This study evaluates the effects of respiratory exercises on respiratory function test parameters and ultrasonographic diaphragmatic measurements. Half of the hemiplegic patients will receive respiratory and neurophysiological exercises, while other half will receive only neurophysiological exercises.
After stroke, diaphragm, the most important muscle of respiration, is wasted as well as the other muscles of the affected side. Ultrasonography is a non-invasive, practical, low cost utility that may measure the thickness of diaphragm in maximum expiration and inspiration thus examining the functionality of the muscle. Correlation between respiratory functional tests and diaphragm ultrasonography has been proven in recent literature. In this manner, the aim of this study is twofold. First is to determine whether ultrasonography can be used practically to evaluate the respiratory functions of the patients after stroke. Respiratory function tests will be used for the correlation analysis. Second is to evaluate the effectiveness of respiratory exercises via diaphragm ultrasonography and respiratory function tests.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
SCREENING
Masking
NONE
Enrollment
40
Static and dynamic control of position, balance skills, weight shift, and activities of daily living.
Forced expiration, forced inspiration (thoracal expansion exercise), coughing exercise, incentive spirometric trainer, diaphragmatic respiration exercise, autogenic drainage, percussion.
Bezmialem Vakıf Univesity
Istanbul, Turkey (Türkiye)
Forced vital capacity (FVC)
The amount of air that can be forcibly exhaled from the lungs after taking the deepest breath possible. Measured by spirometry. \>80% is normal. If the value is lower than the normal limit it indicates either an obstructive or restrictive disease. The lower values show a poorer outcome
Time frame: 6 weeks
Forced expiratory volume in one second (FEV1)
The maximal amount of air you can forcefully exhale in one second. Measured by spirometry. \>80% is normal. If there is an obstruction, this measurement shows the severity of the obstruciton. The lower values show a poorer outcome.
Time frame: 6 weeks
Tiffeneau-Pinelli index
A calculated ratio used in the diagnosis of obstructive and restrictive lung disease. Calculated as FEV1/FVC. \>80% is normal. ≤80% indicates an obstructive pulmonary disease.
Time frame: 6 weeks
Forced expiratory flow at 25% and 75% (FEF 25-75%)
The average forced expiratory flow during the mid (25% - 75%) portion of the FVC. Shows small and medium airway obstruction. \>70% is normal. It shows the small airways impariment
Time frame: 6 weeks
Diaphragmatic thickening fraction (TF)
Thickness of the diaphragm is measured from the zone of apposition (subcostal area between anterior axillary line and mid-axillary line) via ultrasonography. After diaphragm thickness in end expiration (thickness in functional residual capacity- TFRC) and in end inspiration (thickness in total lung capacity- TTLC) are obtained. Thickening fraction is calculated as \[TTLC-TFRC/TFRC\]x100. A higher value shows a better outcome.
Time frame: 6 weeks
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