The Journal of Korean Physical Therapy

The Korean Society of Physical Therapy (대한물리치료학회)
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The Effect of Chest Expansion and Pulmonary Function of Stroke Patients after Breathing Exercise

호흡운동이 뇌졸중 환자의 흉곽 확장과 폐 기능에 미치는 영향

  • Lee, Jeon-Hyeong (Physical Therapy, Department of Rehabilitation Science, Graduate School, Daegu University) ;
  • Kwon, Yoo-Jung (Physical Therapy, Department of Rehabilitation Science, Graduate School, Daegu University) ;
  • Kim, Kyung (Department of Physical Therapy, College of Rehabilitation Science, Daegu University)
  • 이전형 (대구대학교 대학원 재활과학과 물리치료) ;
  • 권유정 (대구대학교 대학원 재활과학과 물리치료) ;
  • 김경 (대구대학교 재활과학대학 물리치료학과)
  • Received : 2009.05.14
  • Accepted : 2009.09.11
  • Published : 2009.09.25
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Abstract

Purpose: This study examined whether breathing exercises might increase the chest expansion and pulmonary function of stroke patients. Methods: Twenty four patients with stroke were assigned randomly into two groups: a combination of diaphragmatic resistive breathing and pursed-lip breathing exercise (CB) group (n=10) and control group (n=14). The CB group completed a 4-week program of diaphragmatic resistive breathing and pursed-lip breathing exercise. The subjects were assessed using the pre-test and post-test measurements of the chest expansion (length for resting, deep inspiration, deep expiration, deep expiration-inspiration) and pulmonary function (forced vital capacity (FVC), forced expiratory volume at one second (FEV1), FEV1/FVC, peak expiratory flow (PEF), vital capacity (VC), tidal volume (TV), expiratory reserve volume (ERV), inspiratory reserve volume (IRV)). Results: A comparison of the chest expansion between the pre and post tests revealed similar rest, deep inspiration, deep expiration, and deep expiration-inspiration lengths in the CB and control groups (p>0.05). A comparison of the pulmonary function between pre and post tests, revealed significant improvements in the FVC, FEV, PEF, VC, IRV, and ERV in the CB group (p<0.05). There was a significant difference in the FVC, FEV1, PEF, VC and IRV between the 2 groups (p<0.05). Conclusion: These findings suggest that breathing exercise should help improve the pulmonary function, such as the volume and capacity. This suggests that the pulmonary functions of stroke patients might be improved further by a continued respiratory exercise program.

