Effect of high-intensity home-based respiratory muscle training on strength of respiratory muscles following a stroke: a protocol for a randomized controlled trial

• Published in: Revista brasileira de fisioterapia (São Carlos (São Paulo, Brazil)) Vol. 21; no. 5; pp. 372 - 377
• Main Authors: Menezes, Kênia Kiefer Parreiras De, Nascimento, Lucas Rodrigues, Polese, Janaine Cunha, Ada, Louise, Teixeira-Salmela, Luci Fuscaldi
• Format: Journal Article
• Language: English
• Published: Brazil Elsevier Editora Ltda 01.09.2017; Departamento de Fisioterapia da Universidade Federal de Sao Carlos
• Subjects: Breathing Exercises; Clinical trial; Clinical Trial Protocol; Gait; Humans; Muscle strength; Muscle Strength - physiology; Rehabilitation; Respiratory Muscles - physiology; Stroke; Stroke - physiopathology; Walking - physiology; Clinical trial; Stroke; Breathing exercises; Muscle strength; Rehabilitation; Gait
• ISSN: 1413-3555; 1809-9246
• DOI: 10.1016/j.bjpt.2017.06.017

•High-intensity respiratory muscle training may improve neurological rehabilitation.•Gains in respiratory muscle strength are expected to be clinically meaningful.•If benefits are carried over to activity, community participation may be enhanced.•If benefits include reduction in hospital admissions, treatment costs may be reduced. Respiratory muscle training has shown to increase strength of the respiratory muscles following a stroke. However, low duration and/or intensity of training may be responsible for the small effect size seen and/or absence of carry-over effects to an activity, e.g., walking. Therefore, an investigation of the effects of long-duration, high-intensity respiratory muscle training is warranted. This proposed protocol for a randomized clinical trial will examine the efficacy of high-intensity respiratory muscle training to increase strength and improve activity following a stroke. This study will be a two-arm, prospectively registered, randomized controlled trial, with blinded assessors. Thirty-eight individuals who have suffered a stroke will participate. The experimental group will undertake a 40-min of respiratory muscle training program, seven days/week, for eight weeks in their homes. Training loads will be increased weekly. The control group will undertake a sham respiratory muscle training program with equivalent duration and scheduling of training. The primary outcome will be the strength of the inspiratory muscles, measured as maximal inspiratory pressure. Secondary outcomes will include expiratory muscle strength, inspiratory muscle endurance, dyspnea, respiratory complications, and walking capacity. Outcomes will be collected by a researcher blinded to group allocation at baseline (Week 0), after intervention (Week 8), and one month beyond intervention (Week 12). High-intensity respiratory muscle training may have the potential to optimize the strength of the respiratory muscles following a stroke. If benefits are carried over to activity, the findings may have broader implications, since walking capacity has been shown to predict physical activity and community participation on this population.