Effects of respiratory muscle training on post-stroke rehabilitation: A systematic review and meta-analysis

I can't figure out what respiratory muscle training is. So go ask your doctor is the instruction in these books better:

'Breath: The New Science of a Lost Art' by James Nestor.

Or;

'The Oxygen Advantage: Simple, Scientifically Proven Breathing Techniques to Help You Become Healthier, Slimmer, Faster, and Fitter' by Patrick McKeown.

 Effects of respiratory muscle training on post-stroke rehabilitation: A systematic review and meta-analysis

Yong-Tao Liu, Xiao-Xin Liu, Yi-Qing Liu, Lei Zhang, Lin-Jing Zhang, Jian-Hua Wang, Yan Shi, Qing-Fan Xie Yong-Tao Liu, Lin-Jing Zhang, Jian-Hua Wang, Yan Shi, Qing-Fan Xie, Department of Rehabilitation, Xingtai People's Hospital, Xingtai 054001, Hebei Province, China Xiao-Xin Liu, Ophthalmologist Clinic, Xingtai People's Hospital, Xingtai 054001, Hebei Province, China Yi-Qing Liu, Department of Cardiology, Xingtai People's Hospital, Xingtai 054001, Hebei Province, China Lei Zhang, Department of Ultrasound, Xingtai People's Hospital, Xingtai 054001, Hebei Province, China ORCID number: Qing-Fan Xie (0009-0009-4134-0101). Author contributions: Liu YT contributed to the conception of the study; Liu YT and Liu XX contributed significantly to the literature search, data analyses, and manuscript preparation; Liu YQ, Shi Y, and Zhang L contributed to improving the article for language and style; Zhang LJ and Wang JH helped perform the analysis with constructive discussions; and Xie QF revised the manuscript and approved the final version. Supported by Scientific Research Project of Hebei Administration of Traditional Chinese Medicine, No. 2022307. Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article. PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised in accordance with this checklist. Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Qing-Fan Xie, MBBS, Doctor, Department of Rehabilitation, Xingtai People's Hospital, No. 818 Xiangdu North Road, Xingtai 054001, Hebei Province, China. jqf190525@126.com Received: April 15, 2024 Revised: May 13, 2024 Accepted: May 27, 2024 Published online: July 16, 2024 Processing time: 76 Days and 19.8 Hours 

 

Abstract 

 

BACKGROUND 

 

Stroke often results in significant respiratory dysfunction in patients. Respiratory muscle training (RMT) has been proposed as a rehabilitative intervention to address these challenges, but its effectiveness compared to routine training remains debated. This systematic review and meta-analysis aim to evaluate the effects of RMT on exercise tolerance, muscle strength, and pulmonary function in post-stroke patients. AIM To systematically assess the efficacy of RMT in improving exercise tolerance, respiratory muscle strength, and pulmonary function in patients recovering from a stroke, and to evaluate whether RMT offers a significant advantage over routine training modalities in enhancing these critical health outcomes in the post-stroke population. 

 

METHODS 

 

Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines, a comprehensive search across PubMed, Embase, Web of Science, and the Cochrane Library was conducted on October 19, 2023, without temporal restrictions. Studies were selected based on the predefined inclusion and exclusion criteria focusing on various forms of RMT, control groups, and outcome measures [including forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), maximal voluntary ventilation (MVV), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), and 6-min walking test (6MWT)]. Only randomized controlled trials (RCTs) were included. Data extraction and quality assessment were conducted independently by two reviewers using the Cochrane Collaboration's risk of bias tool. Statistical analyses, including those using the fixed-effect and random-effects models, sensitivity analysis, and publication bias assessment, were performed using Review Manager software. 

 

RESULTS 

 

A total of 15 RCTs were included. Results indicated significant improvements in MIP (12.51 cmH2O increase), MEP (6.24 cmH2O increase), and various pulmonary function parameters (including FEV1, FVC, MVV, and PEF). A substantial increase in 6MWT distance (22.26 meters) was also noted. However, the heterogeneity among studies was variable, and no significant publication bias was detected. 

 

CONCLUSION 

 

RMT significantly enhances walking ability, respiratory muscle strength (MIP and MEP), and key pulmonary function parameters (FEV1, FVC, MVV, and PEF) in post-stroke patients. These findings support the incorporation of RMT into post-stroke rehabilitative protocols. 

 

Key Words: Respiratory muscle training, Stroke rehabilitation, Pulmonary function, Exercise tolerance, Meta-analysis Core Tip: Our research aimed to contribute to the ongoing discourse regarding the efficacy of respiratory muscle training (RMT) in enhancing rehabilitation outcomes for post-stroke patients. By systematically analyzing data from 15 randomized controlled trials, our meta-analysis provided compelling evidence that RMT significantly improves respiratory muscle strength, pulmonary function, and walking ability in this patient population. These findings hold considerable potential to impact clinical practices and stroke rehabilitation protocols. Citation: Liu YT, Liu XX, Liu YQ, Zhang L, Zhang LJ, Wang JH, Shi Y, Xie QF. Effects of respiratory muscle training on post-stroke rehabilitation: A systematic review and meta-analysis. World J Clin Cases 2024; 12(20): 4289-4300 URL: https://www.wjgnet.com/2307-8960/full/v12/i20/4289.htm DOI: https://dx.doi.org/10.12998/wjcc.v12.i20.4289

Liu YT, Liu XX, Liu YQ, Zhang L, Zhang LJ, Wang JH, Shi Y, Xie QF. Effects of respiratory muscle training on post-stroke rehabilitation: A systematic review and meta-analysis. World J Clin Cases 2024; 12(20): 4289-4300 [DOI: 10.12998/wjcc.v12.i20.4289]