Application of pulmonary rehabilitation in patients with stroke-associated pneumonia: a scoping review_West China Medical Journal

Authors：

LU Ting ¹ ,  LI Juan ² , XIAN Lihong ³ , ZHU Huanhuan ¹ , WEN Qinghua ¹

1. College of Nursing, Guizhou University of Traditional Chinese Medicine, Guiyang, Guizhou 550002, P. R. China;
2. Department of Nursing, the People’s Hospital of Guizhou Province, Guiyang, Guizhou 550002, P. R. China;
3. College of Nursing, Zunyi Medical University, Zunyi, Guizhou 563000, P. R. China;

Corresponding?author：

LI Juan, Email: 694807055@qq.com

Keywords：

Stroke-associated pneumonia; pulmonary rehabilitation; scoping review

DOI：

10.7507/1002-0179.202402044

Video：

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Objective To systematically analyse the application of pulmonary rehabilitation in patients with stroke-associated pneumonia (SAP), in order to provide reference for clinical healthcare professionals to carry out relevant interventions. Methods PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang, Chongqing VIP, and SinoMed were systematically searched, with a search period from database establishment until December 31, 2023. The scoping review method was used to analyze the included studies. Results A total of 16 studies were included, mainly randomized controlled trials and quasi-experimental studies. The research mainly focuses on China and South Korea. The sample size was generally 40-80 cases. The duration of intervention is mostly 2-4 weeks. Six different lung rehabilitation interventions were involved. The main outcome measures included lung function, incidence of SAP, mortality rate, cognitive function, severity of stroke, length of intensive care unit stay, duration of antibiotic use, and daily living activity. Most studies had shown that lung rehabilitation has a significant impact on SAP patients.Conclusions The effectiveness of pulmonary rehabilitation in SAP patients has been preliminarily validated. Future research needs to cover a wider range of regions and larger samples, and conduct long-term tracking studies and multidimensional evaluations to enhance the universality and reliability of the results.

Citation： LU Ting, LI Juan, XIAN Lihong, ZHU Huanhuan, WEN Qinghua. Application of pulmonary rehabilitation in patients with stroke-associated pneumonia: a scoping review. West China Medical Journal, 2024, 39(5): 711-716. doi: 10.7507/1002-0179.202402044 Copy

