Abstract 2394: A Systematic Review of Respiratory Muscle Training in Stroke and Neurological Diseases
Background: Respiratory muscle weakness in stroke patients may contribute to increased risk of pneumonias. We undertook a meta-analysis of randomised controlled trials (RCT) of respiratory muscle training (RMT) to investigate their benefit in stroke patients.
Method: A literature search for relevant articles was performed on Medline, EMBASE, ISI web of knowledge and the Cochrane Central Register for Controlled Trials. Key words searched were stroke, cerebrovascular accident, multiple sclerosis, Parkinson’s disease, motor neurone disease and neurolog* in combination with inspiratory, expiratory, respiratory or ventilatory and training, loading and muscle. Studies were assessed for quality and analyses were undertaken following Cochrane guidelines. The primary outcome measure of muscle strength was the maximum inspiratory mouth pressure (PImax).
Results: The search identified 1140 articles of which 34 remained after screening aganist pre-defined criteria and removal of duplicates. Of these 25 were excluded because 17 were not RCTs, 1 did not assess PI max and 7 investigated children. A total of 103 patients were included in the 9 eligible studies (2 stroke, 7 other neurological diseases). PImax was greater in patients receiving respiratory muscle training compared with controls at the end of training (WMD 6.94 cmH2O, 95% CI 2.84 - 11.04, P = 0.0009). The 2 studies in stroke patients included only 24 patients but showed a definite benefit in improving respiratory muscle strength (WMD for PI max 6.93 cmH2O, 95% CI 1.76 12.09, P = 0.009). (Fig 1)
Conclusion: Large trials of RMT in stroke are lacking but there is a suggestion that stroke patients have a potential to benefit. Large well designed studies are needed to evaluate the effectiveness of RMT for improving respiratory muscle strength and clinical outcomes in stroke patients.
- © 2012 by American Heart Association, Inc.