Effects of diaphragmatic facilitation methods on respiratory muscle strength in patients with chronic stroke: A randomized controlled trial

Background: Stroke significantly leads to altered lung mechanics, irregular respiratory rhythms, and compromised breathing control, thereby impacting pulmonary functions. However, the impact on diaphragmatic function remains underexplored. Aim: Enhanced impact of diaphragmatic facilitation methods on respiratory muscle strength in patients with chronic stroke: a randomized controlled trial (RCT). Methods: Overall, 60 patients with chronic stroke were involved for this single-blinded RCT that was allocated to Group A ( n = 30; all males), which received conventional therapy, while Group B ( n = 30; 28 males, and 2 females) received diaphragmatic facilitation techniques combined with conventional exercise intervention for 4 weeks. Participants were randomly allocated using computer-generated randomization in a 1:1 ratio. An independent administrator prepared opaque, sequentially numbered, sealed envelopes to ensure concealed allocation and minimize selection bias. Outcome assessors and data analysts were blinded to group allocation. Outcome measures included chest expansion at the xiphisternum level, maximum respiratory pressures (Micro RPM), and diaphragmatic thickness (ultrasonography [USG]), that were assessed at baseline and postintervention. For normality evaluation, the Shapiro–Wilk test was applied, and the Mann–Whitney U -test and Wilcoxon paired test were performed for between-group and within-group comparisons. Results: In comparison to Group A, Group B showed enhanced improvements in chest expansion ( P = 0.001), inspiratory pressure ( P = 0.001), and expiratory pressure ( P = 0.001), with no USG changes. Moreover, between-group analysis favored Group B in posttreatment chest expansion ( P = 0.005) and inspiratory pressure ( P = 0.003). Conclusion: The study concluded that diaphragmatic facilitation techniques, combined with conventional therapy, significantly enhance the strength of the respiratory muscles in chronic stroke patients.