Does respiratory muscle training improve cough flow in acute stroke? Pilot randomized controlled trial

Area of Science:

• Neurology
• Pulmonology
• Rehabilitation Medicine

Background:

• Aspiration is a risk following stroke, and cough is a key protective mechanism.
• Respiratory muscle weakness is common after acute stroke, potentially impairing cough effectiveness.
• Investigating interventions to enhance cough function and reduce pneumonia risk is crucial for stroke recovery.

Purpose of the Study:

• To determine if respiratory muscle training improves respiratory muscle strength and cough function in acute stroke patients.
• To assess the potential of respiratory muscle training to reduce the incidence of pneumonia following stroke.

Main Methods:

• A single-blind randomized placebo-controlled trial involving 82 acute stroke patients within 2 weeks of onset.
• Participants were randomized to 4 weeks of daily expiratory, inspiratory, or sham respiratory muscle training.
• Primary outcome was the change in peak expiratory cough flow; intention-to-treat analyses were used.

Main Results:

• All groups showed significant improvements in maximal inspiratory and expiratory mouth pressures and peak expiratory cough flow.
• No significant differences in these measures were found between the respiratory muscle training groups and the sham group.
• The 90-day incidence of pneumonia did not differ between the groups.

Conclusions:

• Respiratory muscle function and cough flow naturally improve over time after acute stroke.
• Additional inspiratory or expiratory respiratory muscle training does not enhance these improvements or reduce pneumonia risk.
• Current respiratory muscle training protocols may not be effective in augmenting post-stroke recovery of cough function.