Purpose: This study aimed to demonstrate reduction in stroke symptoms by analyzing the changes in respiratory function and activities of daily living (ADL) after respiratory muscle strengthening exercise in patients who had a stroke and thereby, propose an efficient exercise method. Methods: Twenty patients with hemiplegic stroke were divided into two groups, with 10 patients in each. The control group (CG) received the traditional exercise therapy, and the experimental group (EG) received the

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... raditional exercise therapy combined with expiratory muscle strengthening training. The training continued for 6 weeks, 5 days a week. Forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1) were measured with a spirometer, SpO2 was measured with a pulse oximeter, and ADL were assessed by using the modified Barthel index (MBI). A paired t test was applied to compare the differences before and after the intervention, and an independent t test was used to compare the differences between the groups. The level of statistical significance was set as α= 0.05. Results: The changes in the FVC and FEV1 values within the group showed significant differences only in the EG (p< 0.01). The betweengroup difference was statistically significant only for FVC and FEV1 in the EG (p< 0.01). The changes in SpO2 and MBI within the group showed significant differences only in the EG and CG (p< 0.01). Between-group differences were statistically significant only for SpO2 and MBI in the EG (p< 0.05). Conclusion: The interventions with active patient involvement and combined breathing exercises had a positive impact on all the functions investigated in this study. This is an Open Access article distribute under the terms of the Creative Commons Attribution Non-commercial License (Http:// creativecommons.org/license/by-nc/4.0.) which permits unrestricted non-commercial use, distribution,and reproduction in any medium, provided the original work is properly cited.