Effects of cardiorespiratory physiotherapy on lung function in stroke: a network meta-analysis.

Area of Science:

• Pulmonary Rehabilitation
• Cardiorespiratory Physiotherapy
• Stroke Recovery

Background:

• The comparative efficacy of diverse physiotherapy interventions for enhancing lung function remains underexplored.
• Stroke patients often experience compromised respiratory function, necessitating effective rehabilitation strategies.

Purpose of the Study:

• To compare cardiorespiratory physiotherapy interventions for improving lung function in stroke patients.
• To prioritize and establish a hierarchy of intervention effectiveness.
• To guide clinical decision-making in stroke rehabilitation.

Main Methods:

• A systematic review and meta-analysis of 12 randomized controlled trials (2000-2022).
• Interventions included aerobic training (AT), combined inspiratory and expiratory training (CIET), inspiratory training (IT), combined aerobic and breath training (CABT), and conventional training (CT).
• Primary outcomes were forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and the FEV1/FVC ratio.

Main Results:

• Inspiratory training (IT) and combined inspiratory-expiratory training (CIET) demonstrated superior efficacy over conventional training (CT) for FEV1 and FVC.
• IT and CIET showed greater effect sizes for FEV1 compared to aerobic training (AT).
• Intervention rankings for FEV1: IT (86.62%), CIET (63.31%), CABT (50.79%), AT (28.72%), CT (20.55%). Rankings for FVC: IT (93.89%), CIET (75.06%), CT (42.38%), CABT (37.73%), AT (0.94%).

Conclusions:

• Breathing exercises, specifically IT and CIET, significantly enhance lung function (FEV1, FVC) in stroke patients compared to AT and CT.
• CIET and IT were more effective for improving FVC in older stroke patients (≥60 years).
• Findings underscore the importance of targeted breathing training in stroke rehabilitation and support evidence-based clinical practice.