Respiratory muscle training in stroke—a narrative review

Stroke causes multidimensional abnormalities seen in neurological, musculo-skeletal, and cardiorespiratory systems leading to reduced respiratory function and pulmonary complications with an associated higher risk of mortality. Physiotherapy rehabilitation, which includes inspiratory and expiratory muscle training (IEMT), neuromuscular electrical stimulation (NMES), breathing exercises, and threshold devices, influences the reduction of ill effects caused by stroke. This review gathers current evidence and physiotherapy practices for improving respiratory muscle strength and reducing pulmonary complications in stroke survivors. An exten-sive literature search was done in the following databases: MEDLINE, PubMed, Scopus, Google Scholar, and Cochrane Library from January 2018 to March 2020. One systematic review, one systematic review with meta-analysis, and four randomized controlled studies investigating the effects of various interventions for respiratory complications in poststroke patients were selected and reviewed. Inspiratory muscle training, neuromuscular electrical stimulation, and other breathing exercises are appropriate for better pulmonary function following stroke.