Effects of Respiratory Physiotherapy on Postural Control, Balance, Respiratory Functions and Respiratory Muscle Strength
Effects of Respiratory Physiotherapy on Postural Control, Balance, Respiratory Functions and Respiratory Muscle Strength
The aim of our study is to determine the effect of respiratory physiotherapy applied on
 stroke diagnosis, balance, respiratory functions and respiratory muscle strength in addition
 to neurodevelopmental treatment in patients with stroke.
Our study will include individuals aged 40-75 years, diagnosed with ischemic or hemorrhagic
 stroke, who applied to the Kırıkkale University Faculty of Medicine physical therapy and
 rehabilitation clinic. After the patients are separated according to the specified exclusion
 and inclusion criteria, they will be divided into 3 groups using the "Online Random
 Allocation Software" program. Evaluations will be made before and after treatment.

 In addition to normal neurodevelopmental therapy (NGT) 5 days a week, respiratory
 physiotherapy will be applied. The total duration of treatment will take 6 weeks.

 1. Neurodevelopmental treatment program (BOBATH treatment approach) will be applied to the
 group.

 2. The group will have a neurodevelopmental treatment program (BOBATH treatment approach)
 and diaphragmatic breathing exercises.

 3. The group will have a neurodevelopmental treatment program (BOBATH treatment approach)
 and respiratory muscle training with the THRESHOLD IMT device.

 Inspiratory Muscle Training Program with Threshold IMT device: Constant pressure is applied
 to the inspiration phase during application. The training group is started from 40% of MIP
 and inspiratory muscle training is given. In practice, patients are asked to sit in a loose
 position on the upper chest and shoulders. After the nose clip is attached, the patient is
 instructed to tighten his lips around the mouthpiece of the instrument, making inspiration
 and expiration. After eight breathing cycles, she is asked to do 1-2 respiratory controls.

 Diaphragmatic breathing exercise: The patient is given a supine position, a pillow is placed
 under his knees and head. The patient is asked to place his right hand in the upper abdomen
 and his left hand in the upper part of his chest. The patient is told to take a slow and deep
 breath through the nose until four counts, and to hold the air in for the breathing time, and
 then to the patient, shrinking his lips like a whistle, and exhaling his breath for a long
 time. Exercises are performed two hours after meals, initially as short as 2-3 minutes,
 within 10 minutes of the patient's tolerance, with an average of 30 minutes per day.
Inclusion Criteria:

 -  Being over 40 years old,

 -  Stroke diagnosis,

 -  The Mini-mental test score is above 23

 Exclusion Criteria:

 -  Other neurological or orthopedic problems that affect functionality and balance, other
 than stroke

 -  High blood pressure, heart disease which may prevent rehabilitation

 -  Patients with pulmonary disease (COPD)

 -  Have undergone thoracic or cardiovascular surgery

 -  Agnosia or a person with visual impairment,

 -  Patients with epilepsy,

 -  The medical condition is not stable,

 -  Patients with reluctance towards treatment,

 -  Patients with communication problem,

 -  An area under 23 points from the Minimental Test,

 -  Patients with peripheral nerve injury before stroke