The aim of this study is to investigate the positive effects of deep, slow breathing exercises and suboccipital relaxation, when added to a routine physiotherapy and rehabilitation program, on autonomic, motor, cognitive, and emotional status functions in individuals who have experienced a stroke, and to examine their superiority compared to routine physiotherapy and rehabilitation alone.
Inclusion Criteria:
Exclusion Criteria:
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Individuals assigned to Group 1 will receive deep breathing exercises in addition to the hospital's routine physiotherapy and rehabilitation program, for a duration of 6 weeks, 3 days per week, with each session lasting 20 minutes. During the application of the breathing exercises, stroke patients will be positioned in a supine position, and the procedure will be conducted according to previously described protocols. The total 20-minute session will consist of breathing cycles with 4 seconds of inspiration and 6 seconds of expiration (6 breaths per minute). At the beginning, participants will be given verbal instructions and will be guided with visual cues during the exercise. Participants will be instructed to fully inflate their lungs during inspiration and completely empty their lungs during expiration. After the breathing exercise is taught, rest intervals will be provided as needed based on the patient's condition.
Individuals assigned to Group 2 will receive the hospital's routine physiotherapy and rehabilitation program. In addition, suboccipital release will be applied for 6 weeks, 3 days per week, with each session lasting 20 minutes. Before initiating the suboccipital release procedure, the patient will be positioned in a supine position, and the practitioner will be seated on a stool at the head of the bed. The bed will be adjusted so that the patient's head is at the level of the practitioner's abdomen, allowing the practitioner to perform the technique with approximately 90° of elbow flexion and proper ergonomics. Once the patient is positioned comfortably and correctly, the practitioner will sit at the head of the bed and place both hands under the patient's head, in the occipital region. The practitioner will then palpate along the occipital ridge and gently move the hands inferiorly until muscle tissue is identified. Subsequently, the practitioner will flex the fingers upward toward
Individuals assigned to Group 3 will receive only the hospital's routine physiotherapy and rehabilitation program. All participants will be included in this standard program, which consists of gait training, balance training, and upper extremity rehabilitation commonly applied to stroke patients. Under the supervision of a physiotherapist, patients will perform normal range of motion exercises in bed, upper extremity exercises in a sitting position, and functional activities such as walking, stair climbing, and ball throwing and catching while standing. This program will be standardized for all patients in terms of session frequency and duration, with each session lasting approximately 45-50 minutes according to the routine protocol.
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