Background: Stroke is considered one of the major causes of impairments in activities of daily living. Respiratory dysfunction in stroke patients, especially those with bilateral hemisphere involvement, is often overlooked despite its critical role in recovery. This study focuses on the prevalence and impact of respiratory impairment in cerebrovascular accident (CVA) patients with bilateral hemispheric involvement. Objectives: The objective of this study was to determine the prevalence of respiratory impairment in stroke patients with bilateral hemisphere involvement. Materials and Methods: A cross-sectional study was conducted on 37 stroke patients with bilateral CVA admitted to the Jorhat Medical College & Hospital. Variables such as Peak Expiratory Flow Rate (PEFR), inspiratory muscle strength (IMS), expiratory muscle strength (EMS), and the rate of dyspnea (RDOS) were assessed. Statistical analysis was conducted using SPSS software, and chi-square tests and Spearman's correlation were applied to evaluate relationships between variables. Regression analysis was used to model the relationship between PEFR and RDOS. Results: Statistical analysis revealed no significant associations between sex, age, or type of CVA and respiratory function (p > 0.05). However, a strong negative correlation (r = -0.885) was found between PEFR and RDOS, indicating that lower respiratory function was associated with increased dyspnea. Regression analysis provided the equation Y = 6.208 – 0.013X for predicting RDOS from PEFR. Conclusion: The results suggest that respiratory impairment is significant in stroke patients with bilateral hemisphere involvement. Lower PEFR was strongly associated with higher dyspnea rates, reinforcing the need for respiratory-focused interventions in stroke rehabilitation.

Keywords: Stroke, Cerebrovascular Accident, Respiratory Impairment, PEFR, Dyspnea, Bilateral Hemisphere, Rehabilitation

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1. Murphy SJX, Werring DJ. Stroke: Causes and Clinical Features. Medicine. 2020;48(9):561–6. doi:10.1016/j.mpmed.2020.06.002.
2. Kuriakose D, Xiao Z. Pathophysiology and Treatment of Stroke: Present Status and Future Perspectives. Int J Mol Sci. 2020;21(20):7609. doi:10.3390/ijms21207609.
3. Pollock RD, Rafferty GF, Moxham J, Kalra L. Respiratory Muscle Strength and Training in Stroke and Neurology: A Systematic Review. Int J Stroke. 2013;8:124-130.
4. Schmutzhard E. Central Breathing Disturbances in Stroke. J Neurol Sci. 2019;405S:103684. doi:10.1016/j.jns.2019.10.023.
5. Gregson J. Reliability of measurement of muscle tone and muscle power in stroke patients. Age Ageing. 2000;29(3):223 228.doi:10.1093/ageing/29.3.223.
6. Hislop HJ, Montgomery J. Daniels and Worthingham’s muscle testing: Techniques of manual examination. St. Louis, Mo: Saunders / Elsevier; 2007.
7. Adeniyi, Bamidele & Erhabor, Gregory. (2011). The peak flow meter and its use in clinical practice. Afr J Respir Med.
8. Zhuang Q, Yang GM, Neo SH-S, Cheung YB. Validity, reliability, and diagnostic accuracy of the Respiratory Distress Observation Scale for assessment of dyspnea in adult palliative care patients. J Pain Symptom Manage. 2019;57(2):304-310. doi:10.1016/j.jpainsymman.2018.10.506.
9. Ospel J, Singh N, Ganesh A, Goyal M. Sex and gender differences in stroke and their practical implications in acute care. Journal of Stroke. 2023 Jan 31;25(1):16–25. doi:10.5853/jos.2022.04077
10. Lee K. Correlation between respiratory muscle strength and pulmonary function with respiratory muscle length increase in healthy adults. Physical Therapy Rehabilitation Science. 2021 Dec 30;10(4):398–405. doi:10.14474/ptrs.2021.10.4.398
11. Yildiz A, Mustafaoglu R, Bardak AN. Respiratory muscle strength in stroke: A case-control study. Revista da Associação Médica Brasileira. 2024;70(8). doi:10.1590/1806-9282.20240061

