Importance of respiratory and motor functional assessment of hemiparetic stroke patients

Authors

  • Letícia Ville Santos Faculdade Guilherme Guimbala
  • Fernando Luís Fischer Eichinger Faculdade Guilherme Guimbala e Universidade da Região de Joinville
  • Fabrício Noveletto Faculdade Guilherme Guimbala e Universidade do Estado de Santa Catarina
  • Antonio Vinicius Soares Faculdade Guilherme Guimbala e Universidade da Região de Joinville e Faculdade IELUSC
  • Helton Eckermann da Silva Faculdade Guilherme Guimbala.

DOI:

https://doi.org/10.34024/rnc.2020.v28.10013

Keywords:

Respiratory Function Tests, Physical Functional Performance, Muscle Strength, Hemiparesis, stroke

Abstract

Introduction. Hemiparetics post-stroke have several motor and respiratory dysfunctions, which are related to functional impairment, leading to a worse quality of life. Objective. To evaluate the respiratory and motor function of hemiparetic stroke patients and the correlation between these important variables for functional capacity. Method. This is a cross-sectional study involving 25 post-stroke hemiparetic patients. Functional independence (modified Barthel index), handgrip strength (dynamometry), gait speed, functional mobility (Timed Up and Go Test), peak expiratory flow (PEF) and maximal inspiratory and expiratory pressures (manovacuometry) were evaluated. Results. Deficits in motor and respiratory variables were found. The respiratory pressure values ​​were lower when compared to the predicted values ​​for healthy, with the maximum inspiratory pressure of 58.74% and the maximum expiratory pressure of 62.92% of the predicted value (p<0.001). There were correlations between PEF and all motor variables only in acute patients. Conclusion. Hemiparetic patients have significant motor and respiratory impairment. The evaluation of respiratory muscle post-stroke, sometimes not performed, is necessary in clinical practice because it provides important information on pulmonary function, contributing to the prevention of respiratory complications in these patients.

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Author Biographies

  • Fernando Luís Fischer Eichinger, Faculdade Guilherme Guimbala e Universidade da Região de Joinville

    Bacharel em Fisioterapia, Mestre em Ciências do Movimento Humano.

  • Fabrício Noveletto , Faculdade Guilherme Guimbala e Universidade do Estado de Santa Catarina

    Bacharel em Engenharia Elétrica, Doutor em Engenharia Elétrica.

  • Antonio Vinicius Soares , Faculdade Guilherme Guimbala e Universidade da Região de Joinville e Faculdade IELUSC

    Bacharel em Fisioterapia, Doutor em Ciências do Movimento Humano.

  • Helton Eckermann da Silva , Faculdade Guilherme Guimbala.

    Bacharel em Fisioterapia, Mestre em Saúde e Meio Ambiente.

References

Ildstad F, Ellekjar H, Wethal T, Lydersen S, Kutschera JS, Fjaertoft H, et al. Stroke risk after transient ischemic attack in a Norwegian prospective cohort. BMC Neurol 2019;19:2. http://dx.doi.org/10.1186/s12883-018-1225-y

Dorsch S, Ada L, Canning CG. Lower limb strength is significantly impaired in all muscle groups in ambulatory people with chronic stroke: a cross-sectional study. Arch Phys Med Rehabil 2016;97:522-7. http://dx.doi.org/10.1016/j.apmr.2015.10.106

Najafi Z, Rezaeitalab F, Yaghubi M, Manzari ZS. The effect of biofeedback on the motor - muscular situation in rehabilitation of stroke patients: a randomized controlled trial. J Caring Sci 2018;7:89-93. http://dx.doi.org/10.15171/jcs.2018.014

Lee K, Park D, Lee G. Progressive respiratory muscle training for improving trunk stability in chronic stroke survivors: a pilot randomized controlled trial. J Stroke Cerebrovasc Dis 2019;28:1200-11. http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2019.01.008

