JMIR Publications

ABSTRACT

Background:

Respiratory dysfunction in acute stroke impairs functional recovery, yet hospital-based interventions were limited by insufficient staffing and inconsistent service delivery. Telerehabilitation offers a promising solution, but its efficacy in acute inpatient settings remain unexplored.

Objective:

we aimed to evaluate the efficacy and safety of comprehensive mobile-based respiratory training program in the early stage of stroke recovery.

Methods:

This single-center, assessor-blinded, randomized controlled trial enrolled 40 patients with moderate acute stroke (September 2024–March 2025). Patients were randomized 1:1 to a 2-week hospital-based comprehensive mobile-based respiratory training program (CMRTP) plus conventional rehabilitation or conventional rehabilitation alone. The respiratory function on forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), and respiratory muscle strength on maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), function ability on Modified Barthel Index (MBI) were measured at baseline,1 and 2 weeks after intervention. Repeated-measures analysis of covariance was used for data analysis.

Results:

Of 40 patients (mean age, 62.5 years; 90% ischemic stroke), 39 completed the study. At week 2, the CTRTP group showed greater FVC improvement (1.15 L; 95% CI, 0.47-1.83) than the control group (0.59 L; 95% CI, 0.03-1.14; LS mean difference, 0.54; 95% CI, 0.14-0.94; P=0.01), exceeding the minimal clinically important difference (10%). Significant improvements occurred in MIP (LS mean difference, 8.04; P=0.008), MEP (15.62; P<0.001), and MBI (7.75; P=0.005) at week 2, and MIP at week 1 (8.26; P=0.007). No differences were observed in FEV1 or PEF. No adverse events occurred.

Conclusions:

The 2-week CMRTP significantly enhanced respiratory function, respiratory muscle strength, and functional capacity in acute stroke inpatients, proving safe and feasible. As the first trial of inpatient telerehabilitation for pulmonary rehabilitation, it supports integrating CMRTP into acute stroke care. Clinical Trial: The study was registered with the Chinese Clinical Trial Registry (ChiCTR2400088647).