1.	李煜超, 王燕. 泛素蛋白酶體系統在腦卒中后病理過程中的機制探討. 中風與神經疾病雜志, 2022, 39(2): 187-189.
2.	Feigin VL, Brainin M, Norrving B, et al. World Stroke Organization (WSO): global stroke fact sheet 2022. Int J Stroke, 2022, 17(1): 18-29.
3.	王擁軍, 陳玉國, 呂傳柱, 等. 卒中相關性肺炎診治中國專家共識(2019 更新版). 中國卒中雜志, 2019, 14(12): 1251-1262.
4.	Ali AN, Howe J, Majid A, et al. The economic cost of stroke-associated pneumonia in a UK setting. Top Stroke Rehabil, 2018, 25(3): 214-223.
5.	Teh WH, Smith CJ, Barlas RS, et al. Impact of stroke-associated pneumonia on mortality, length of hospitalization, and functional outcome. Acta Neurol Scand, 2018, 138(4): 293-300.
6.	de Montmollin E, Ruckly S, Schwebel C, et al. Pneumonia in acute ischemic stroke patients requiring invasive ventilation: impact on short and long-term outcomes. J Infect, 2019, 79(3): 220-227.
7.	范亭亭, 李瑞, 朱余友, 等. 急性腦梗死機械取栓后發生呼吸機相關性肺炎的危險因素分析. 中華全科醫學, 2023, 21(10): 1654-1656, 1788.
8.	Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med, 2013, 188(8): e13-e64.
9.	仇如霞, 顧艷葒. 范圍綜述報告規范(PRISMA-ScR)的解讀. 中國循證醫學雜志, 2022, 22(6): 722-730.
10.	Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med, 2018, 169(7): 467-473.
11.	Kulnik ST, Birring SS, Moxham J, et al. Does respiratory muscle training improve cough flow in acute stroke? Pilot randomized controlled trial. Stroke, 2015, 46(2): 447-453.
12.	Na EH, Han SJ, Yoon TS. Effect of active pulmonary rehabilitation on pulmonary function in patients with brain lesion. NeuroRehabilitation, 2014, 35(3): 459-466.
13.	Elnemr R, Helmy TA, Elsayed MW, et al. Effect of a pulmonary rehabilitation program on hospital mortality and disability in patients with acute ischemic stroke. Crit Rev Phys Rehabil Med, 2022, 34(2): 41-54.
14.	Choi HE, Jo GY, Do HK, et al. Comprehensive respiratory muscle training improves pulmonary function and respiratory muscle strength in acute stroke patients. J Cardiopulm Rehabil Prev, 2021, 41(3): 166-171.
15.	Yoo HJ, Pyun SB. Efficacy of bedside respiratory muscle training in patients with stroke: a randomized controlled trial. Am J Phys Med Rehabil, 2018, 97(10): 691-697.
16.	Güngen BD, Tun? A, Aras YG, et al. Predictors of intensive care unit admission and mortality in patients with ischemic stroke: investigating the effects of a pulmonary rehabilitation program. BMC Neurol, 2017, 17(1): 132.
17.	Kim CY, Lee JS, Kim HD, et al. Effects of the combination of respiratory muscle training and abdominal drawing-in maneuver on respiratory muscle activity in patients with post-stroke hemiplegia: a pilot randomized controlled trial. Top Stroke Rehabil, 2015, 22(4): 262-270.
18.	胡宏美, 楊聰, 黎巧玲, 等. 分級肺康復護理方案預防腦卒中相關性肺炎的效果. 護理研究, 2023, 37(21): 3917-3924.
19.	馬海, 劉梅, 拜承萍, 等. 早期肺康復訓練對腦卒中相關性肺炎患者的臨床應用價值探索. 系統醫學, 2023, 8(15): 8-12.
20.	劉翠, 甄巧霞, 齊琳, 等. 主動循環呼吸技術在腦卒中相關性肺炎氣管切開患者治療中的臨床價值研究. 中國醫學裝備, 2022, 19(4): 114-117.
21.	梁天佳, 莫明玉, 周開斌, 等. 氣道廓清術在腦卒中相關性肺炎氣管切開患者康復中的應用. 中國呼吸與危重監護雜志, 2021, 20(4): 270-273.
22.	金國華, 陸靜玨, 周一心, 等. 針刺聯合肺康復治療卒中相關性肺炎療效觀察. 河南中醫, 2020, 40(6): 913-917.
23.	阮恒芳, 林蓉芳, 沈利平, 等. ICU 專科護士實施早期肺康復方案在卒中相關性肺炎患者中的效果研究. 中國實用護理雜志, 2019, 35(9): 654-658.
24.	楊濤, 歐陽斐, 趙焱, 等. 呼吸康復訓練治療出血性腦卒中相關性肺炎的療效觀察. 中華物理醫學與康復雜志, 2019, 41(3): 210-212.
25.	薛廷婷, 劉琳, 胡亞麗. 呼吸肌功能鍛煉聯合吞咽功能訓練在預防卒中患者相關性肺炎中的應用. 護理實踐與研究, 2018, 15(12): 5-7.
26.	林曉群, 石敏麗, 唐麗軍. 針刺聯合肺康復訓練治療腦卒中相關性肺炎臨床觀察. 中國中醫藥現代遠程教育, 2023, 21(22): 114-117.
27.	Pollock RD, Rafferty GF, Moxham J, et al. Respiratory muscle strength and training in stroke and neurology: a systematic review. Int J Stroke, 2013, 8(2): 124-130.
28.	Manifield J, Chaudhry Y, Singh SJ, et al. Changes in physical activity, sedentary behaviour and sleep following pulmonary rehabilitation: a systematic review and network meta-analysis. Eur Respir Rev, 2024, 33(172): 230225.
29.	Gordon CS, Waller JW, Cook RM, et al. Effect of pulmonary rehabilitation on symptoms of anxiety and depression in COPD: a systematic review and meta-analysis. Chest, 2019, 156(1): 80-91.

