Impaired respiratory function is common in patients with stroke. The purpose of this study were to investigate the effectiveness of exercises and to assess forced vital capacity and peak cough flow after completion of neck stabilizing and respiratory reeducation exercises (combining diaphragmatic breathing and pursed-lip breathing exercises). The 45 participants were randomly assigned to an experimental group 1 (n1=15), experimental group 2 (n2=15), and a control group (n3=15). All subjects performed conservative physical therapy for 30 minutes. Experimental group 1 undertook the neck stabilizing exercise and the respiratory reeducation exercise. Experimental group 2 undertook the respiratory reeducation exercise. Additional exercise did not exceed 30 minutes, five times a week for six weeks. The subjects were assessed for deep neck flexor thickness and breathing function (forced vital capacity, forced expiratory volume at one second, forced expiratory volume at one second/forced vital capacity, peak expiratory flow, and manual assisted peak cough flow) at pre-post value. The results of this study were as follows. Experimental group 1 showed a significant increase only in deep neck flexor thickness change rate (p<.05). All groups showed significant increases in forced vital capacity, forced expiratory volume at one second, and peak expiratory flow in pre-post measurement (p<.05). Experimental groups 1 and 2 showed an increase in manual assisted peak cough flow in pre-post measurement (p<.05). There was no significant difference between experimental group 1 and experimental group 2, but experimental group 1 improved more than experimental group 2 in respiratory function as a whole. In conclusion, these findings suggest that the neck stabilizing exercise in combination with the respiratory reeducation exercise can improve forced vital capacity and peak cough flow in patients with stroke.

It is important to find the effective position for cough and sputum clearance in respiratory physical therapy. The purpose of this study was to compare the changes in peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV1), and peak cough flow (PCF) related to functional level and measurement position in patients with Duchenne muscular dystrophy. Twenty one subjects were classified into three functional levels, and measurements was undertaken in three different measurement positions (upright sitting, 45˚ reclining and supine). Vitalograph PEF/FEV DIARY was used to measure PEF and FEV1, and Ferraris Pocket Peak was used to measure PCF. Mixed two-way analysis of variance and Bonferroni post-hoc test were used for statistical analysis. The results of the study were as follows: 1) Significant main effects for measurement position were found. 2) PEF was the highest in upright sitting, followed by 45˚ reclining, and supine in order. 3)FEV1 in upright sitting and 45˚ reclining were significantly greater compared with that in supine. 4) PCF in upright sitting and 45˚ reclining were significantly greater compared with that in supine. 5) No significant main effects for functional level were found in PEF, FEV1, and PCF. 6) No significant functional level by measurement position interactions were found in PEF, FEV1, and PCF. Therefore, it is concluded that upright sitting and 45˚ degree reclining positions are recommended for effective cough and sputum clearance.