Respiratory muscle strength in stroke: a case-control study

The study was conducted with 171 patients who had a stroke between 2017 and 2021 and 32 healthy controls. Respiratory muscle strength and inspiratory and expiratory mouth pressure (MIP and MEP) were measured using the portable MicroRPM device (Micro Medical, Basingstoke, UK).

RESULTS:

The stroke group exhibited significantly lower values in both MIP for men (p<0.001) and women (p=0.013) and maximal expiratory pressure for men (p<0.001) and women (p=0.042), compared with the healthy control group. Notably, there was a significant difference in the MIPmen (p=0.026) and MEPmen (p=0.026) values when comparing the reference values, which were calculated based on age and sex, with those of the healthy group. The baseline values calculated according to age for stroke patients were as follows: MIPmen 31.68%, MIPwomen 63.58%, MEPmen 22.54%, and MEPwomen 42.30%.

CONCLUSION:

This study highlights the significant respiratory muscle weakness experienced by stroke patients, with gender-specific differences. It highlights the importance of incorporating respiratory assessments and interventions into stroke rehabilitation protocols to improve the overall health and well-being of stroke patients.

KEYWORDS:
Stroke; Muscle strength; Rehabilitation

Variable	Stroke group (n=171)	Healthy group (n=32)	Differences between groups
Variable	Mean±SD n (%)	Mean±SD n (%)	Diff. means	p
Sex (male/female)	66 (39.60)/105 (61.40)	18 (56.25)/14 (43.75)		0.063
Age (years)	54.53±10.27	51.28±7.40	3.28	0.091
Height (cm)	167.05±8.14	165.50±8.44	1.55	0.326
Weight (kg)	76.69±12.52	72.66±16.25	4.03	0.113
BMI (kg/m²2 Kubo H, Nozoe M, Yamamoto M, Kamo A, Noguchi M, Kanai M, et al. Recovery process of respiratory muscle strength in patients following stroke: a pilot study. Phys Ther Res. 2020;23(2):123-31. https://doi.org/10.1298/ptr.E10006 https://doi.org/10.1298/ptr.E10006... )	27.44±4.45	26.36±4.58	1.08	0.210
Time since stroke onset (days)	388.39±731.96

Variable	Stroke group (n=171)	Healthy group (n=32)	Differences between groups		95%CI
Variable	Mean±SD	Mean±SD	Diff. means	p	95%CI
MIPmen (cmH2O)	36.17±20.87	56.89±16.55	-20.72	<0.001^* * Statistical significance.	-31.33 to −10.12
MIPmen (cmH2O) R.V.^ Reference values were calculated using Black and Hyatt predictive equations.	114.17±6.89	117.92±2.29	-3.75	0.026^* * Statistical significance.	-34.85 to −10.23
MEPmen (cmH2O)	47.02±25.17	69.56±13.77	-22.54	<0.001^* * Statistical significance.	-7.03 to −0.45
MEPmen (cmH2O) R.V.^ Reference values were calculated using Black and Hyatt predictive equations.	208.62±14.19	216.33±4.72	-7.71	0.026^* * Statistical significance.	-14.49 to 0.93
MIPwomen (cmH2O)	47.52±23.59	64.43±22.39	-16.91	0.013^* * Statistical significance.	-30.13 to −3.69
MIPwomen (cmH2O) R.V.^ Reference values were calculated using Black and Hyatt predictive equations.	74.74±5.70	77.12±5.08	-2.38	0.140	-28.94 to −0.54
MEPwomen (cmH2O)	59.05±25.14	73.79±25.62	-14.74	0.042^* * Statistical significance.	-5.55 to 0.79
MEPwomen (cmH2O) R.V.^ Reference values were calculated using Black and Hyatt predictive equations.	139.59±5.92	142.06±5.28	-2.47	0.140	-5.77 to 0.82

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[1] *Corresponding author: fzt.ayz@gmail.com