The Effects of Thoracic Joint Mobilization on Pulmonary Functions of Patients With Stroke

INTRODUCTION Stroke is defined as sudden neurological deficit due to an abnormality in cerebral blood flow, with sign and symptoms lasting for more than 24 hours. Strokes can be grouped into two fundamental classification according to the American Stroke Association (ASA), first is ischemic (87%) and the second is Hemorrhagic (13%). In epidemiological and genetic studies a stroke subtype classification is useful indicator in our clinical practice. Many serious physical and cognitive deficits results due to injury to the brain tissue. Depending upon the region of the brain that is involved and amount of damage, a person can recovers from stroke.

Stroke is associated with many primary and secondary complications. Here mentioned some primary complications. Sensation, Pain, Visual changes, Motor Function, Weakness, Alternation in Tone, Abnormal Reflexes, Altered Coordination, Altered Postural control and Balance. The main Indirect or secondary complications are Musculoskeletal Complications, Neurological Complications, Cardiovascular Complications, Pulmonary Complications, and Integumentary Complications.

Pulmonary Functions are usually impaired in individuals with stroke. The common findings associated with pulmonary functions in Stroke patients are Decreased lung volumes, decreased pulmonary perfusion and vital capacity and altered chest wall excursion. Individuals with stroke are, associated with dysphagia which leads to dehydration and compromised nutrition. Dysphagia has been related with enlarged risk of pulmonary difficulties and also death. According to research evidence primary findings of dysphagia in patients having acute stroke significantly decreases complications. It also decreases the length of hospital stay and overall health expenditure.

Dysphagia further leads to Aspiration. Aspiration, is penetration of food, liquid, saliva or gastric reflux into the airways. It usually occurs in acute phase of recovery or during swallowing. Aspiration is an important complication and can leads to aspiration pneumonia if left untreated, death can occur.

Impaired Pulmonary functions limits physical activities as well. Because the decreased respiratory output is accompanied by increased oxygen demands required during altered movement patterns in stroke. Furthermore people with stroke usually undergo irregular breathing because of damage to the respiratory muscles (such as Diaphragm).