Ultrasonographic Evaluation of Respiratory Muscles in Stroke Patients

Study Overview
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Brief Summary
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Ultrasonographic evaluation of respiratory muscle thickness in stroke patients, determination of its correlation with pulmonary function test (PFT) , and the first evaluation method to determine respiratory rehabilitation goals and to use it in the follow-up of the effectiveness of the treatment.

Detailed Description
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The study is planned as a cross-sectional prospective study. Healthy volunteers and stroke patients who are planned to be hospitalized in the Stroke clinic for rehabilitation in Istanbul Physical Medicine Rehabilitation Training and Research Hospital are evaluated and included in the study according to the inclusion and exclusion criteria. Demographic data of patients (gender, age, height, weight, body mass index, comorbidity status, smoking/alcohol use, dominant extremity, stroke etiology, duration, side), functional status (Brunnstrom stages, Functional Ambulation Scale (FAS), Daily Living Activity (ADL) Index), Pulmonary Function Test (PFT) measurement results and bilateral diaphragm and abdominal muscle thicknesses and thickening ratio in ultrasonography, demographic data of healthy volunteers (gender, age, height, weight, body mass index, comorbidity status, smoking/alcohol use, dominant side), PFT measurement results and the dominant side diaphragm and abdominal muscle thicknesses and thickening ratio in ultrasonography is done and included in the study. In the ultrasonographic evaluation of the participants, using a 7-12 Mhz linear Probe, measurements are made of the diaphragm at the end of tidal expiration and forced inspiration, abdominal muscles at the end of tidal expiration and at the end of forced expiration, while all respiratory muscles are lying in the supine position. Diaphragm thickness is measured between the 8th and 9th ribs at the level of the anteroaxillary line, rectus abdominis; 4 cm lateral of the umbilicus, transversus abdominis, external oblique, internal oblique muscles' measurement is made from the middle of the lowest part of the 12. rib and the highest point of the iliac crest and 2.5 cm in front of the midaxillary line. All measurements are repeated 3 times and the average value will be recorded. Vital capacity[VC], forced vital capacity [FVC], forced expiratory volume 1 second [FEV1] , FEV1/FVC, maximal expiratory flow rate [PEF], maximum inspiratory pressure [MIP] maximum expiratory pressure [MEP] in patients' PFT ] measurement results are checked. Intragroup and intergroup data are compared.

Official Title
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Ultrasonographic Evaluation of Respiratory Muscles in Stroke Patients and Correlation With Pulmonary Function Tests

Conditions
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Respiratory Muscle, Pulmonary Function Test

Intervention / Treatment
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* Diagnostic Test: Spirometry and ultrasonography in stroke group
* Diagnostic Test: Spirometry and ultrasonography in healthy group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Ischemic or Hemorrhagic stroke patients Stroke duration >6 months Mini-mental test score >24 Exclusion Criteria: Individuals with acute or chronic lung disease Patients with a history of thoracic or abdominal surgery Patients with other neuromuscular diseases Aphasia type with impaired understanding Facial paralysis

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Stroke patients<br>Ultrasonographic measurements were performed of the bilateral diaphragm and abdominal muscle thickness and thickening ratio of stroke patients. Spirometry evaluation was performed by another investigator. Diagnostic Test: Bilaterally diaphragm and abdominal muscle thickness and thickening ratio with ultrasonography | Diagnostic Test: Spirometry and ultrasonography in stroke group<br>* Ultrasonographic measurements were performed of the bilateral diaphragm and abdominal muscle thickness and thickening ratio in the supine position in the stroke patient group. The spirometric evaluation was also performed<br>|
| Healthy individuals<br>Ultrasonographic measurements were performed of dominant side diaphragm and abdominal muscle thickness and thickening ratio. Spirometry evaluation was performed by another investigator. Diagnostic Test: Dominant side diaphragm and abdominal muscle thickness and thickening ratio with ultrasonography | Diagnostic Test: Spirometry and ultrasonography in healthy group<br>* Ultrasonographic measurements were performed of dominant side diaphragm and abdominal muscle thickness and thickening ratio in the supine position in healthy individuals group. The spirometric evaluation was also performed<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Diaphragma and Abdominal Muscle Thickness and thickening ratio | Diaphragma and Abdominal Muscle ultrasonographic millimetric measurement | 1 day (a single point in time) | 
| Forced vital capacity [FVC] | >%80 is normal results | 1 day (a single point in time) | 
| Forced expiratory volume 1 second [FEV1] | >%80 is normal results | 1 day (a single point in time) | 
| FEV1/FVC | >%80 is normal results | 1 day (a single point in time) | 
| Maximal expiratory flow rate [PEF] | >%80 is normal results | 1 day (a single point in time) | 
| Maximum inspiratory pressure [MIP], | >80cmH2O is normal results | 1 day (a single point in time) | 
| Maximum expiratory pressure [MEP] | >95cmH2O is normal results | 1 day (a single point in time) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Brunnstrom stages | min 1 max 6, bigger values mean better results, | 1 day (a single point in time) | 
| Functional Ambulation Scale (FAS) | min 0 max 5, bigger values mean better results, | 1 day (a single point in time) | 
| Daily Living Activity (ADL) Index | min 0 max 100, bigger values mean better results, | 1 day (a single point in time) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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stroke, pulmonary function, ultrasound, respiratory muscle thickness