.jpg

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