Association between pulmonary function and balance, motor function, and trunk stability in stroke survivors

Post-stroke rehabilitation is often delivered in a fragmented manner across disciplines, with respiratory function routinely overlooked. This oversight represents a significant gap in comprehensive stroke management, potentially limiting functional recovery, and undermining efforts to deliver truly integrated, patient-centered rehabilitation.

This study aims to provide empirical evidence supporting the integration of pulmonary assessment into multidisciplinary stroke rehabilitation by examining, in stroke survivors, the associations between standard pulmonary function parameters and key functional domains, including objective measures of balance, lower-limb motor function, and trunk stability.

In this observational study, 46 patients with stroke underwent comprehensive assessments, which included pulmonary function [percent predicted vital capacity (VC%), inspiratory capacity (IC%), forced vital capacity (FVC%), forced expiratory volume in 1 s (FEV1%), ratio of FEV1 to FVC (FEV1/FVC), peak expiratory flow (PEF%), maximum voluntary ventilation (MVV%)], the Berg Balance Scale (BBS), the Fugl-Meyer Assessment for Lower Extremity (FMA-LE), the Trunk Impairment Scale (TIS), and plantar pressure analysis [center of pressure (COP) path length, COP velocity, and 95% confidence ellipse area].

In this exploratory analysis, the BBS and FMA-LE scores showed positive correlations with VC%, FEV1%, and PEF% (r = 0.30-0.48, p < 0.05). TIS scores were positively associated with multiple pulmonary parameters (VC%, IC%, FVC%, FEV1%, FEV1/FVC, PEF%, MVV%; r = 0.31-0.54, p < 0.05), with the strongest exploratory correlation observed with PEF% (r = 0.54, p < 0.001). Furthermore, PEF% was negatively correlated with COP path length and velocity (r _s = -0.30 to -0.33, p < 0.05). The 95% confidence ellipse area was negatively correlated with IC% (r _s = -0.40, p < 0.01) and PEF% (r _s = -0.34, p < 0.05).

Our results support the integration of simple, low-cost pulmonary screening, particularly PEF measurement, into stroke rehabilitation workflows. Such integration can act as a practical trigger for timely multidisciplinary collaboration among general practitioners, respiratory therapists, and rehabilitation specialists, thereby fostering a more cohesive, proactive approach to improving long-term functional trajectories in stroke survivors.