Effects of Inspiratory Muscles Training Plus Rib Cage Mobilization on Chest Expansion, Inspiratory Accessory Muscles Activity and Pulmonary Function in Stroke Patients

Abstract

After stroke, limited ribcage movement may lead to impaired respiratory function. Combining threshold inspiratory muscle training with rib cage joint mobilization has been shown to enhance the recovery of respiratory function in patients with stroke. The present study investigated whether the combination of rib cage joint mobilization and inspiratory muscle training would improve chest expansion, inspiratory muscle activity, and pulmonary function after stroke. Thirty stroke patients were recruited and randomly assigned to one of the two groups, namely 6-week rib cage joint mobilization with inspiratory muscle training (experimental group) or inspiratory muscle training alone (control group). Outcome measures included upper and lower chest expansion, activity of accessory inspiratory muscles (latissimus dorsi (LD) and upper trapezius (UT)), and pulmonary function (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and peak expiratory flow (PEF)). All evaluations were conducted at baseline and after 6 weeks of inspiratory muscle training. Significant increases were observed in upper and lower chest expansion, LD and UT muscle activity, FVC, FEV1, and PEF in both the groups. Upper and lower chest expansion and muscle activity of UT and LD were significantly higher in the experimental group than in the control group. No significant differences were observed in FVC, FEV1, and PEF between the groups. Inspiratory muscle training is effective in improving chest expansion, inspiratory muscle activity, and pulmonary function after stroke. The addition of rib cage joint mobilization further increases chest expansion and inspiratory muscle activity.

Effect of Chest Resistance and Expansion Exercises on Respiratory Muscle Strength, Lung Function, and Thoracic Excursion in Children with a Post-Operative Congenital Diaphragmatic Hernia

“…Our findings are supported by Hernández-Álvarez et al, who investigated the effect of 8 weeks of respiratory muscle training using threshold IMT on lung function and respiratory muscle strength in sedentary young people and discovered a significant change in FEV1, which was associated with a noticeable improvement in respiratory muscle strength [39]. Park also concluded that inspiratory muscle training in combination with rib cage mobilization is effective in improving chest wall movement, pulmonary function, chest expansion, and inspiratory muscle strength [40]. In addition, Rehman et al, found that passive stretching of the respiratory muscles can effectively benefit the status of such individuals, particularly in terms of chest expansion and functional capacity.…”

Effects of Cervical Spine Mobilization on Respiratory Function and Cervical Angles of Stroke Patients: A Pilot Study

“…The maximum voluntary expiration entails the shortening of the abdominal muscles, and the FVC, PEF, and FEV1 are dependent on it. In a previous study, spine mobilization applied on the rib cage to increase the inspiratory capacity of stroke patients increased the inspiratory muscle activity but had no effect on pulmonary function [ 48 ]. This result supports the results of our study.…”

Correlation between trunk rotation and lateral flexion range of motion, peak cough flow, and chest expansion in stroke patients

“…The rib cage circumference was measured horizontally using a tape measure with the help of marked reference points. Upper and lower chest expansions were performed three times and the mean value was used (Bockenhauer et al., 2007; Park, 2020).…”