Effects of Liuzijue Qigong on respiratory function, trunk control, and balance after stroke: a randomized controlled trial

PurposeTo evaluate the effects of adding Liuzijue Qigong (LQG) to standard rehabilitation on respiratory function, trunk control, and balance after stroke, and to explore a possible respiratory-core-balance pathway.Materials and methodsIn this assessor-blinded randomized controlled trial, 120 post-stroke inpatients were randomly assigned (1:1) to LQG plus standard rehabilitation or standard rehabilitation alone for 3 weeks. Primary outcomes were trunk control, assessed by the Trunk Impairment Scale (TIS), and pulmonary function, assessed by forced vital capacity (FVC) and peak expiratory flow (PEF). Secondary outcomes included balance, assessed by the Berg Balance Scale (BBS), affected-side external oblique (EO) surface electromyography (sEMG), forced expiratory volume in 1 s (FEV1), and the forced expiratory volume in 1 s to forced vital capacity ratio (FEV1/FVC). Between-group differences in change scores were analyzed, and exploratory correlation and path analyses were performed.ResultsBoth groups showed significant within-group improvements in the TIS and BBS after the 3-week intervention. However, between-group differences in TIS and BBS change scores were not statistically significant (p = 0.092 and p = 0.073, respectively). Compared with the control group, the LQG group showed greater improvements in FVC (Δ0.51 vs. 0.25 L; p < 0.001), PEF (Δ52.0 vs. 11.0 L/min; p < 0.001), and affected-side EO activation (Δ11.0 vs. 3.0; p < 0.001). In exploratory analyses, change scores were positively correlated (ΔPEF–ΔEO r = 0.58; ΔEO–ΔTIS r = 0.63; ΔTIS–ΔBBS r = 0.50; all p < 0.001), and the path model was consistent with a possible sequential respiratory-core-balance pathway.ConclusionAdding LQG to standard rehabilitation yielded greater improvements in FVC, PEF, and affected-side EO activation after stroke. Although additional gains in trunk control and balance scales were not statistically significant over 3 weeks, exploratory analyses suggested a possible respiratory-core-balance pathway that warrants further validation.Trial registrationhttps://www.chictr.org.cn/. Identifier (ChiCTR1800020170).