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Cough function is impaired after stroke; this may be important for protection against chest infection. Reflex cough (RC) intensity indices have not been described after stroke. RC, voluntary cough (VC) and respiratory muscle strength were studied in patients within 2 weeks of hemispheric infarct. The null hypotheses were that patients with cortical hemisphere stroke would show the same results as healthy controls on: 1) objective indices of RC and VC intensity; and 2) respiratory muscle strength tests.

Peak cough flow rate (PCFR) and gastric pressure (P_ga) were measured during maximum VC and RC. Participants also underwent volitional and nonvolitional respiratory muscle testing. Nonvolitional expiratory muscle strength was assessed by measuring P_ga increase after magnetic stimulation over the T₁₀ nerve roots (twitch T₁₀ P_ga). Stroke severity was scored using the National Institutes of Health Stroke Scale …