Pulmonary Rehabilitation after Stroke

Abstract

Respiratory dysfunction is a common complication following a stroke; however, the pulmonary rehabilitation of stroke patients has not been heavily emphasized until recently. PUBMED databases were searched systematically (since inception to December 2016) using the following search terms: “stroke” in Title/Abstract and “pulmonary rehabilitation” in all field. Articles published in a language other than English excluded. The original search yielded 404 articles, of which 57 articles were included in this systematic review.

After a stroke, the respiratory center and related motor pathways can directly decrease respiratory muscle strength and subsequently induce a change in breathing patterns. As a result, pneumonia, pulmonary ventilation disorders, lung injury, lung ischemia reperfusion injury, decreased pulmonary compliance, abnormal posture, and obstructive sleep apnea can occur following a stroke. Thus, pulmonary rehabilitation is critical to reducing these complications. The main forms of pulmonary rehabilitation include exercise training, respiratory muscle training, oxygen therapy, noninvasive ventilation, nutrition support, social psychological support, and health education.

Although pulmonary rehabilitation has become a definitive therapy of chronic respiratory diseases, the mechanisms of pulmonary rehabilitation, including the specific methods used for stroke patients requires further investigation. To provide some useful information for clinicians on treating respiratory dysfunction, we reviewed the type of stroke-related respiratory dysfunction and pulmonary rehabilitation methods in our manuscript.

Zusamenfassung

Atemfunktionsstörungen sind eine häufige Komplikation nach einem Schlaganfall; bis vor kurzem stand jedoch die pneumologische Rehabilitation von Schlaganfallpatienten nicht im Vordergrund. PUBMED Datenbanken wurden systematisch untersucht (seit Beginn im Dezember 2016), wobei folgende Suchbegriffe verwendet wurden: „Schlaganfall“ im Titel/in der Zusammenfassung und „pneumologische Rehabilitation“ in allen Feldern. Es wurden nur englischsprachige Artikel untersucht. Die ursprüngliche Suche ergab 404 Artikel, davon wurden 57 Artikel in die systematische Übersicht einbezogen.

Nach einem Schlaganfall können das Atemzentrum und die motorischen Nervenbahnen direkt die Muskelkraft der Atemmuskeln schwächen und so veränderte Atemmuster bewirken. Als Folge davon können Lungenentzündungen, Störungen der Lungenventilation, Verletzungen der Lunge, ischemische Reperfusionsschäden der Lunge, verminderte Lungencompliance, eine krankhafte Körperhaltung und obstruktive Schlafapnoe nach einem Schlaganfall auftreten. Um diese Komplikationen zu vermindern, ist daher die pneumologische Rehabilitation von entscheidender Bedeutung. Zu den wichtigsten Komponenten der pneumologischen Rehabilitation gehören körperliches Training, Atemmuskeltraining, Sauerstoffbehandlung, nicht-invasive Beatmung, Ernährungsberatung, sozial-psychologische Unterstützung und Gesundheitsberatung.

Obwohl die pneumologische Rehabilitation eine fester Bestandteil in der Behandlung von chronischen Erkrankungen der Atemwege geworden ist, bedarf es weiterer Untersuchungen zu den Wirkungsweisen der pneumologischen Rehabilitation, einschließlich der spezifischen Methoden, die für Schaganfallpatienten eingesetzt werden. Um Klinikern nützliche Informationen für die Behandlung von Atemfunktionsstörungen an die Hand zu geben, haben wir hier die Art der Atemfunktionsstörungen nach einem Schlaganfall und die relevanten pneumologischen Rehabilitationsmethoden untersucht.

Key words

Pulmonary Rehabilitation - Stroke - Outcomes

Schlüsselwörter

pneumologische Rehabilitation - Schlaganfall - Outcome

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