Expiratory Muscle Training in Stroke

NCT ID: NCT04569968

Last Updated: 2023-03-31

Study Results

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

146 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-08-18

Study Completion Date

2021-11-03

Brief Summary

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Stroke affects the vital activities of daily living such as breathing and swallowing. After stroke excursion of the diaphragm reduces about 50%, and also the maximum expiratory pressure of the individual 50% or higher. Dysphagia occurs in 29% to 45% of the acute stroke cases.

Detailed Description

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As a third leading cause of death and one of the major causes of disability, stroke still maintain its bad reputation in worldwide. Stroke owes its fame on wide range of symptoms mostly the musculoskeletal system symptoms such as spasticity, equilibrium and gait problems. Although mentioned symptoms keep their popularity devious two dysfunction caused by stroke; stomatognathic system dysfunction and respiratory dysfunction appears to change this equation. Considering the high incidence of dysphagia and the reduced cardiopulmonary capacity of the stroke patients, it seems inevitable. From this perspective aim of this study is to assess the effect of expiratory muscle training on the stomatognathic system in patients with stroke and as mentioned aid to shatter the mentioned equation.

Conditions

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Stroke Mastication Disorder Temporomandibular Disorders Dysphagia Stomatognathic Diseases

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Two groups as an intervention and control.
Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors
Outcome measures will be performed by an another investigator.

Study Groups

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Expiratory muscle training group

Daily expiratory muscle training for four weeks will be applied.

Group Type EXPERIMENTAL

Expiratory muscle training

Intervention Type OTHER

For training group first maximum expiratory pressure measurement will be assessed with portable expiratory measurement device. Measurement will be taken while the patient in a sitting position. Three measurement values with 5% variation will be taken an average of these values recorded as a maximum expiratory pressure of the patient. After the maximum expiratory pressure of the patient is measured 50% percent of the related value will be set on the expiratory muscle trainer. Then patient will be informed about how to use the trainer. Trainer will be used daily for four weeks with 50 repetitions. At the end of every week pressures will be measured again for re-calibration of the trainer.

Control group

Nothing will be applied except for the hospital conventional physiotherapy program.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Expiratory muscle training

For training group first maximum expiratory pressure measurement will be assessed with portable expiratory measurement device. Measurement will be taken while the patient in a sitting position. Three measurement values with 5% variation will be taken an average of these values recorded as a maximum expiratory pressure of the patient. After the maximum expiratory pressure of the patient is measured 50% percent of the related value will be set on the expiratory muscle trainer. Then patient will be informed about how to use the trainer. Trainer will be used daily for four weeks with 50 repetitions. At the end of every week pressures will be measured again for re-calibration of the trainer.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Mini mental score is 24 or higher
* 55 years of age or higher
* Currently not taking respiratory muscle training
* Fonseca Questionnaire score is 20 or higher
* Onset of stroke is between 3 months and 5 years

Exclusion Criteria

* Developed dysphagia caused by other diseases rather than stroke
* Repetitive stroke story
* Cancer in head and neck region
* Abdominal or thoracic surgery story
* Existence of neurodegenerative disease
Minimum Eligible Age

55 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Abant Izzet Baysal University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ömer Dursun, MSc

Role: PRINCIPAL_INVESTIGATOR

Bolu Abant İzzet Baysal University

Tamer Çankaya, PhD

Role: PRINCIPAL_INVESTIGATOR

Bolu Abant İzzet Baysal University

Erdal Dilekçi, MD

Role: PRINCIPAL_INVESTIGATOR

Bolu Abant İzzet Baysal University

Locations

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İzzet Baysal Physical Therapy and Rehabilitation Education and Research Hospital

Bolu, , Turkey (Türkiye)

Site Status

Bolu Abant İzzet Baysal University

Bolu, , Turkey (Türkiye)

Site Status

Countries

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Turkey (Türkiye)

References

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Similowski T, Catala M, Rancurel G, Derenne JP. Impairment of central motor conduction to the diaphragm in stroke. Am J Respir Crit Care Med. 1996 Aug;154(2 Pt 1):436-41. doi: 10.1164/ajrccm.154.2.8756819.

Reference Type BACKGROUND
PMID: 8756819 (View on PubMed)

Finestone HM, Greene-Finestone LS, Wilson ES, Teasell RW. Malnutrition in stroke patients on the rehabilitation service and at follow-up: prevalence and predictors. Arch Phys Med Rehabil. 1995 Apr;76(4):310-6. doi: 10.1016/s0003-9993(95)80655-5.

Reference Type BACKGROUND
PMID: 7717830 (View on PubMed)

Khedr EM, El Shinawy O, Khedr T, Abdel aziz ali Y, Awad EM. Assessment of corticodiaphragmatic pathway and pulmonary function in acute ischemic stroke patients. Eur J Neurol. 2000 Sep;7(5):509-16. doi: 10.1046/j.1468-1331.2000.00104.x.

Reference Type BACKGROUND
PMID: 11054135 (View on PubMed)

Messaggi-Sartor M, Guillen-Sola A, Depolo M, Duarte E, Rodriguez DA, Barrera MC, Barreiro E, Escalada F, Orozco-Levi M, Marco E. Inspiratory and expiratory muscle training in subacute stroke: A randomized clinical trial. Neurology. 2015 Aug 18;85(7):564-72. doi: 10.1212/WNL.0000000000001827. Epub 2015 Jul 15.

Reference Type BACKGROUND
PMID: 26180145 (View on PubMed)

Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006 Nov;3(11):e442. doi: 10.1371/journal.pmed.0030442.

Reference Type BACKGROUND
PMID: 17132052 (View on PubMed)

Miller EL, Murray L, Richards L, Zorowitz RD, Bakas T, Clark P, Billinger SA; American Heart Association Council on Cardiovascular Nursing and the Stroke Council. Comprehensive overview of nursing and interdisciplinary rehabilitation care of the stroke patient: a scientific statement from the American Heart Association. Stroke. 2010 Oct;41(10):2402-48. doi: 10.1161/STR.0b013e3181e7512b. Epub 2010 Sep 2. No abstract available.

Reference Type BACKGROUND
PMID: 20813995 (View on PubMed)

Yelnik AP, Le Breton F, Colle FM, Bonan IV, Hugeron C, Egal V, Lebomin E, Regnaux JP, Perennou D, Vicaut E. Rehabilitation of balance after stroke with multisensorial training: a single-blind randomized controlled study. Neurorehabil Neural Repair. 2008 Sep-Oct;22(5):468-76. doi: 10.1177/1545968308315996.

Reference Type BACKGROUND
PMID: 18780882 (View on PubMed)

Sommerfeld DK, Eek EU, Svensson AK, Holmqvist LW, von Arbin MH. Spasticity after stroke: its occurrence and association with motor impairments and activity limitations. Stroke. 2004 Jan;35(1):134-9. doi: 10.1161/01.STR.0000105386.05173.5E. Epub 2003 Dec 18.

Reference Type BACKGROUND
PMID: 14684785 (View on PubMed)

Dursun O, Cankaya T. Assessment of Temporomandibular Joint Dysfunction in Patients with Stroke. J Stroke Cerebrovasc Dis. 2018 Aug;27(8):2141-2146. doi: 10.1016/j.jstrokecerebrovasdis.2018.03.007. Epub 2018 Apr 9.

Reference Type BACKGROUND
PMID: 29650380 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Statistical Analysis Plan

View Document

Document Type: Informed Consent Form

View Document

Other Identifiers

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BAIBU-FTR-ÖD-01

Identifier Type: -

Identifier Source: org_study_id

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