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AuthorsGuðbjörg Þóra Andresdóttir
MetadataShow full item record
CitationSjúkraþjálfarinn 2007, 34(2):16-20
AbstractBackground: Stroke patients often demonstrate difficulties in breathing during early rehabilitation, but few studies have addressed this problem. Purpose: To compare respiratory movement patterns in patients with acute hemispheric stroke to healthy individuals and compare respiratory movement patterns in patients with a left- versus right-sided stroke. Material and Methods: Acute hemispheric stroke patients admitted to Landspitali University Hospital who had suffered a sequele so severe that they needed assistance from at least one person to perform activities of daily living were asked to participate. Exclusion criteria were: pulmonary diseases, congestive heart failure, severe aphasia, severe dementia, diseases other than stroke affecting mobility and former history of stroke of the contralateral side. Respiratory movement patterns were measured with Respiratory Movement Measuring Instrument (RMMI), measuring movements of thorax and abdomen. Their physical performance was assessed using the MAS-scale, their neglect was assessed using a lettercancellation- test. Results: Subjects were 18, 10 left hemiparesis (mean age 62.2±14.2 years) and 8 had right hemiparesis (mean age 651±8.9 years). The differences in age, BMI, number of days from insult to measurement and median score on MAS were not significant. Respiratory rate in quiet breathing was regular, only one patient with right sided hemiplegia had irregular rate. During deep breathing the rate became irregular, particularly among those with left hemiparesis. Six patients had irregular range of respiratory motion in quiet breathing, four of them had Cheyne-Stokes breathing. During deep breathing the range of respiratory motion was more irregular, particularly among those with left hemiparesis. The study group had significantly (p=0.003) more irregular range of respiratory motion during deep breathing than a control group of AS patients, but the irregularity in frequency of respiratory motion was not significant (p=0.058). The mean respiratory rate among stroke patients was significantly higher than among healthy people both during quiet (p<0.03) and deep breathing (p=0.002). The stroke patients had also significantly (p<0.001) reduced range of motion during deep breathing. No significant differences were found between stroke groups (right and left sided hemiparesis) in respiratory rate, regularity/irregularity in frequency and range. Magnitude of range of respiratory motion was not compared between stroke groups due to the small sample size. Conclusion: Many stroke patients in this study showed irregularity in frequency and range of respiratory motion, especially right hemispheric stroke. The mean respiratory rate was higher and the breathing shallower than among healthy controls, especially in deep breathing. This is the first indication of disturbed respiratory movement patterns after hemispheric stroke and a possible difference in the effects of right versus left hemispheric stroke on those patterns. Further studies are needed to draw more definit conclusions.
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