Post-stroke exercise tolerance improves after RMT

Many conditions may develop post-stroke. There are common conditions that improve over time and with rehabilitation. These include physical conditions, cognitive impairment and how you feel emotionally.

Physical conditions post-stroke

Although everyone will experience different effects after a stroke, there are  commonalities. For instance after a stroke you may feel fatigued. And in fact it is fatigue, or lack of energy that is one of the most common effects after a stroke. This can lead to difficulty in everyday life and during rehabilitation. Fatigue is influenced by several factors, including depression, poor sleep, medication and pain. But physical symptoms too will cause fatigue. For instance limb weakness will make movement harder work. Consequently movement will require more energy and subsequently fatigue will set in. Finally this results in a reduction in exercise tolerance, the level of exertion you can achieve before you become exhausted.

Improving exercise tolerance post-stroke

The good news is that new research shows Respiratory Muscle Training (RMT) to be effective at improving exercise tolerance poststroke.

What is RMT

RMT is a technique that aims to improve the function of the respiratory muscles. It is achieved through specific exercises. These exercises increase the strength and endurance of your respiratory muscles. Your respiratory muscles are those you use for inhalation and exhalation. As exhalation is mostly passive, it’s inhalation that you can influence. You can exercise the muscles you use to inhale with Inspiratory Muscle Training (IMT).

POWERbreathe IMT is beneficial post-stroke

POWERbreathe IMT is clinically proven Inspiratory Muscle Training. It is a Class 1 Medical Device. POWERbreathe IMT exercises the muscles you use to inhale, your inspiratory muscles. And scientific tests show that it increases inspiratory muscle strength, improves inspiratory stamina and reduces fatigue.

Latest research in poststroke patients

Findings from this new research are that RMT should be considered an effective method of improving respiratory function, inspiratory muscle strength, and exercise tolerance in patients poststroke.

Systematic Review of IMT After Cerebrovascular Accident


Systematic Review of Inspiratory Muscle Training After Cerebrovascular Accident
Martín-Valero R, De La Casa Almeida M, Casuso-Holgado MJ, Heredia-Madrazo A.

The objective of this Systematic Review, published in Respiratory Care (November 2015), was to “examine levels of evidence and recommendation grades of various therapeutic interventions of inspiratory muscle training in people who have had a stroke”.

Studies of relevance were searched for in MEDLINE, PEDro, OAIster, Scopus, PsycINFO, Web of Knowledge, CINAHL, SPORTDiscus, DOAJ, Cochrane, Embase, Academic Search Complete, Fuente Académica, and MedicLatina. Out of the 20 articles identified, 6 of these studies were found to be relevant to this review.

The Review concluded that more long-term studies are needed and “It is necessary to apply respiratory muscle training as a service of the national health system and to consider its inclusion in the conventional neurological program.”

Read the Systematic Review here >

Home-based Respiratory Training After Stroke

This new clinical trial, which is not yet open for participant recruitment, will test the hypothesis that home-based combined inspiratory muscular training (IMT) plus expiratory muscular training (EMT) program is effective in improving strength and endurance of the inspiratory and expiratory muscles, fatigue, exercise capacity, and quality of life (QoL) with stroke subjects.

Located at the Department of Physical Therapy, Universidade Federal de Minas Gerais in Brazil, the starting date for this trial is July 2015, with an estimated study completion of December 2017.


Effects of Home-based Respiratory Training After Stroke: A Randomized Controlled Trial


“Weakness of the respiratory muscles demonstrated by individuals with stroke, may generate important symptoms, such as fatigue and dyspnea. Since adequate strength of the inspiratory and expiratory muscles is required, mainly when performing physical activities, rehabilitation interventions for stroke subjects should include respiratory training.”

See more Inspiratory Muscle Training Research >

RMT study – improve cough effectiveness & reduce incidence of pneumonia in acute stroke

This Open Access article was published in April 2014.

Study Protocol:

A pilot study of respiratory muscle training to improve cough effectiveness and reduce the incidence of pneumonia in acute stroke: study protocol for a randomized controlled trial 


“After stroke, pneumonia is a relevant medical complication that can be precipitated by aspiration of saliva, liquids, or solid food. Swallowing difficulty and aspiration occur in a significant proportion of stroke survivors. Cough, an important mechanism protecting the lungs from inhaled materials, can be impaired in stroke survivors, and the likely cause for this impairment is central weakness of the respiratory musculature. Thus, respiratory muscle training in acute stroke may be useful in the recovery of respiratory muscle and cough function, and may thereby reduce the risk of pneumonia. The present study is a pilot study, aimed at investigating the validity and feasibility of this approach by exploring effect size, safety, and patient acceptability of the intervention.”


“Various novel pharmacologic and nonpharmacologic approaches for preventing stroke-associated pneumonia are currently being researched. This study investigates a novel strategy based on an exercise intervention for cough rehabilitation.

Trial registration: Current Controlled Trials ISRCTN40298220

View the Study Protocol online

View list of published research that used POWERbreathe as the IMT intervention of choice in POWERbreathe in Research.

Find more published research on our Inspiratory Muscle Training Research blog.