4. Discussion
respiratory muscle efficiency, Stroke, chronic stroke, stroke, impaired trunk control [In this study
STROKE, STROKE
This study was conducted to investigate the effects of an intervention combining chest mobilization and breathing exercises on respiratory function, trunk control, and endurance in stroke patients who contracted COVID-19. Thirty stroke patients who had recovered from COVID-19 were randomized into the CMEBE and CPTBE groups. Respiratory function, trunk control, and endurance were measured in both groups before and after the intervention to evaluate the pre–post changes within each group and between the two groups.Stroke results in significant changes in respiratory function due to impaired trunk control [In this study, the respiratory function of stroke patients was evaluated by measuring FVC, FEV1, and PEF. FVC measures the maximum volume of air that a patient can forcefully exhale after inhaling as deeply and rapidly as possible. FEV1 measures the volume of forcefully exhaled air over one second while measuring FVC. PEF measures the flow of air during a forced expiration after inhaling the maximum possible amount of air. Significant increases in FVC, FEV1, and PEF were observed in both the CMEBE and CPTBE groups, with the CMEBE group showing greater improvements in FEV1 and PEF. Respiratory intervention methods are categorized into voluntarily controlled breathing and breathing using resistance-training devices. A study using a respiratory resistance-training device in chronic stroke patients reported significant improvements in FVC, FEV1, and PEF [Restricted physical capacity and resulting physical inactivity can lead to decreased respiratory muscle efficiency and increased rib cage asymmetry, resulting in restricted movement. To address this problem, it is necessary to apply an appropriate respiratory exercise program that directly or indirectly enhances the mobility and endurance of respiratory muscles [The CMEBE group showed a significant increase in FEV1, to a greater extent than the CPTBE group, supporting the results of a previous study [The outcome values of this study showed partial increases and significant differences, rather than overall improvements. There are three limitations to this study that should be noted. First, as this study was conducted only in inpatients and outpatients of Y Rehabilitation Hospital in Gangwon Province, the results may not be generalizable to all stroke patients. Second, as this study recruited patients with reduced respiratory function due to COVID-19 among chronic stroke patients, the results may not be generalizable to all chronic stroke patients. Third, this study could not control for factors that may affect the measurement results of stroke patients other than intervention variables, including daily life and psychological factors. Overcoming these limitations in future research and applying the intervention method of combining chest mobilization and breathing exercises proposed in this study to stroke patients could more effectively improve their respiratory function, trunk stability, and endurance. Additionally, it is necessary to conduct follow-up studies to examine the maintenance of the intervention’s effects and further test its effectiveness.