Lee DK, Kim SH. The effect of respiratory exercise on trunk control, pulmonary function, and trunk muscle activity in chronic stroke patients. J Phys Ther Sci 2018;30:700-3. http://dx.doi.org/10.1589/jpts.30.700

Caruso P, Albuquerque AL, Santana PV, Cardenas LZ, Ferreira JG, Prina E, et al. Diagnostic methods to assess inspiratory and expiratory muscle strength. J Bras Pneumol 2015;41:110-23. http://dx.doi.org/10.1590/S1806-37132015000004474

Silva SM, Corrêa JCF, Silva C, Silva PFC, Corrêa FI. Relação entre a força de preensão manual e capacidade funcional após acidente vascular cerebral. Rev Neurocienc 2014;23:74-80. https://doi.org/10.34024/rnc.2015.v23.8052

Bertolucci PHF, Brucki SMD, Campacci SR, Juliano YO. Mini-exame do estado mental em uma população geral: impacto da escolaridade. Arq Neuropsiquiatr 1994;52:1-7. https://doi.org/10.1590/S0004-282X1994000100001

Cincura C, Pontes Neto OM, Neville IS, Mendes HF, Menezes DF, Mariano DC, et al. Validation of the national institutes of health stroke scale, modified rankin scale and barthel index in Brazil: the role of cultural adaptation and structured interviewing. Cerebrovasc Dis 2009;27:119-22. http://dx.doi.org/10.1159/000177918

Ekstrand E, Lexell J, Brogårdh C. Grip strength is a representative measure of muscle weakness in the upper extremity after stroke. Top Stroke Rehabil 2016;23:400-5. http://dx.doi.org/10.1080/10749357.2016.1168591

Fritz S, Lusardi M. White paper: "walking speed: the sixth vital sign". J Geriatr Phys Ther 2009;32:46-9. https://journals.lww.com/jgpt/fulltext/2009/32020/white_paper___walking_speed__the_sixth_vital_sign_.2.aspx

Podsiadlo D, Richardson S. The timed up and go: a test of basic functional, ability for frail elderly persons. J Am Geriatr Soc 1991;39:142-8. http://dx.doi.org/10.1111/j.1532-5415.1991.tb01616.x

Jandt S, Caballero R, Forgiarini J, Alberto L, Dias A. Correlation between trunk control, respiratory muscle strength and spirometry in patients with stroke: An observational study. Physiother Res Int 2011;16:218-24. http://dx.doi.org/10.1002/pri.495

Pessoa IMBS, Houri Neto M, Montemezzo LA, Silva LAM, Andrade AD, Parreira VF. Predictive equations for respiratory muscle strength according to international and Brazilian guidelines. Braz J Phys Ther 2014;18:410-8. http://dx.doi.org/10.1590/bjpt-rbf.2014.0044

Leiner GC, Abramowitz S, Small MJ, Stenby VB, Lewis WA. Expiratory peak flow rate. Standard values for normal subjects. Use as a clinical test of ventilatory function. Am Rev Respir Dis 1963;88:644-51. http://dx.doi.org/10.1164/arrd.1963.88.5.644

Teixeira Salmela LF, Parreira VF, Britto RR, Brant TC, Inácio EP, Alcântara TO, et al. Respiratory pressures and thoracoabdominal motion in community-dwelling chronic stroke survivors. Arch Phys Med Rehabil 2005;86:1974-8. http://dx.doi.org/10.1016/j.apmr.2005.03.035

Neder JA, Andreoni S, Lerario MC, Nery LE. Reference values for lung function tests: II. Maximal respiratory pressures and voluntary ventilation. Braz J Med Biol Res 1999;32:719-27. http://dx.doi.org/10.1590/S0100-879X1999000600007

Torres GV, Reis LA. Assessment of functional capacity in elderly residents of an outlying area in the hinterland of Bahia/Northeast Brazil. Arq Neuropsiquiatr 2010;68:39-43. http://dx.doi.org/10.1590/S0004-282X2010000100009

