Topics in stroke rehabilitation · 2025
Peak cough flow and diaphragmatic excursion during coughing in stroke patients with tracheostomy: a cross-sectional study.
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Li Dan, Yao Pengfei, Wang Juan, Wang Yulong
Аннотация
BACKGROUND: Although peak cough flow (PCF) is a critical indicator for tracheostomized stroke patients, it remains unclear whether diaphragmatic excursion during reflex cough, as the primary driver of inspiration, can predict PCF.
OBJECTIVE: To explore whether the diaphragmatic excursion during reflex coughing can predict PCF in stroke patients with tracheostomy.
METHODS: A total of 57 stroke patients were included in the study. The diaphragm excursion and PCF were measured and a simple linear regression was used to analyze the relationship between them. T-test, Chi-square test and Mann-Whitney U test were used to analyze the influencing factors of PCF, and multiple linear regression was used to construct a regression model.
RESULTS: A simple regression model showed significant associations between diaphragmatic excursion and PCF in patients with unilateral and bilateral paralysis (p = 0.036, R = 0.372, R2 = 0.139 for patients with unilateral paralysis; p = 0.002, R = 0.592, R2 = 0.350 for patients with bilateral paralysis). Except for the diaphragmatic excursion, the type of paresis was also an influencing factor for PCF. A multiple regression model adjusted for type of paresis showed a significant association between PCF and diaphragmatic excursion (p < 0.001, adjusted regression coefficient = 7.883, adjusted R2 = 0.257).
CONCLUSIONS: Diaphragmatic excursion during coughing was correlated with PCF. Furthermore, the type of paresis in stroke patients was identified as a significant factor affecting PCF. Our study established the preliminary diaphragmatic excursion-adjusted type of paresis equation as a predictor for estimating PCF in patients with stroke who underwent tracheostomy.
TRIAL REGISTRATION NUMBERS: ChiCTR2200063174.
OBJECTIVE: To explore whether the diaphragmatic excursion during reflex coughing can predict PCF in stroke patients with tracheostomy.
METHODS: A total of 57 stroke patients were included in the study. The diaphragm excursion and PCF were measured and a simple linear regression was used to analyze the relationship between them. T-test, Chi-square test and Mann-Whitney U test were used to analyze the influencing factors of PCF, and multiple linear regression was used to construct a regression model.
RESULTS: A simple regression model showed significant associations between diaphragmatic excursion and PCF in patients with unilateral and bilateral paralysis (p = 0.036, R = 0.372, R2 = 0.139 for patients with unilateral paralysis; p = 0.002, R = 0.592, R2 = 0.350 for patients with bilateral paralysis). Except for the diaphragmatic excursion, the type of paresis was also an influencing factor for PCF. A multiple regression model adjusted for type of paresis showed a significant association between PCF and diaphragmatic excursion (p < 0.001, adjusted regression coefficient = 7.883, adjusted R2 = 0.257).
CONCLUSIONS: Diaphragmatic excursion during coughing was correlated with PCF. Furthermore, the type of paresis in stroke patients was identified as a significant factor affecting PCF. Our study established the preliminary diaphragmatic excursion-adjusted type of paresis equation as a predictor for estimating PCF in patients with stroke who underwent tracheostomy.
TRIAL REGISTRATION NUMBERS: ChiCTR2200063174.