In this study we want to introduce the beneficiary combine effects of chest mobilization and chest physiotherapy exercises by using cough peak flow meter and chest expansion in stroke patients. by using theses combine exercises physiotherapist can develop target rehabilitation strategies for stroke survivors.

Stroke is a neurological deficit and acute focal injury of the by a vascular cause, including cerebral infarction, intracerebral hemorrhage and subarachnoid hemorrhage and is a major cause of disability and death worldwide. 2nd most deadly cause of death and disability in patients. This disease have long lasting effect on human body and also cause complication of lung function like pneumonia and respiratory distress function syndrome for this purpose to reduce chest complication and neurological defect use of chest physiotherapy and chest mobilization exercises are introduce so that hospital stay of patients reduces and recovery at high speed according to previous studies there is very strong relationship between trunk muscles and respiratory muscle with pulmonary function and physiotherapist can develop target rehabilitation strategies for stroke survivors.however in previous studies age group of patients acute subacute or chronic and diaphragmatic breathing are not included for the improvement of effective cough.

Inclusion Criteria:

• Both gender
• Age > 50
• Right or left hemiplegic acute stroke patients
• Diagnosed cases of stroke patient
• Duration: 4 weeks being diagnosed
• Can sit with at least 10sec
• Can perform exercises with Active Assistance
• Patients who easily perform exercises
• Patients who response to commands

Exclusion Criteria:

• Patients with serious comorbidities like cancer
• Uncontrolled hypertension SBP > 140mmhg and DBP > 90mmhg
• Vitally unstable patient's
• Red flags for physiotherapy i.e. sudden dizziness, unexplained pain during exercise, chest pain.
• DVT Deep Vein Thrombosis