{"title":"呼吸运动对脑卒中康复患者呼吸功能的临床疗效：网络meta分析。","authors":"So Hyun Kim, Sung Hyoun Cho","doi":"10.1093/ptj/pzaf112","DOIUrl":null,"url":null,"abstract":"<p><strong>Importance: </strong>Determining the most effective intervention to improve respiratory function is complex.</p><p><strong>Objective: </strong>This study aimed to determine the effectiveness of various cardiorespiratory physical therapist interventions to improve respiratory function in patients with stroke and to prioritize them.</p><p><strong>Data sources: </strong>This network meta-analysis examined randomized controlled trials published between 2000 and 2023.</p><p><strong>Study selection: </strong>Randomized controlled trials that enrolled patients with stroke and examined various cardiorespiratory physical therapist interventions were selected. The interventions included combined aerobic and breathing training, combined inspiratory and expiratory training (CIET), conventional training (CT), expiratory training, ground-based aerobic training (GBAT), inspiratory training (IT), and sham intervention (S).</p><p><strong>Data extraction and synthesis: </strong>Data were independently extracted by 2 authors. Comprehensive Meta-Analysis Software program was used to analyze the data and determine effect sizes.</p><p><strong>Main outcomes and measures: </strong>Outcome variables were maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP), and peak expiratory flow (PEF).</p><p><strong>Results: </strong>Thirteen studies, involving 416 participants, were selected. CIET was more effective than CT in improving MEP, MIP, and PEF, with Hedges g (g) values of 0.890 (95% CI = 0.560 to 1.220), 0.948 (95% CI = 0.648 to 1.248), and 1.014 (95% CI = 0.636 to 1.391), respectively. IT was more effective than S for MEP (g = 0.582, 95% CI = 0.091 to 1.072) and more effective than CT for MIP (g = 0.934, 95% CI = 0.576 to 1.293). PEF analysis revealed that CIET was more effective than GBAT (g = -1.215, 95% CI = -2.035 to -0.395).Conclusions and Relevance: CIET or IT may improve respiratory function in patients with stroke more effectively than uniformly applied GBAT or CT. CIET and IT are effective regardless of age or intervention duration. Cardiopulmonary training is encouraged during the chronic phase of stroke to improve respiratory muscle strength, with at least 6 weeks of training recommended.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinical Efficacy of Respiratory Exercise for Respiratory Function in Stroke Rehabilitation: A Network Meta-Analysis.\",\"authors\":\"So Hyun Kim, Sung Hyoun Cho\",\"doi\":\"10.1093/ptj/pzaf112\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Importance: </strong>Determining the most effective intervention to improve respiratory function is complex.</p><p><strong>Objective: </strong>This study aimed to determine the effectiveness of various cardiorespiratory physical therapist interventions to improve respiratory function in patients with stroke and to prioritize them.</p><p><strong>Data sources: </strong>This network meta-analysis examined randomized controlled trials published between 2000 and 2023.</p><p><strong>Study selection: </strong>Randomized controlled trials that enrolled patients with stroke and examined various cardiorespiratory physical therapist interventions were selected. The interventions included combined aerobic and breathing training, combined inspiratory and expiratory training (CIET), conventional training (CT), expiratory training, ground-based aerobic training (GBAT), inspiratory training (IT), and sham intervention (S).</p><p><strong>Data extraction and synthesis: </strong>Data were independently extracted by 2 authors. Comprehensive Meta-Analysis Software program was used to analyze the data and determine effect sizes.</p><p><strong>Main outcomes and measures: </strong>Outcome variables were maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP), and peak expiratory flow (PEF).</p><p><strong>Results: </strong>Thirteen studies, involving 416 participants, were selected. CIET was more effective than CT in improving MEP, MIP, and PEF, with Hedges g (g) values of 0.890 (95% CI = 0.560 to 1.220), 0.948 (95% CI = 0.648 to 1.248), and 1.014 (95% CI = 0.636 to 1.391), respectively. IT was more effective than S for MEP (g = 0.582, 95% CI = 0.091 to 1.072) and more effective than CT for MIP (g = 0.934, 95% CI = 0.576 to 1.293). PEF analysis revealed that CIET was more effective than GBAT (g = -1.215, 95% CI = -2.035 to -0.395).Conclusions and Relevance: CIET or IT may improve respiratory function in patients with stroke more effectively than uniformly applied GBAT or CT. CIET and IT are effective regardless of age or intervention duration. Cardiopulmonary training is encouraged during the chronic phase of stroke to improve respiratory muscle strength, with at least 6 weeks of training recommended.