The effect of functional inspiratory muscle training versus inspiratory muscle training on trunk control and respiratory functions in patients with chronic stroke

Introduction: Loss of trunk control and respiratory muscle weakness are frequently encountered after stroke. Aim: To compare the effects of a program including functional inspiratory muscle training (FIM) with Neurodevelopmental Therapy (NGT) and inspiratory muscle training (IMT) in chronic stroke patients on trunk control, respiratory parameters, balance, and gait, core muscles, exercise capacity, and independent level. Method: 44 chronic stroke patients (40-70 years of age) were randomly divided into the FIM group (8 women) and the IMI group (9 women). The trainings under the supervision of a physiotherapist were applied in the laboratory for 8 weeks, 3 sessions/week for 60 minutes. In addition, IMI was given to both groups as a home program for 30 minutes per day, 2 days per week. Before and after the training, trunk control with the Trunk Impairment Scale (TIS) and Trunk Control Test (TCT), respiratory muscle strength and endurance, lung volumes, balance and walking performance with the Berg Balance Scale (BBS), Timed Up & Go Test (TUG), and 10-meter Walk Test (10MWT), abdominal muscle performance with the PRONE test, exercise capacity with the Six-Minute Walk Test (6MWT), and independence level with the Barthel Index (BI) were assessed. Data were analyzed in the SPSS 24.0 program (p<0.05). Results: The groups were found to be similar in terms of sociodemographic and clinical characteristics (p>0.05). There was a statistically significant difference in favor of the FIMT Group in terms of TIS, TCT, MIP, %MIP, MEP, %MEP, RMET, BBS, TUG, 10MWT, PRONE test, FVC(L) and FEV1/FVC values (p<0.05). There was no significant difference between the groups in terms of 6MWT, FEV1(L), FEV1(%), FVC(%), FEV1/FVC, PEF(L), PEF(%), and BI values (p>0.05). Conclusion: FIMT is more effective than IMT in improving trunk control, respiratory muscle strength and endurance, balance and walking performance, and transversus abdominis muscle activity in chronic stroke patients. Therefore, FIMT should be included in stroke patients' rehabilitation programs to improve respiratory functions, postural control, and mobility. Keywords: Balance, Functional İnspiratory Muscle Training, Respiratory Muscles, Stroke, Trunk Control