Background: Decreased respiratory muscle strength in patients with stroke may cause breathing difficulties, and cardiopulmonary function and exercise capacity may decline, which may reduce balance and gait ability. Objects: This study aimed to determine the influence of improved respiratory muscle strength on the recovery of balance and gait ability at discharge in patients with stroke. Methods: This prospective observational study involved 21 patients clinically diagnosed with stroke. Multiple regression models with a forward selection procedure were used to investigate whether the improvement of respiratory muscle strength (maximal inspiratory pressure [MIP] and maximal expiratory pressure) can contribute to the recovery of balance (Trunk Impairment Scale, Berg Balance Scale, Brunel Balance Assessment, and five times sit-to-stand) and gait (10-meter walk test, timed up and go, and 6-minute walk test [6MWT]) ability. Results: In the forward selection regression analysis, MIP was an influencing factor, accounting for 36.2% of the variance in the 6MWT. Conclusion: This result suggests that an improvement in MIP influences the increase in distance in the 6MWT. Therefore, it is important to evaluate respiratory muscle strength. Inspiratory muscle strengthening can recommended improving endurance and functional walking ability in patients with stroke.

Background: Trunk movements are an important factor in activities of daily living; however, these movements can be impaired by stroke. It is difficult to quantify and measure the active range of motion (AROM) of the trunk in patients with stroke. Objects: To determine the reliability and validity of measurements using a digital goniometer (DG) and smart phone (SP) applications for trunk rotation and lateral flexion in stroke patients. Methods: This is an observational study, in which twenty participants were clinically diagnosed with stroke. Trunk rotation and lateral flexion AROM were assessed using the DG and SP applications (Compass and Clinometer). Intrarater reliability was determined using intraclass correlation coefficients (ICCs) with 95% confidence intervals. Pearson correlation coefficient was used to determine the validity of the DG and SP in AROM measurement. The level of agreement between the two instruments was shown by Bland–Altman plot and 95% limit of agreement (LoA) was calculated. Results: The intrarater reliability (rotation with DG: 0.96–0.98, SP: 0.98; lateral flexion with DG: 0.97–0.98, SP: 0.96) was excellent. A strong and significant correlation was found between DG and SP (rotation hemiplegic side: r = 0.95; non-hemiplegic side: r = 0.90; lateral flexion hemiplegic side: r = 0.88; non-hemiplegic side: r = 0.78). The level of agreement between the two instruments was rotation (hemiplegic side: 23.02° [LoA 17.41°, –5.61°]; non-hemiplegic side: 31.68° [LoA 23.87°, –7.81°]) and lateral flexion (hemiplegic side: 20.94° [LoA 17.48°, –3.46°]; non-hemiplegic side: 27.12° [LoA 18.44°, –8.68°]). Conclusion: Both DG and SP applications can be used as reliable methods for measuring trunk rotation and lateral flexion in patients with stroke. Although, considering the level of clinical agreement, DG and SP could not be used interchangeably for measurements.