</p>\",\"PeriodicalId\":20093,\"journal\":{\"name\":\"Physical Therapy\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-09-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Physical Therapy\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/ptj/pzaf112\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physical Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ptj/pzaf112","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
引用次数: 0
摘要
重要性：确定最有效的干预措施以改善呼吸功能是复杂的。目的：本研究旨在确定各种心肺物理治疗师干预措施改善脑卒中患者呼吸功能的有效性，并对其进行优先排序。数据来源：该网络荟萃分析检查了2000年至2023年间发表的随机对照试验。研究选择：选择随机对照试验，纳入中风患者并检查各种心肺物理治疗师干预措施。干预措施包括有氧和呼吸联合训练、吸气和呼气联合训练（CIET）、常规训练（CT）、呼气训练、地面有氧训练（GBAT）、吸气训练（IT）和假干预(S)。数据提取与综合：数据由2位作者独立提取。采用综合meta分析软件程序对数据进行分析并确定效应量。主要结局和测量指标：结局变量为最大呼气压（MEP）、最大吸气压（MIP）和呼气峰流量（PEF）。结果：入选13项研究，共纳入416名受试者。CIET在改善MEP、MIP和PEF方面比CT更有效，其Hedges g (g)值分别为0.890 （95% CI = 0.560 ~ 1.220）、0.948 （95% CI = 0.648 ~ 1.248）和1.014 （95% CI = 0.636 ~ 1.391）。IT治疗MEP优于S (g = 0.582, 95% CI = 0.091 ~ 1.072)， MIP优于CT （g = 0.934, 95% CI = 0.576 ~ 1.293）。PEF分析显示CIET比GBAT更有效（g = -1.215, 95% CI = -2.035 ~ -0.395）。结论和意义：CIET或IT比统一应用GBAT或CT更有效地改善脑卒中患者的呼吸功能。无论年龄或干预时间长短，CIET和IT均有效。在中风慢性期鼓励心肺训练，以提高呼吸肌力量，建议至少进行6周的训练。
Clinical Efficacy of Respiratory Exercise for Respiratory Function in Stroke Rehabilitation: A Network Meta-Analysis.
Importance: Determining the most effective intervention to improve respiratory function is complex.
Objective: This study aimed to determine the effectiveness of various cardiorespiratory physical therapist interventions to improve respiratory function in patients with stroke and to prioritize them.
Data sources: This network meta-analysis examined randomized controlled trials published between 2000 and 2023.
Study selection: Randomized controlled trials that enrolled patients with stroke and examined various cardiorespiratory physical therapist interventions were selected. The interventions included combined aerobic and breathing training, combined inspiratory and expiratory training (CIET), conventional training (CT), expiratory training, ground-based aerobic training (GBAT), inspiratory training (IT), and sham intervention (S).
Data extraction and synthesis: Data were independently extracted by 2 authors. Comprehensive Meta-Analysis Software program was used to analyze the data and determine effect sizes.
Main outcomes and measures: Outcome variables were maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP), and peak expiratory flow (PEF).
Results: Thirteen studies, involving 416 participants, were selected. CIET was more effective than CT in improving MEP, MIP, and PEF, with Hedges g (g) values of 0.890 (95% CI = 0.560 to 1.220), 0.948 (95% CI = 0.648 to 1.248), and 1.014 (95% CI = 0.636 to 1.391), respectively. IT was more effective than S for MEP (g = 0.582, 95% CI = 0.091 to 1.072) and more effective than CT for MIP (g = 0.934, 95% CI = 0.576 to 1.293). PEF analysis revealed that CIET was more effective than GBAT (g = -1.215, 95% CI = -2.035 to -0.395).Conclusions and Relevance: CIET or IT may improve respiratory function in patients with stroke more effectively than uniformly applied GBAT or CT. CIET and IT are effective regardless of age or intervention duration. Cardiopulmonary training is encouraged during the chronic phase of stroke to improve respiratory muscle strength, with at least 6 weeks of training recommended.
期刊介绍：
Physical Therapy (PTJ) engages and inspires an international readership on topics related to physical therapy. As the leading international journal for research in physical therapy and related fields, PTJ publishes innovative and highly relevant content for both clinicians and scientists and uses a variety of interactive approaches to communicate that content, with the expressed purpose of improving patient care. PTJ"s circulation in 2008 is more than 72,000. Its 2007 impact factor was 2.152. The mean time from submission to first decision is 58 days. Time from acceptance to publication online is less than or equal to 3 months and from acceptance to publication in print is less than or equal to 5 months.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
