AUTHOR=Abdullahi Auwal , Wong Thomson WL , Ng Shamay SM 

TITLE=Efficacy of diaphragmatic breathing exercise on respiratory, cognitive, and motor function outcomes in patients with stroke: a systematic review and meta-analysis

JOURNAL=Frontiers in Neurology

VOLUME=Volume 14 - 2023

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1233408

DOI=10.3389/fneur.2023.1233408

ISSN=1664-2295

ABSTRACT=Background: Stroke disrupts the functions carried out by the brain such as the control of movement, sensation and cognition. Disruption of movement control results in hemiparesis that affects the function of the diaphragm. Impaired function of the diaphragm can in turn affect many outcomes such as respiratory, cognitive and motor function. The aim of this study is to carry out a systematic review and meta-analysis to determine the efficacy of diaphragmatic breathing exercise on respiratory, cognitive and motor outcomes after stroke. Method: The study was registered in PROSPERO (CRD42023422293). PubMED, Embase, Web of Science (WoS), PEDro, Scopus and CENTRAL were searched until September 2023. Only randomized controlled trials comparing diaphragmatic breathing exercise with a control were included.Information on the study authors, time since stroke and mean age, height, weight, sex, and the protocols of the experimental and control interventions including intensity, mean scores on the outcomes such as respiratory, cognitive and motor functions were extracted. Cochrane risks of bias assessment tool and PEDro scale were used to assess the risks of bias and methodological quality of the studies. Narrative synthesis and meta-analysis were used to summarize the results, which were then presented in Tables, Risk of Bias graph and Forest Plots. The meta-analysis was carried out on respiratory function (forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, peak expiratory flow (PEF)) and motor function (trunk impairment, and internal and external oblique muscles activity). Results: Six studies consisting of 151 participants were included. The results of the meta-analyses showed that, it is only superior to the control at improving respiratory function, FVC (MD = 0.90, 95% CI = 0.76 to 1.04, P < 0.00001), FEV1 (MD = 0.32, 95% CI = 0.11 to 0.52, P = 0.002), and PEF (MD = 1.48, 95% CI = 1.15 to 1.81, P < 0.00001). Conclusion: There is a low evidence that, diaphragmatic breathing exercise may help enhance respiratory function, which may help enhance recovery of function post stroke.