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 c...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.展开更多
Objective To evaluate the feasibility and safety of Liuzijue exercise(LE)for the clinical effect in patients after cardiac surgery.Methods Totally 120 patients who underwent cardiac surgery and were admitted to the Ca...Objective To evaluate the feasibility and safety of Liuzijue exercise(LE)for the clinical effect in patients after cardiac surgery.Methods Totally 120 patients who underwent cardiac surgery and were admitted to the Cardiothoracic Intensive Care Unit of Nanjing Drum Tower Hospital between July and Oclober,2022 were allocated to the LE group,the conventional respiratory training(CRT)group,and the control group by a random number table at a ratio of 1:1:1;40 patients in each group.All patients received routine treatment and cardiac rehabilitation.LE group and CRT group respectively performed LE and CRT once a day for 30 min for 7 days.Control group did not receive specialized respiratory training.The forced vital capacity,forced expiratory volume in 1 s,peak inspiratory flow rate,peak expiratory flow rate,maximum inspiratory pressure,maximum expiratory pressure,modified Barthel index(MBI),and Hamilton Rating Scale for Anxiety(HAM-A)were evaluated before,after 3 and 7 days of intervention.In addition,the postoperative length of hospital stay(LOS)and the adverse events that occurred during the intervention period were compared.Results A total of 107 patients completed the study,120 patients were included in the analysis.After 3 days of intervention,the pulmonary function,respiratory muscle strength,MBI and HAM-A of all 3 groups improved compared with that before the intervention(P<0.05 or P<0.01).Compared with the control group,pulmonary function and respiratory muscle strength were significantly improved in the CRT and LE groups(P<0.05 or P<0.01).MBI and HAM-A were significantly improved in the LE group compared with the control and CRT groups(P<0.05 or P<0.01).On the 7th day after intervention,the difference was still statistically significant(P<0.01),and was significantly different from that on the 3rd day(P<0.05 or P<0.01).In addition,on the 7th day of intervention,the pulmonary function and respiratory muscle strength in the LE group were significantly improved compared with those in the CRT group(P<0.01).MBI and HAM-A were significantly improved in the CRT group compared with the control group(P<0.01).There were no significant differences in postoperative LOS among the 3 groups(P>0.05).No training-related adverse events occurred during the intervention period.Conclusions LE is safe and feasible for improving pulmonary function,respiratory muscle strength,the ability to complete activities of daily living and for relieving anxiety of patients after cardiac surgery(Registration No.ChiCTR2200062964).展开更多
基金Scientific Research Project of Hebei Administration of Traditional Chinese Medicine,No.2022307.
文摘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.
基金Supported by Nanjing Drum Tower Hospital Clinical Research Special Fund(No.2022-LCYJ-MS-32)NHC Contraceptives Adverse Reaction Surveillance Center,Jiangsu Health Development Research Center Fund(No.JSHD2021001)。
文摘Objective To evaluate the feasibility and safety of Liuzijue exercise(LE)for the clinical effect in patients after cardiac surgery.Methods Totally 120 patients who underwent cardiac surgery and were admitted to the Cardiothoracic Intensive Care Unit of Nanjing Drum Tower Hospital between July and Oclober,2022 were allocated to the LE group,the conventional respiratory training(CRT)group,and the control group by a random number table at a ratio of 1:1:1;40 patients in each group.All patients received routine treatment and cardiac rehabilitation.LE group and CRT group respectively performed LE and CRT once a day for 30 min for 7 days.Control group did not receive specialized respiratory training.The forced vital capacity,forced expiratory volume in 1 s,peak inspiratory flow rate,peak expiratory flow rate,maximum inspiratory pressure,maximum expiratory pressure,modified Barthel index(MBI),and Hamilton Rating Scale for Anxiety(HAM-A)were evaluated before,after 3 and 7 days of intervention.In addition,the postoperative length of hospital stay(LOS)and the adverse events that occurred during the intervention period were compared.Results A total of 107 patients completed the study,120 patients were included in the analysis.After 3 days of intervention,the pulmonary function,respiratory muscle strength,MBI and HAM-A of all 3 groups improved compared with that before the intervention(P<0.05 or P<0.01).Compared with the control group,pulmonary function and respiratory muscle strength were significantly improved in the CRT and LE groups(P<0.05 or P<0.01).MBI and HAM-A were significantly improved in the LE group compared with the control and CRT groups(P<0.05 or P<0.01).On the 7th day after intervention,the difference was still statistically significant(P<0.01),and was significantly different from that on the 3rd day(P<0.05 or P<0.01).In addition,on the 7th day of intervention,the pulmonary function and respiratory muscle strength in the LE group were significantly improved compared with those in the CRT group(P<0.01).MBI and HAM-A were significantly improved in the CRT group compared with the control group(P<0.01).There were no significant differences in postoperative LOS among the 3 groups(P>0.05).No training-related adverse events occurred during the intervention period.Conclusions LE is safe and feasible for improving pulmonary function,respiratory muscle strength,the ability to complete activities of daily living and for relieving anxiety of patients after cardiac surgery(Registration No.ChiCTR2200062964).
