Effect Of Breather On Pulmonary And Physical Function In Post Stroke Survivors
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      Stroke is the second major cause of death and disability worldwide with over 13 million new
      cases annually.

      Egypt, a low-middle-income country, is the most populated nation in the Middle East with a
      high overall crude prevalence rate of stroke (963/100,000 inhabitants), accounting for 6.4%
      of all deaths and the incidence of stroke annually is approximately 150,000-210,000.

      Stroke has a direct impact on health systems, resulting in high costs, and is also considered
      a global public health problem due to serious disabilities, functional limitations and
      compromised quality of life (QoL).

      The Breather a drug-free, evidence-based inspiratory/expiratory respiratory muscle training
      (RMT) device used by Dysphagia, COPD, CHF, Parkinson's, and neuromuscular disease patients,
      as well as children 4+ and adults interested in healthy aging.
    

Detailed description: 
      Stroke is a leading cause of death and disability in globally and particularly in low and
      middle-income countries, and this burden is increasing.

      The expected spontaneous biological recovery follows the "proportional recovery rule" - most
      patients recover 70% of their impaired motor or verbal function during the first three months
      after stroke however, 90% of them have residual deficit.

      Stroke patients may experience a reduction of up to 50% in respiratory function when compared
      to age- and gender-matched norms. The reduction in respiratory function can lead to decreased
      endurance, dyspnea and increased sedentary behaviour, as well as an elevated risk of
      recurrent stroke. The reduction in respiratory function may also cause aspiration, leading to
      pneumonia. Previous research showed that pneumonia was an independent risk factor for
      mortality and a poor prognosis in stroke patients. Research also showed that a reduction in
      respiratory muscle and abdominal muscle strength contributed to pulmonary and respiratory
      dysfunction following a stroke.

      After a stroke, the respiratory center and related motor pathways can directly decrease
      respiratory muscle strength and subsequently induce a change in breathing patterns. As a
      result, pneumonia, pulmonary ventilation disorders, lung injury, lung ischemia reperfusion
      injury, decreased pulmonary compliance, abnormal posture, and obstructive sleep apnea can
      occur following a stroke. Thus, pulmonary rehabilitation is critical to reducing these
      complications. The main forms of pulmonary rehabilitation include exercise training,
      respiratory muscle training, oxygen therapy, noninvasive ventilation, nutrition support,
      social psychological support, and health education.

      The inspiratory muscles can be specifically trained, with improvement of both muscle strength
      and endurance by using the breather device.

      As result utilizing the breather may help stroke patients recover quickly and avoid
      respiratory complication.
    

Intervention name(s): BREATHER; physiotherapy prgramme for rehabilitation of stroke patients
Intervention type(s): Device; Other
Intervention description(s): respiratory muscle trainer used to strength inspiratory an expiratory muscles through breathing in and out against aresistence which is determined individually according to each patient.; physiotherapy prgramme for rehabilitation of stroke patients which include:
Passive stretching exercise, strengthening exercise.
Postural control and balance exercise from different positions as quadruped, kneeling, sitting and standing.
Gait training.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment