Respiratory Muscle Strength in Chronic Stroke Survivors and Its Relation With the 6-Minute Walk Test

Objectives: To compare respiratory muscle strength in stroke survivors (SS) with that in a control group (CG) of healthy people matched by age and sex, as well as to investigate any relation between respiratory muscle strength and the distance walked during the 6-minute walk test (6MWT). Design: Cross-sectional study. Setting: This study comprised patients from a private neurological rehabilitation center and a public association for patients with acquired brain injury. Participants: Chronic SS with a diagnosis of hemiplegia/hemiparesis who were able to walk (n=30) and healthy individuals matched by sex and age (n=30) (N=60). Interventions: Not applicable. Main Outcome Measures: Respiratory muscle strength was assessed using maximal expiratory pressure (MEP) and maximal inspiratory pressure (MIP) with a pressure transducer and a diver nozzle. The distance walked during the 6MWT was also registered for both groups. The motricity index and the Scale Impact of Stroke version 16.0 were also measured in SS. Results: The Student t test revealed significantly lower values of MIP and MEP in SS than in the CG (MEP, 95.93 +/- 43.12cmH(2)O in SS vs 158.43 +/- 41.6cmH(2)O in the CG; MIP, 58.7 +/- 24.67cmH(2)O in SS vs 105.7 +/- 23.14cmH(2)O in the CG; P<.001). Moreover, these findings were clinically relevant because both MIP and MEP in SS were <60% of the predicted values. A positive correlation between the 6MWT and MIP was found using the Pearson coefficient (r=.43; P<.018). Conclusions: Respiratory muscle weakness should be considered in a holistic approach to stroke rehabilitation. (C) 2016 by the American Congress of Rehabilitation Medicine