# Impact of respiratory training combined with electrical phrenic nerve stimulation on pulmonary and trunk function in individuals who have recently experienced a stroke

## TL;DR

This study finds that combining respiratory training with phrenic nerve stimulation improves lung and core functions in stroke patients.

## Contribution

The novel contribution is demonstrating the effectiveness of combining phrenic nerve stimulation with respiratory training in post-stroke rehabilitation.

## Key findings

- Both groups showed improved trunk control, balance, and pulmonary function after 4 weeks of treatment.
- The experimental group showed significant improvements in movement metrics and respiratory muscle strength.
- Combined phrenic nerve stimulation and training enhanced post-stroke pulmonary and trunk function.

## Abstract

This study aims to explore the effects of combining phrenic nerve electrical stimulation with respiratory training on pulmonary and trunk function in post-stroke individuals. Rationale for combining these interventions stems from the diaphragm’s dual role in respiration and postural control, as well as the limitations of conventional respiratory training in addressing phrenic nerve dysfunction and impaired diaphragm coordination after stroke.

In this single-blinded randomized controlled trial, 160 early stroke patients were randomly assigned via computer-generated random number tables with allocation concealment using sealed opaque envelopes to a control group receiving standard therapy and an experimental group receiving additional phrenic nerve stimulation and breathing training. Each group comprised 80 patients. To evaluate the trunk function and balance before and after the treatment, the Sheikh Trunk Control Scale, Berg Balance Scale (BBS), and Balance Feedback Training Device were utilized. Additionally, pulmonary function was assessed using a pulmonary function measuring instrument.

Following 4 weeks of treatment, there was a statistically significant enhancement in the Sheikh Trunk Control Scale and BBS scores, respiratory muscle strength index, and peak inspiratory flow rate for patients in both groups (p < 0.05). Additionally, there were significant reductions in measures related to balance, including movement length, movement area, as well as mean anterior–posterior and left–right movement speeds (p < 0.05). Consequently, after the 4-week treatment period, the trunk function and balance, pulmonary function all improved in the experimental group.

Combining phrenic nerve stimulation with respiratory training can effectively improve lung and core functions during post-stroke rehabilitation. However, generalizability is limited by the short follow-up period and strict exclusion criteria. Future research should explore long-term outcomes and compare combined interventions with standalone therapies.