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<p>Post-stroke sarcopenia (PSP) poses a significant rehabilitation challenge due to substantial clinical heterogeneity in stroke type and comorbidities. While respiratory muscle training (RMT) offers a promising approach by targeting core physiological function, its consistent efficacy across diverse PSP subtypes remains unestablished. This study aimed to determine whether RMT’s benefits are consistent regardless of stroke etiology, pneumonia status, or cardiac function. This study consisted of two phases. Phase 1 was a retrospective analysis of 89 PSP patients to characterize clinical heterogeneity. Phase 2 was a prospective randomized controlled trial in which PSP patients were allocated to RMT plus standard care (<i>n</i> = 30) or standard care alone (<i>n</i> = 30). The protocol included 8 weeks of supervised RMT targeting diaphragmatic and accessory respiratory muscles. Outcomes included muscle mass (ASMI, calf circumference) and strength (handgrip) as primary measures, with physical function (MBI, FMA) as secondary outcomes. Prespecified subgroup analyses evaluated treatment interactions with stroke type, pneumonia, and cardiac function. The RMT group demonstrated significantly greater improvements in functional outcomes (MBI: <i>p</i> &lt; 0.01; FMA: <i>p</i> &lt; 0.05) and muscle mass metrics (ASMI: <i>p</i> &lt; 0.05; calf circumference: <i>p</i> &lt; 0.05) compared to controls. Crucially, subgroup analyses revealed no significant interactions between treatment effect and stroke type (ischemic/hemorrhagic), pneumonia status, or cardiac function (all <i>p</i> &gt; 0.05), suggesting consistent efficacy of RMT across these subgroups. Exploratory analysis further showed RMT mitigated the limiting effects of baseline physiological status on rehabilitation potential. RMT constitutes an effective foundational rehabilitation strategy for PSP, demonstrating consistent efficacy across major clinical subtypes. These findings support implementation as standard care irrespective of specific stroke characteristics or cardiopulmonary comorbidities, addressing a critical need in heterogeneous PSP populations.</p><p><b>Clinical trial registration number</b>: ChiCTR2500111452</p>

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Respiratory muscle training improves post-stroke sarcopenia independent of stroke type, pneumonia, and cardiac comorbidities

  • 期刊论文

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  • 发表日期：

    2026年6月23日

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  • Muhua Zhou,
  • Dongmei Li,
  • Sijun Li,
  • Xiaojuan Wang,
  • Junrui He,
  • Xibao Luo,
  • Zhenzxiu Qin,
  • Wei Lin

摘要

Post-stroke sarcopenia (PSP) poses a significant rehabilitation challenge due to substantial clinical heterogeneity in stroke type and comorbidities. While respiratory muscle training (RMT) offers a promising approach by targeting core physiological function, its consistent efficacy across diverse PSP subtypes remains unestablished. This study aimed to determine whether RMT’s benefits are consistent regardless of stroke etiology, pneumonia status, or cardiac function. This study consisted of two phases. Phase 1 was a retrospective analysis of 89 PSP patients to characterize clinical heterogeneity. Phase 2 was a prospective randomized controlled trial in which PSP patients were allocated to RMT plus standard care (n = 30) or standard care alone (n = 30). The protocol included 8 weeks of supervised RMT targeting diaphragmatic and accessory respiratory muscles. Outcomes included muscle mass (ASMI, calf circumference) and strength (handgrip) as primary measures, with physical function (MBI, FMA) as secondary outcomes. Prespecified subgroup analyses evaluated treatment interactions with stroke type, pneumonia, and cardiac function. The RMT group demonstrated significantly greater improvements in functional outcomes (MBI: p < 0.01; FMA: p < 0.05) and muscle mass metrics (ASMI: p < 0.05; calf circumference: p < 0.05) compared to controls. Crucially, subgroup analyses revealed no significant interactions between treatment effect and stroke type (ischemic/hemorrhagic), pneumonia status, or cardiac function (all p > 0.05), suggesting consistent efficacy of RMT across these subgroups. Exploratory analysis further showed RMT mitigated the limiting effects of baseline physiological status on rehabilitation potential. RMT constitutes an effective foundational rehabilitation strategy for PSP, demonstrating consistent efficacy across major clinical subtypes. These findings support implementation as standard care irrespective of specific stroke characteristics or cardiopulmonary comorbidities, addressing a critical need in heterogeneous PSP populations.

Clinical trial registration number: ChiCTR2500111452