Comparative Effect Of Liuzijue Qigong And Conventional Respiratory Training On Trunk Control Ability And Respiratoy Muscle Function In Patients At An Early Recovery Stage From Stroke

Purpose: The aim of this study was to compare the effects of Liuzijue Qigong and conventional respiratory training on trunk control ability and respiratory muscle function in patients at an early recovery stage from stroke.Methods: Patients were recruited in the Department of Rehabilitation of Shanghai Xuhui Central Hospital,Shanghai between January 2019 and July 2019.60 patients who met the requirements were screened by the inclusion and exclusion criteria.The diagnostic criteria refer to the relevant diagnostic criteria for cerebral infarction and cerebral hemorrhage in the 2015 edition of Chinese guidelines for the prevention and treatment of cerebrovascular diseases.Our study was approved by the Ethics Committee of Shanghai Xuhui Central Hospital.All participants provided written informed consent.In this study,participants were randomly allocated to either the ‘conventional rehabilitation training + Liuzijue exercise'(group A),or the ‘conventional rehabilitation training + conventional respiration training'(group B),based on a randomization table and allocation(1:1)using sealed opaque envelopes.Patients assigned to the experimental group received the Liuzijue exercise according to our improved scheme of the Healthcare Qigong Liuzijue instructions compiled by the Health Qigong Management Center of China Sport General Administration.In order to adapt to patients' functional characteristics in the early recovery stages after stroke,we have made some necessary improvements to the breathing and movements.The total time of treatment for patients in each group was 45 min: the Liuzijue training(20 min);conventional respiration training(20 min);followed by conventional rehabilitation therapy(25 min),conducted 5 times per week for 3 weeks.Trunk Impairment Scale(TIS),Maximum inspiratory pressure(MIP)and Maximum expiratory pressure(MEP)were used as the primary outcome measures to observe the improvement of trunk control ability and respiratory muscle function in patients at an early recovery stage from stroke.The diaphragmatic movement at the time of quiet breathing and the deep breathing,the change of intra-abdominal pressure(IAP),Berg Balance Scale(BBS)and the Modified Barthel index(MBI)were used to assessed the improvement of diaphragm function,lung ventilation function,balance function and daily living activity in patients.Results: 1.The comparsion of TISAfter 3 weeks of intervention,comparison within groups showed that static sitting balance,dynamic sitting balance,coordination of trunk movement subscales of TIS and TIS total scores of the two groups were significantly higher than before the intervention(P<0.01).A statistically significant difference was found between the two groups in the dynamic sitting balance,coordination subscales and TIS total scores(P<0.01).The static sitting balance subscales showed no statistically significant difference between the two groups(P>0.05).2.The comparsion of MIP,MEPThe MIP,MEP of group A and MIP of group B were significantly increased compared to values before the intervention(P < 0.01),but no significant difference(P>0.05)was found in the MEP of group B.There was a significant difference in MIP and MEP score changes between the two groups(P<0.01).3.The comparsion of change of intra-abdominal pressureThe changes in the intra-abdominal pressure of both group A and group B showed significantly differences compared to before the intervention(P < 0.01).The data revealed that the change in intra-abdominal pressure between group A and group B was significantly different(P<0.01).4.The comparsion of diaphragmatic movementThe diaphragmatic movements of quiet breathing in group A were significantly higher than before the intervention(P<0.01),but the diaphragmatic movement of quiet breathing in group B showed no significant difference(P>0.05).The diaphragmatic movement of deep breathing in group A and group B appeared to have improved after 3 weeks of the intervention(P>0.05);however,the finding did not reach statistical significance.There was no statistically significant difference between the two groups in diaphragmatic movement of quiet breathingand deep breathing(P>0.05).5.The comparsion of lung ventilation functionsThis study revealed that after 3 weeks of intervention,compared with before treatment,lung ventilation function in both patient groups was improved.The FEV1(P<0.01),FVC(P<0.01),PEF(P<0.01),and MMEF of group A,and FVC(P<0.05),PEF(P<0.01)of group B were significantly increased compared to values before the intervention.No statistically significant differences were found in FEV1 and MMEF of group B(P>0.05).These findings showed that changes in the FEV1,PEF and MMEF of group A were significantly higher than those in group B(P<0.01).There was no significant difference in FVC between the two groups(P>0.05).6.The comparsion of BBS and MBIThe BBS and MBI of the two groups were significantly higher than before the intervention(P<0.01).The MBI score changes were significantly different between the two groups(P<0.01).No statistically significant difference was found between the two groups' BBS(P>0.05).Conclusion1.Compared with conventional respiratory training,the Liuzijue intervention was more effective in improving trunk control ability and respiratory muscle function in patients at an early recovery stage from stroke.2.Compared with conventional respiratory training,the Liuzijue intervention was more effective in improving the lung ventilation function and ADL.