Background: Weakness of the abdominal muscles reduces trunk control and impairs respiratory function in stroke patients. To strengthen the abdominal muscles, threshold expiratory muscle training and trunk FES can be used. Objectives: This study aimed to investigate whether a combined intervention of threshold expiratory muscle training and trunk FES is more effective in improving trunk control and respiratory function than threshold expiratory muscle training alone. Design: Randomized controlled trial. Methods: Thirty individuals with stroke were randomly assigned to either the experimental group (n=15) or the control group (n=15). The experimental group received threshold expiratory muscle training with trunk electrical stimulation, while the control group performed threshold expiratory muscle training only. Both groups underwent training three times per week for four weeks. Trunk control and respiratory function were assessed pre and post the intervention. Results: Both groups showed significant post-intervention improvement in respiratory function; however, the experimental group demonstrated a greater change than the control group. The control group showed significant improvement only in the total TIS score, whereas the experimental group showed significant improvement across all TIS subcomponents. Conclusion: Combining threshold expiratory muscle training with trunk FES is an effective approach for enhancing not only respiratory function but also trunk control. Synchronizing electrical stimulation with expiratory timing may increase efficiency and strengthen functional muscle contraction, suggesting meaningful clinical value.

INTRODUCTION
SUBJECTS AND METHODS
    Study Procedure
    Subjects
    Outcome Measures
    Interventions
    Data and Statistical Analysis
RESULTS
DISCUSSION
CONCLUSION
FUNDING
CONFLICTS OF INTEREST
AUTHOR CONTRIBUTIONS
REFERENCES

• Kyungsu Jeon(Department of Physical Therapy, Bundang Jesaeng Hospital, Seongnam, Republic of Korea)
• Yunghyun Jeon(Department of Physical Therapy, Gunpo Sanbon Tntnchuk Clinic, Gunpo, Republic of Korea)
• Kyunhee Cho(Department of Physical Therapy, Suwon Women's University, Hwaseong, Republic of Korea)
• Shinjun Park(Department of Physical Therapy, Suwon Women's University, Hwaseong, Republic of Korea) Corresponding author