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. 泛素蛋白酶体系统在脑卒中后病理过程中的机制探讨. 中风与神经疾病杂志, 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.	王拥军, 陈玉国, 吕传柱, 等. 卒中相关性肺炎诊治中国专家共识(2019 更新版). 中国卒中杂志, 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. 急性脑梗死机械取栓后发生呼吸机相关性肺炎的危险因素分析. 中华全科医学, 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, 顾艳荭. 范围综述报告规范(PRISMA-ScR)的解读. 中国循证医学杂志, 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, Tunç 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, 杨聪, 黎巧玲, 等. 分级肺康复护理方案预防脑卒中相关性肺炎的效果. 护理研究, 2023, 37(21): 3917-3924.
19.	马海, 刘梅, 拜承萍, 等. 早期肺康复训练对脑卒中相关性肺炎患者的临床应用价值探索. 系统医学, 2023, 8(15): 8-12.
20.	刘翠, 甄巧霞, 齐琳, 等. 主动循环呼吸技术在脑卒中相关性肺炎气管切开患者治疗中的临床价值研究. 中国医学装备, 2022, 19(4): 114-117.
21.	梁天佳, 莫明玉, 周开斌, 等. 气道廓清术在脑卒中相关性肺炎气管切开患者康复中的应用. 中国呼吸与危重监护杂志, 2021, 20(4): 270-273.
22.	金国华, 陆静珏, 周一心, 等. 针刺联合肺康复治疗卒中相关性肺炎疗效观察. 河南中医, 2020, 40(6): 913-917.
23.	阮恒芳, 林蓉芳, 沈利平, 等. ICU 专科护士实施早期肺康复方案在卒中相关性肺炎患者中的效果研究. 中国实用护理杂志, 2019, 35(9): 654-658.
24.	杨涛, 欧阳斐, 赵焱, 等. 呼吸康复训练治疗出血性脑卒中相关性肺炎的疗效观察. 中华物理医学与康复杂志, 2019, 41(3): 210-212.
25.	薛廷婷, 刘琳, 胡亚丽. 呼吸肌功能锻炼联合吞咽功能训练在预防卒中患者相关性肺炎中的应用. 护理实践与研究, 2018, 15(12): 5-7.
26.	林晓群, 石敏丽, 唐丽军. 针刺联合肺康复训练治疗脑卒中相关性肺炎临床观察. 中国中医药现代远程教育, 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. 泛素蛋白酶体系统在脑卒中后病理过程中的机制探讨. 中风与神经疾病杂志, 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. 王拥军, 陈玉国, 吕传柱, 等. 卒中相关性肺炎诊治中国专家共识(2019 更新版). 中国卒中杂志, 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. 急性脑梗死机械取栓后发生呼吸机相关性肺炎的危险因素分析. 中华全科医学, 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, 顾艳荭. 范围综述报告规范(PRISMA-ScR)的解读. 中国循证医学杂志, 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, Tunç 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, 杨聪, 黎巧玲, 等. 分级肺康复护理方案预防脑卒中相关性肺炎的效果. 护理研究, 2023, 37(21): 3917-3924.
19. 马海, 刘梅, 拜承萍, 等. 早期肺康复训练对脑卒中相关性肺炎患者的临床应用价值探索. 系统医学, 2023, 8(15): 8-12.
20. 刘翠, 甄巧霞, 齐琳, 等. 主动循环呼吸技术在脑卒中相关性肺炎气管切开患者治疗中的临床价值研究. 中国医学装备, 2022, 19(4): 114-117.
21. 梁天佳, 莫明玉, 周开斌, 等. 气道廓清术在脑卒中相关性肺炎气管切开患者康复中的应用. 中国呼吸与危重监护杂志, 2021, 20(4): 270-273.
22. 金国华, 陆静珏, 周一心, 等. 针刺联合肺康复治疗卒中相关性肺炎疗效观察. 河南中医, 2020, 40(6): 913-917.
23. 阮恒芳, 林蓉芳, 沈利平, 等. ICU 专科护士实施早期肺康复方案在卒中相关性肺炎患者中的效果研究. 中国实用护理杂志, 2019, 35(9): 654-658.
24. 杨涛, 欧阳斐, 赵焱, 等. 呼吸康复训练治疗出血性脑卒中相关性肺炎的疗效观察. 中华物理医学与康复杂志, 2019, 41(3): 210-212.
25. 薛廷婷, 刘琳, 胡亚丽. 呼吸肌功能锻炼联合吞咽功能训练在预防卒中患者相关性肺炎中的应用. 护理实践与研究, 2018, 15(12): 5-7.
26. 林晓群, 石敏丽, 唐丽军. 针刺联合肺康复训练治疗脑卒中相关性肺炎临床观察. 中国中医药现代远程教育, 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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