The Manifestation of Surface EMG of Swallowing Muscles in Stroke Patients With Respiratory Muscle Training
Cerebrovascular Disorders
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About this trial
This is an interventional treatment trial for Cerebrovascular Disorders focused on measuring Respiratory muscle training, Spirometry, Maximal Inspiratory Pressure, Maximal Expiratory pressure, Surface electromyography
Eligibility Criteria
Inclusion Criteria:
- Patients identified as stroke,
- Diagnosed by magnetic resonance image or computerized tomography
- Capable of performing voluntary respiratory maneuvers
Exclusion Criteria:
- Increased intracranial pressure
- Uncontrolled hypertension
- Complicated arrhythmia
- Decompensated heart failure
- Unstable angina
- Myocardial infarction in the preceding 3 months
- Pneumothorax
- Bullae/blebs
- Severe cognitive function
- Emotional disturbance
- Infection
Sites / Locations
- Department of Physical Medicine and Rehabilitation, Kaohsiung Chang Gung Memorial Hospital.
Arms of the Study
Arm 1
Arm 2
Arm 3
Experimental
Active Comparator
Experimental
IMST group
Control group
EMST group
Interventions: Respiratory muscle training for IMST. Inspiratory muscle training for patients with inspiratory muscle weakness (MIP less than 70% of normal range). IMT will commence from 30% to 60 % of MIP and then adjust one level of training loading according to the tolerance of continuously breathing through a respiratory trainer for two sets of 30 breaths or 6 sets of 10 repetitions with one or two minute of rest between sets, once per day, 5 days per week.
Intervention: Non-training group, receive regular rehabilitation. All participants will receive usual rehabilitation care including body positioning instruction, postural correction, breathing control, cough maneuver, respiratory muscle stretch, chest wall mobility exercise and ventilation, fatigue management.
Intervention: Respiratory muscle training for EMST. For patients with only swallowing disturbance. Training resistance will be adjusted accordingly. The loading will be performed with the previous resistance setting or even lower if training load is not tolerated or not completed.