Effect of individualized respiratory function training in patients with stroke complicated by dysphagia
Objective To analyze the effect of individualized respiratory function training combined with swallowing function training on lung function,dyspnea symptoms,and incidence of aspiration pneumonia in patients with stroke complicated by dysphagia.Methods A total of 120 patients with stroke complicated by dysphagia who received treatment at Bao Ji People's Hospital from January 2022 to March 2023 were included in this study.These patients were assigned to a control group and a study group,with 60 patients in each group,using simple randomization.The control group received conventional swallowing function training,while the study group underwent individualized respiratory function training combined with swallowing function training.Both groups were treated for 8 weeks.Rehabilitation outcomes,repetitive saliva swallowing times,quality of oral intake(the Functional Oral Intake Scale score),and lung function parameters(peak expiratory flow rate,forced vital capacity,and forced expiratory volume in 1 second,dyspnea symptoms(the Modified Medical Research Council Dyspnea Scale score),respiratory muscle strength(maximum expiratory pressure percentage and maximum inspiratory pressure percentage),quality of life[the Swallowing Quality of Life questionnaire score],psychological status(the Depression,Anxiety and Stress Scale-21 Items score),incidence of aspiration pneumonia,and severity of aspiration(the Rosenbek scale score)were compared between the two groups.Results The total response rate in the study group was 95.0％(57/60),which was significantly higher than that in the control group[81.7％(49/60),x2=5.18,P=0.023].After 4 and 8 weeks of training,repetitive saliva swallowing times[(3.86±0.25)times,(4.35±0.30)times]and Functional Oral Intake Scale scores[(5.29±0.61)points,(5.94±0.50)points]in the study group were significantly higher compared with the control group[(3.45±0.28)times,(3.81±0.32)times,(4.73±0.58)points,(5.18±0.54)points,t=8.46,9.54,5.15,8.00,all P＜0.05].The values for forced vital capacity,forced expiratory volume in 1 second,and peak expiratory flow rate in the study group were significantly higher than those in the control group,and the Modified Medical Research Council Dyspnea Scale score in the study group was significantly lower than that in the control group(t=4.88,6.05,7.34,7.35,3.82,4.32,4.63,9.23,all P＜0.05).The maximum expiratory pressure percentage and maximum inspiratory pressure percentage in the study group were significantly higher than those in the control group(t=3.84,3.82,0.65,3.69,all P＜0.05).The Swallowing Quality of Life questionnaire scores in the study group[(179.26±20.17)points,(189.54±21.06)points]were significantly higher than those in the control group[(162.75±18.43)points,(170.61±20.35)points,t=4.68,5.01,both P＜0.05].The scores for the Depression,Anxiety and Stress Scale-21 Items in the study group[(28.03±2.74)points,(25.71±2.68)points]were significantly lower than those in the control group[(30.15±2.96)points,(28.20±3.17)points,t=4.07,4.65,both P＜0.05].During the training period,the incidence of aspiration pneumonia in the study group was significantly lower than that in the control group[3.3％(2/60)vs.15.0％(9/60),x2=4.90,P=0.027].After 8 weeks of training,the severity of aspiration in the study group was milder than that in the control group(Z=2.54,P=0.011).Conclusion Individualized respiratory function training combined with swallowing function training can effectively improve lung function,reduce dyspnea symptoms,and decrease the incidence of aspiration pneumonia in patients with stroke who are experiencing dyspnea.
StrokeDeglutition disordersRehabilitationResistance trainingRespiratory function testsDyspneaPneumonia,aspiration
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