Table 2 Characteristics of the included 9 studies
Study | Country | Participants | Intervention | Control | Outcome measures |
|---|---|---|---|---|---|
Liu et al. 2022 [44] | China | n = 86 IG: 46 CG: 40 65% men 51 years Stroke < 3 months MIP: NR MEP: NR | Modality: IMT + EMT Intensity: 30% of MIP and MEP Frequency: 30 min, 6 times/week Duration: 6 weeks Device: threshold resistance (Saike (Xiamen) Medical Equipment Co., Ltd) Progression: NR Regular rehabilitation programs as CG | Regular rehabilitation programs: limb stretching training, rollover training, balance training (sitting and standing), and gait training (30 min, 6 times/week, 6 weeks) | Respiratory function: FVC, FEV1, PEF Functional capacity: FMA |
Choi et al. 2021 [6] | Korea | n = 44 IG: 22 CG: 22 47.7% men 67.4 years Stroke < 2 weeks MIP: NR MEP: NR | Modality: IMT + EMT Intensity: 50% of MIP and MEP Frequency: 30 min, 5 times/week Duration: 4 weeks Device: POWERbreathe (POWERbreathe International Ltd) and Threshold IMT/PEP (variable resistance) (Philips Respironics) Progression: resistance increased 1 or 2 cmH2O as the participants became accustomed to the resistance Regular rehabilitation programs as CG | Regular rehabilitation programs: physical and occupational therapy sessions (5 times/week, 4 weeks) | Respiratory function: MIP, MEP, FVC, FEV1, PEF Functional capacity: FAC |
Sun et al. 2021 [43] | China | n = 50 IG: 25 CG: 25 54% men 50.4 years Stroke < 3 months MIP: NR MEP: NR | Modality: IMT + EMT Intensity: 30% of MIP and MEP Frequency: 30 min, 6 times/week Duration: 6 weeks Device: threshold resistance (Saike (Xiamen) Medical Equipment Co., Ltd) Progression: NR Regular rehabilitation programs as CG | Regular rehabilitation programs: physical factor therapy, muscle strength training, stretching training, balance training (sitting and standing), gait training, and activity of daily living training (30 min, 6 times/week, 6 weeks) | Respiratory function: FVC, FEV1, PEF Functional capacity: FMA |
Gu et al. 2020 [45] | China | n = 60 IG: 30 CG: 30 38.3% men 59.3 years Stroke < 2 weeks MIP: NR MEP: NR | Modality: MIP Intensity: 30% of MIP Frequency: 5–10 sets of 3 repetitions, 5 times/week Duration: 8 weeks Device: SECCO S2 intelligent respiratory training instrument (variable resistance) ( Saike (Xiamen) Medical Equipment Co., Ltd) Progression: resistance increased the pressure by 10% after 3 days and gradually increased the training load according to the participant’s tolerance Regular rehabilitation programs as CG | Regular rehabilitation programs: good limb placement, posture management, exercise therapy, occupational therapy, acupuncture, low and medium frequency electrotherapy (once a day, 5 times/week, 8 weeks) | Respiratory function: MIP, MEP, FVC, PEF |
Yoo and Pyun 2018 [47] | Korea | n = 40 IG: 20 CG: 20 65% men 61 years Stroke < 3 months MIP: NR MEP: NR | Modality: IMT + EMT Intensity: NR Frequency: 30 min, twice a day, 7 times/week Duration: 3 weeks Device: A flow-oriented incentive spirometer for IMT (Hyupsung, Seoul, Korea); Acapella vibratory PEP for EMT (threshold resistance) (Smith Medical, Minnesota, MN, USA) Progression: NR Regular rehabilitation programs as CG | Regular rehabilitation programs: motion exercises, muscle strengthening, gait training, fine motor exercises, and activity of daily living training (30 min, twice a day, 5 days/week, 3 weeks) | Respiratory function: FVC, FEV1, PEF Functional capacity: FMA |
Guillén-Solà et al. 2017 [22] | Spain | n = 41 IG: 20 CG: 21 68.3% men 68.4 years Stroke within 1 to 3 weeks MIP: 37 cmH2O MEP: 56 cmH2O | Modality: IMT + EMT Intensity: 30% of MIP and MEP Frequency: 5 sets of 10 repetitions, twice a day, 5 times/week Duration: 3 weeks Device: Orygen Dual Valve (threshold resistance) (Orygen Dual Valve®, Forumed SL, Barcelona, Catalonia, Spain) Progression: resistance increased weekly at intervals of 10 cmH2O Regular rehabilitation programs as CG | Regular rehabilitation programs: physical, occupational and speech therapy targeting specific impairments in mobility, activities of daily living, standard swallow therapy and communication skills (3 h per day, 5 times/week, 3 weeks) Sham MIP + MEP with the workloads fixed at 10 cmH2O (5 sets of 10 repetitions, twice a day, 5 times/week, 3 weeks) | Respiratory function: MIP, MEP |
Yu et al. 2016 [46] | China | n = 45 IG: 22 CG: 23 52.7% men 66.4 years Stroke within 1 to 3 weeks MIP: NR MEP: NR | Modality: IMT Intensity: 30% of MIP Frequency: 20–30 min, twice a day, 6 days/week Duration: 3 weeks Device: Threshold IMT (threshold resistance) (Yuyao Shengchang Medical Equipment Co., Ltd) Progression: resistance increased the training load by 10% Regular rehabilitation programs as CG | Regular rehabilitation programs: nerve stimulation, muscle strength training, balance function training, gait training, low and medium frequency electric therapy, acupuncture, and daily living ability training (twice a day, 6 days/week, 3 weeks) | Respiratory function: MIP, MEP, FVC, FEV1, PEF Functional capacity: FMA |
Kulnik et al. 2015 [49] | Britain | n = 51 IG: 26 CG: 25 60.2% men 64.4 years Stroke < 2 weeks MIP: 42 cmH2O MEP: 61 cmH2O | Modality: IMT Intensity: 50% of MIP Frequency: 5 sets of 10 breaths/day, 7 times/week Duration: 4 weeks Device: Threshold IMT; Threshold PEP-Respironics (threshold resistance) (Respironics, Parsippany, NJ) Progression: resistance adjusted to 50% of MIP every week | Sham MIP + MEP with a fixed load of 10% of maximum pressure (5 sets of 10 breaths/day, 7 times/week, 4 weeks) | Respiratory function: MIP, MEP |
Messaggi-Sartor et al. 2015 [48] | Spain | n = 109 IG: 56 CG: 53 57.8% men 66.5 years Stroke < 3 weeks MIP: 41 cmH2O MEP: 63 cmH2O | Modality: IMT + EMT Intensity: 30% of MIP and MEP Frequency: 5 sets of 10 repetitions, twice a day, 5 times/week Duration: 3 weeks Device: Orygen-Dual valve (threshold resistance) ( LungOn, European distributors) Progression: resistance increased 10 cmH2O every week Regular rehabilitation programs as CG | Regular rehabilitation programs: physical, occupational, and speech therapy sessions (3 h per day, 5 days a week, 3 weeks) Sham MIP + MEP at a fixed workload of 10 cmH2O (5 sets of 10 repetitions, twice a day, 5 times/week, 3 weeks) | Respiratory function: MIP, MEP |