title: Inspiratory muscular weakness is most evident in chronic stroke survivors with lower walking speeds.
abstract: BACKGROUND
  Respiratory muscular weakness and associated changes in thoracoabdominal motion have been poorly studied in stroke subjects, since the individuals' functional levels were not previously considered in the investigations.
  
  
  OBJECTIVE
  To investigate the breathing patterns, thoracoabdominal motion, and respiratory muscular strength in chronic stroke subjects, who were stratified into two groups, according to their walking speeds.
  
  
  METHODS
  Cross-sectional, observational study.
  
  
  METHODS
  University laboratory.
  
  
  METHODS
  Eighty-nine community-dwelling chronic stroke subjects
  
  
  METHODS
  The subjects, according to their gait speeds, were stratified into community (gait speed ≥0.8 m/s) and non-community ambulators (gait speed <0.8 m/s). Variables related to pulmonary function, breathing patterns, and thoracoabdominal motions were assessed. Measures of maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were obtained and were compared with the reference values for the Brazilian population. The MIP and MEP values were expressed as percentages of the predicted values. Mann-Whitney-U or independent Student t-tests were employed to compare the differences between the two groups for the selected variables.
  
  
  RESULTS
  No significant between-group differences were found for the variables related to the breathing patterns and thoracoabdominal motions (0.01 < z/t < 1.51; 0.14<P<0.99). Compared to the predicted values, the stroke subjects demonstrated decreases of 26.5 and 20% of the MIP and MEP, respectively. Non-community ambulators showed significant lower predicted MIP values than those from the community ambulators (t=2.10; P=0.04). However, no significant between-group differences were found for the predicted MEP measures (t = -1.10; P=0.25).
  
  
  CONCLUSIONS
  Stroke subjects demonstrated weakness of the respiratory muscles and lower predicted MIP values were found for the non-community ambulators.
  
  
  CONCLUSIONS
  Evaluations and interventions involving respiratory muscular training could be included in stroke rehabilitation, especially for individuals with lower functional levels.
authors: Universidade Federal de Minas Gerais Belo Horizonte, Minas Gerais, Brazil - lfts@ufmg.br.
authors: M B
authors: MB
authors: Pinheiro
authors: J C
authors: JC
authors: Polese
authors: C D
authors: CD
authors: Faria
authors: G C
authors: GC
authors: Machado
authors: V F
authors: VF
authors: Parreira
authors: R R
authors: RR
authors: Britto
authors: L F
authors: LF
authors: Teixeira-Salmela
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001945:Breathing Exercises / Q000379:methods*; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D012132:Respiratory Muscles / Q000503:physiopathology*; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D016138:Walking / Q000502:physiology*; D055815:Young Adult