Stock R, Thrane G, Askim T, Anke A, Mork PJ. Development of grip strength during the first year after stroke. J Rehabil Med 2019;51:248-56. http://dx.doi.org/10.2340/16501977-2530

Massy Westropp NM, Gill TK, Taylor AW, Bohannon RW, Hill CL. Hand grip strength: age and gender stratified normative data in a population-based study. BMC Res Notes 2011;4:127-31. http://dx.doi.org/10.1186/1756-0500-4-127

Novaes RD, Miranda AS, Dourado VZ. Velocidade usual da marcha em brasileiros de meia idade e idosos. Rev Bras Fisioter 2011;15:117-22. http://dx.doi.org/10.1590/S1413-35552011000200006

Bohannon RW. Reference values for the timed up and go test: a descriptive meta-analysis. J Geriatr Phys Ther 2006;29:64-8. http://dx.doi.org/10.1519/00139143-200608000-00004

Andersson ÅG, Kamwendo K, Seiger Å, Appelros P. How to identify potential fallers in a stroke unit: validity indexes of four test methods. J Rehabil Med 2006;38:186-91. http://dx.doi.org/10.1080/16501970500478023

Meneghetti C, Figueiredo V, Guedes C, Batistela A. Avaliação da força muscular respiratória em indivíduos acometidos por Acidente Vascular Cerebral. Rev Neurocienc 2011;19:56-60. https://doi.org/10.34024/rnc.2011.v19.8398

Zaleski TDP, Camera F, Wisniewski E, Wisniewski M. Avaliação da força muscular respiratória e função pulmonar em indivíduos com acidente vascular cerebral. Perspectiva 2018;42:15-22. http://www.uricer.edu.br/site/pdfs/perspectiva/1005_655.pdf

Nagato AC, Nunes LAS, Dourado VA, Diniz MF, Silva MAS, Dornelas G, et al. Correlação entre a pressão expiratória máxima (PEmáx) e pico de fluxo expiratório máximo (PFE) em indivíduos saudáveis. Rev Int Est Exp 2012;4:7-15. https://periodicos.ufjf.br/index.php/riee/article/view/23989

Sartor MM, Guillen Solà A, Ramirez Fuentes C, Duarte E, Marco E. Peak expiratory cough flow and respiratory muscle function in acute stroke patients. Eur Respir J 2017;50: PA3696. http://dx.doi.org/10.1183/1393003.congress-2017.PA3696

Kim NS. Correlation between grip strength and pulmonary function and respiratory muscle strength in stroke patients over 50 years of age. ‎J Exerc Rehabil 2018;14:1017-23. http://dx.doi.org/10.12965/jer.1836444.222

Reis L, Moreira J, Duarte S. Risk of falling, respiratory and functional capacity in elderly residents in institutions of long stay. Rev Neurocienc 2015;23(3):397-404. https://doi.org/10.34024/rnc.2015.v23.8008

Santos RS, Dall’alba SCF, Forgiarini SGI, Rossato D, Dias AS, Forgiarini Júnior A. Relationship between pulmonary function, functional independence, and trunk control in patients with stroke. Arq Neuropsiquiatr 2019;77:387-92. http://dx.doi.org/10.1590/0004-282x20190048

Pompeu S, Pompeu J, Rosa M, Silva M. Correlação entre função motora, equilíbrio e força respiratórios pós acidente vascular cerebral. Rev Neurocienc 2011;19:614-20. https://doi.org/10.34024/rnc.2011.v19.8324

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Published

2020-09-23

Issue

Vol. 28 (2020)

Section

Artigos Originais

How to Cite

1.
Ville Santos L, Luís Fischer Eichinger F, Noveletto F, Vinicius Soares A, Eckermann da Silva H. Importance of respiratory and motor functional assessment of hemiparetic stroke patients. Rev Neurocienc [Internet]. 2020 Sep. 23 [cited 2025 Dec. 16];28:1-22. Available from: https://periodicos.unifesp.br/index.php/neurociencias/article/view/10013
Received 2019-11-26
Accepted 2020-08-31
Published 2020-09-23