INSPIRATORY muscle training strengthened diaphragm measures, and inspiratory strength in subacute stroke participants in six weeks.
Inspiratory Muscle Training Improved Diaphragm Function
Respiratory dysfunction is common after stroke and can complicate rehabilitation by limiting ventilatory capacity and exercise tolerance. In a single-blind randomized controlled trial, adding inspiratory muscle training to usual poststroke care improved key ultrasound markers of diaphragm function and increased respiratory muscle strength in patients with subacute ischemic stroke.
Trial Design and Rehabilitation Context
Twenty-six patients more than 1 month after ischemic stroke onset were randomized to an intervention group or control group. Both groups received standard neurorehabilitation alongside aerobic training and the Active Cycle of Breathing Technique. The intervention group also completed inspiratory muscle training 5 days per week for 6 weeks, totaling 30 sessions. Outcomes captured both physiological and functional domains, including maximal inspiratory pressure and maximal expiratory pressure, diaphragm thickness and excursion measured by ultrasonography, six-minute walk test performance, and patient-reported activity performance using the Canadian Occupational Performance Measure.
Strength Gains Without Clear Functional Separation
Twenty-two participants completed the study. Within each group, measures improved over time, including inspiratory and expiratory pressures, diaphragm thickness and excursion, walking distance, and activity performance scores. However, the between-group comparisons favored the inspiratory muscle training group for changes in inspiratory and expiratory pressures and multiple diaphragm ultrasound parameters, including thickness on the affected side and excursion. In contrast, functional outcomes that reflect broader stroke recovery, such as six-minute walk test and occupational performance scores, did not differ significantly between groups over the study period.
Overall, these findings suggest inspiratory muscle training can meaningfully strengthen respiratory mechanics in subacute ischemic stroke and may serve as a practical adjunct to multidisciplinary rehabilitation, particularly when clinicians aim to target diaphragm performance directly.
Reference: Akçay S et al. Effect Of Inspiratory Muscle Traınıng on Diaphragm Functıon and Activıty Performance in Subacute Ischemıc Stroke Patıents: A Sıngle-Blind Randomized-Controlled Trial. Neurorehabil Neural Repair. 2026;doi:10.1177/15459683251412282.