Background: Stroke is considered one of the major causes of impairments in activities of daily living. Respiratory dysfunction in stroke patients, especially those with bilateral hemisphere involvement, is often overlooked despite its critical role in recovery. This study focuses on the prevalence and impact of respiratory impairment in cerebrovascular accident (CVA) patients with bilateral hemispheric involvement. Objectives: The objective of this study was to determine the prevalence of respiratory impairment in stroke patients with bilateral hemisphere involvement. Materials and Methods: A cross-sectional study was conducted on 37 stroke patients with bilateral CVA admitted to the Jorhat Medical College & Hospital. Variables such as Peak Expiratory Flow Rate (PEFR), inspiratory muscle strength (IMS), expiratory muscle strength (EMS), and the rate of dyspnea (RDOS) were assessed. Statistical analysis was conducted using SPSS software, and chi-square tests and Spearman's correlation were applied to evaluate relationships between variables. Regression analysis was used to model the relationship between PEFR and RDOS. Results: Statistical analysis revealed no significant associations between sex, age, or type of CVA and respiratory function (p > 0.05). However, a strong negative correlation (r = -0.885) was found between PEFR and RDOS, indicating that lower respiratory function was associated with increased dyspnea. Regression analysis provided the equation Y = 6.208 – 0.013X for predicting RDOS from PEFR. Conclusion: The results suggest that respiratory impairment is significant in stroke patients with bilateral hemisphere involvement. Lower PEFR was strongly associated with higher dyspnea rates, reinforcing the need for respiratory-focused interventions in stroke rehabilitation.

Keywords: Stroke, Cerebrovascular Accident, Respiratory Impairment, PEFR, Dyspnea, Bilateral Hemisphere, Rehabilitation

🔒 This is a subscription article

Full text is available to subscribers and institutional members. Please choose an option below to access it.

1. Murphy SJX, Werring DJ. Stroke: Causes and Clinical Features. Medicine. 2020;48(9):561–6. doi:10.1016/j.mpmed.2020.06.002.
2. Kuriakose D, Xiao Z. Pathophysiology and Treatment of Stroke: Present Status and Future Perspectives. Int J Mol Sci. 2020;21(20):7609. doi:10.3390/ijms21207609.
3. Pollock RD, Rafferty GF, Moxham J, Kalra L. Respiratory Muscle Strength and Training in Stroke and Neurology: A Systematic Review. Int J Stroke. 2013;8:124-130.
4. Schmutzhard E. Central Breathing Disturbances in Stroke. J Neurol Sci. 2019;405S:103684. doi:10.1016/j.jns.2019.10.023.
5. Gregson J. Reliability of measurement of muscle tone and muscle power in stroke patients. Age Ageing. 2000;29(3):223 228.doi:10.1093/ageing/29.3.223.
6. Hislop HJ, Montgomery J. Daniels and Worthingham’s muscle testing: Techniques of manual examination. St. Louis, Mo: Saunders / Elsevier; 2007.
7. Adeniyi, Bamidele & Erhabor, Gregory. (2011). The peak flow meter and its use in clinical practice. Afr J Respir Med.
8. Zhuang Q, Yang GM, Neo SH-S, Cheung YB. Validity, reliability, and diagnostic accuracy of the Respiratory Distress Observation Scale for assessment of dyspnea in adult palliative care patients. J Pain Symptom Manage. 2019;57(2):304-310. doi:10.1016/j.jpainsymman.2018.10.506.
9. Ospel J, Singh N, Ganesh A, Goyal M. Sex and gender differences in stroke and their practical implications in acute care. Journal of Stroke. 2023 Jan 31;25(1):16–25. doi:10.5853/jos.2022.04077
10. Lee K. Correlation between respiratory muscle strength and pulmonary function with respiratory muscle length increase in healthy adults. Physical Therapy Rehabilitation Science. 2021 Dec 30;10(4):398–405. doi:10.14474/ptrs.2021.10.4.398
11. Yildiz A, Mustafaoglu R, Bardak AN. Respiratory muscle strength in stroke: A case-control study. Revista da Associação Médica Brasileira. 2024;70(8). doi:10.1590/1806-9282.20240061