1. 李煜超, 王燕. 泛素蛋白酶體系統在腦卒中后病理過程中的機制探討. 中風與神經疾病雜志, 2022, 39(2): 187-189.
2. Feigin VL, Brainin M, Norrving B, et al. World Stroke Organization (WSO): global stroke fact sheet 2022. Int J Stroke, 2022, 17(1): 18-29.
3. 王擁軍, 陳玉國, 呂傳柱, 等. 卒中相關性肺炎診治中國專家共識(2019 更新版). 中國卒中雜志, 2019, 14(12): 1251-1262.
4. Ali AN, Howe J, Majid A, et al. The economic cost of stroke-associated pneumonia in a UK setting. Top Stroke Rehabil, 2018, 25(3): 214-223.
5. Teh WH, Smith CJ, Barlas RS, et al. Impact of stroke-associated pneumonia on mortality, length of hospitalization, and functional outcome. Acta Neurol Scand, 2018, 138(4): 293-300.
6. de Montmollin E, Ruckly S, Schwebel C, et al. Pneumonia in acute ischemic stroke patients requiring invasive ventilation: impact on short and long-term outcomes. J Infect, 2019, 79(3): 220-227.
7. 范亭亭, 李瑞, 朱余友, 等. 急性腦梗死機械取栓后發生呼吸機相關性肺炎的危險因素分析. 中華全科醫學, 2023, 21(10): 1654-1656, 1788.
8. Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med, 2013, 188(8): e13-e64.
9. 仇如霞, 顧艷葒. 范圍綜述報告規范(PRISMA-ScR)的解讀. 中國循證醫學雜志, 2022, 22(6): 722-730.
10. Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med, 2018, 169(7): 467-473.
11. Kulnik ST, Birring SS, Moxham J, et al. Does respiratory muscle training improve cough flow in acute stroke? Pilot randomized controlled trial. Stroke, 2015, 46(2): 447-453.
12. Na EH, Han SJ, Yoon TS. Effect of active pulmonary rehabilitation on pulmonary function in patients with brain lesion. NeuroRehabilitation, 2014, 35(3): 459-466.
13. Elnemr R, Helmy TA, Elsayed MW, et al. Effect of a pulmonary rehabilitation program on hospital mortality and disability in patients with acute ischemic stroke. Crit Rev Phys Rehabil Med, 2022, 34(2): 41-54.
14. Choi HE, Jo GY, Do HK, et al. Comprehensive respiratory muscle training improves pulmonary function and respiratory muscle strength in acute stroke patients. J Cardiopulm Rehabil Prev, 2021, 41(3): 166-171.
15. Yoo HJ, Pyun SB. Efficacy of bedside respiratory muscle training in patients with stroke: a randomized controlled trial. Am J Phys Med Rehabil, 2018, 97(10): 691-697.
16. Güngen BD, Tun? A, Aras YG, et al. Predictors of intensive care unit admission and mortality in patients with ischemic stroke: investigating the effects of a pulmonary rehabilitation program. BMC Neurol, 2017, 17(1): 132.
17. Kim CY, Lee JS, Kim HD, et al. Effects of the combination of respiratory muscle training and abdominal drawing-in maneuver on respiratory muscle activity in patients with post-stroke hemiplegia: a pilot randomized controlled trial. Top Stroke Rehabil, 2015, 22(4): 262-270.
18. 胡宏美, 楊聰, 黎巧玲, 等. 分級肺康復護理方案預防腦卒中相關性肺炎的效果. 護理研究, 2023, 37(21): 3917-3924.
19. 馬海, 劉梅, 拜承萍, 等. 早期肺康復訓練對腦卒中相關性肺炎患者的臨床應用價值探索. 系統醫學, 2023, 8(15): 8-12.
20. 劉翠, 甄巧霞, 齊琳, 等. 主動循環呼吸技術在腦卒中相關性肺炎氣管切開患者治療中的臨床價值研究. 中國醫學裝備, 2022, 19(4): 114-117.
21. 梁天佳, 莫明玉, 周開斌, 等. 氣道廓清術在腦卒中相關性肺炎氣管切開患者康復中的應用. 中國呼吸與危重監護雜志, 2021, 20(4): 270-273.
22. 金國華, 陸靜玨, 周一心, 等. 針刺聯合肺康復治療卒中相關性肺炎療效觀察. 河南中醫, 2020, 40(6): 913-917.
23. 阮恒芳, 林蓉芳, 沈利平, 等. ICU 專科護士實施早期肺康復方案在卒中相關性肺炎患者中的效果研究. 中國實用護理雜志, 2019, 35(9): 654-658.
24. 楊濤, 歐陽斐, 趙焱, 等. 呼吸康復訓練治療出血性腦卒中相關性肺炎的療效觀察. 中華物理醫學與康復雜志, 2019, 41(3): 210-212.
25. 薛廷婷, 劉琳, 胡亞麗. 呼吸肌功能鍛煉聯合吞咽功能訓練在預防卒中患者相關性肺炎中的應用. 護理實踐與研究, 2018, 15(12): 5-7.
26. 林曉群, 石敏麗, 唐麗軍. 針刺聯合肺康復訓練治療腦卒中相關性肺炎臨床觀察. 中國中醫藥現代遠程教育, 2023, 21(22): 114-117.
27. Pollock RD, Rafferty GF, Moxham J, et al. Respiratory muscle strength and training in stroke and neurology: a systematic review. Int J Stroke, 2013, 8(2): 124-130.
28. Manifield J, Chaudhry Y, Singh SJ, et al. Changes in physical activity, sedentary behaviour and sleep following pulmonary rehabilitation: a systematic review and network meta-analysis. Eur Respir Rev, 2024, 33(172): 230225.
29. Gordon CS, Waller JW, Cook RM, et al. Effect of pulmonary rehabilitation on symptoms of anxiety and depression in COPD: a systematic review and meta-analysis. Chest, 2019, 156(1): 80-91.

West China Medical Journal

Application of pulmonary rehabilitation in patients with stroke-associated pneumonia: a scoping review

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