The purpose of the research is to investigate the effects of respiratory training on respiratory and functional performance in patients with stroke.

Stroke ranks third in the global cause of death, behind cancer and coronary heart disease. Stroke is also the third largest cause of death in Taiwan in 2014. Stroke patients in the course of exercise are in addition to muscle weakness and reduced endurance, but usually also accompanied by respiratory damage. From past studies have shown that stroke patients whose respiratory function has significant change, such as decreased respiratory muscle strength, reduced respiratory movement of the affected hemithorax, declined in maximum breathing pressure and decreased amplitude of diaphragmatic movements on the paralyzed side. But whether respiratory training can improve respiratory and functional performance of stroke patients, because of the limited research results could not be confirmed.

Inclusion Criteria:

• first episode of unilateral stroke.
• the definition of stroke was according to the World Health Organization (WHO) criteria (Hatano 1976), confirmed by computerized tomography (CT) or magnetic resonance imaging (MRI).
• older than 20 years.
• had maximum inspiratory pressure (MIP) values lower than 90% of those predicted and adjusted for age and sex.
• facial palsy, which could not prevent proper labial occlusion.
• ability to understand and follow simple verbal instructions.
• no receptive aphasia.
• not undergone thoracic or abdominal surgery.

Exclusion Criteria:

• unable to perform the tests.
• impaired level of consciousness and evidence of gross cognitive impairment.
• excluded patients with comorbidities of respiratory system disease (e.g. chronic obstructive pulmonary disease, asthma, cystic fibrosis), or other diseases leading to the impairment of respiratory muscle (e.g. myasthenia gravis).