Keywords

References

  1. Duncan PW, Horner RD, Reker DM et al. Adherence to postacute rehabilitation guidelines is associated with functional recovery in stroke. Stroke. 2002;33(1):167-77. https://doi.org/10.1161/hs0102.101014
  2. Macko RF, Katzel LI, Yataco A et al. Low-velocity graded treadmill stress testing in hemiparetic stroke patients. Stroke. 1997;28(5):988-92. https://doi.org/10.1161/01.STR.28.5.988
  3. Sharp SA, Brouwer BJ. Isokinetic strength training of the hemiparetic knee: effects on function and spasticity. Arch Phys Med Rehabil. 1997;78(11):1231-6. https://doi.org/10.1016/S0003-9993(97)90337-3
  4. Ferretti G, Antonutto G, Denis C et al. The interplay of central and peripheral factors in limiting maximal O2 consumption in man after prolonged bed rest. J Physiol. 1997;15(3):677-86.
  5. Ferretti G, Girardis M, Moia C et al. Effects of prolonged bed rest on cardiovascular oxygen transport during submaximal exercise in humans. Eur J Appl Physiol Occup Physiol. 1998;78(5):398-402. https://doi.org/10.1007/s004210050437
  6. Frownfelter D, Dean E. Cardiovascular and pulmonary physical therapy: evidence and practice. 4th ed. Philadelphia, Mosby, 2006:569-93.
  7. Skinner JS. Exercise testing & exercise prescription for special cases: theoretical basis & clinical application. 3rd ed. Philadelphia, Lippincott Williams & Wilkins, 2005:3-21.
  8. Kwon MJ. Daily physical functioning and quality of life for stroke. J Kor Soc Phys Ther. 2007;19(5):87-96.
  9. Lee TS, Kim HH. The effect of physical function and quality of life in patient with amyotrophic lateral sclerosis through physical therapy and occupational therapy: a case study. J Kor Soc Phys Ther. 2007;19(5):77-85. https://doi.org/10.1589/jpts.19.77
  10. Lee TS, Goo BO. Study of importance of grade decision to enforce the insurance policy for long-term care. J Kor Soc Phys Ther. 2008;20(2):43-8.
  11. Pryor JA, Prasad SA. Physiotherapy for respiratory and cardiac problems. 3rd ed. Singapore, Churchill Livingstone, 2002:170-6
  12. Kisner C, Collby LA. Therapeutic exercise: foundations and techniques. 5th ed. Philadelphia, F. A. Davis Co, 2002:852-3.
  13. Cameron MH, Monroe LG. Physical rehabilitation: evidencebased examination, evaluation, and intervention. Philadelphia, Elsevier Health Sciences, 2007:689-732.
  14. Kelly JO, Kilbreath SL, Davis GM et al. Cardiorespiratory fitness and walking ability in subacute stroke patients. Arch Phys Med Rehabil. 2003;84(12):1780-5. https://doi.org/10.1016/S0003-9993(03)00376-9
  15. Mackay-Lyons MJ, Makrides L. Exercise capacity early after stroke. Arch Phys Med Rehabil. 2002;83(12):1697-702. https://doi.org/10.1053/apmr.2002.36395
  16. Carr M, Jones J. Physiological effects of exercise on stroke survivors. Top Stroke Rehabil. 2003;9(4):57-64. https://doi.org/10.1310/0J2K-MDNX-1Q0L-8LX6
  17. Riolo L, Fisher K. Is there evidence that strength training could help improve muscle function and other outcomes without reinforcing abnormal movement patterns or increasing reflex activity in a man who has had a stroke? Phys Ther. 2003;83(9):844-51.
  18. Katz-Leurer M, Shochina M, Carmeli E et al. The influence of early aerobic training on the functional capacity in patients with cerebrovascular accident at the subacute stage. Arch Phys Med Rehabil. 2003;84(11):1609-14. https://doi.org/10.1053/S0003-9993(03)00344-7
  19. Macko RF, Ivey FM, Forrester LW et al. Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke. Stroke. 2005;36(10):2206-11. https://doi.org/10.1161/01.STR.0000181076.91805.89
  20. Bianchi R, Gigliotti F, Romagnoli I et al. Chest wall kinematics and breathlessness during pursed-lip breathing in patients with COPD. Chest. 2004;125(2):459-65. https://doi.org/10.1378/chest.125.2.459
  21. Ugalde V, Breslin EH, Walsh SA et al. Pursed lips breathing improves ventilation in myotonic muscular dystrophy. Arch Phys Med Rehabil. 2000;81(4):472-8. https://doi.org/10.1053/mr.2000.3790
  22. Ito M, Kakizaki F, Tsuzura Y et al. Immediate effect of respiratory muscle stretch gymnastics and diaphragmatic breathing on respiratory pattern. Intern Med. 1999;38(2):126 -32. https://doi.org/10.2169/internalmedicine.38.126
  23. Jones AY, Dean E, Chow CC. Comparison of the oxygen cost of breathing exercises and spontaneous breathing in patients with stable chronic obstructive pulmonary disease. Phys Ther. 2003;83(5):424-31.
  24. Lanini B, Bianchi R, Romagnoli I et al. Chest wall kinematics in patients with hemiplegia. Am J Respir Crit Care Med. 2003;168(1):109-13. https://doi.org/10.1164/rccm.200207-745OC
  25. Han KJ, Choi BK. Comparison of the surface electromyographic signal of progressive resistance increase and progressive resistance decrease exercise. J Kor Soc Phys Ther. 2008;20(1):11-6.
  26. Kim JH, Hong WS, Bae SS. The effect of chest physical therapy on improvement of pulmonary function in the patients with stroke. J Kor Soc Phys Ther. 2000;12(2):133-44.
  27. Kim BJ. The effects the forceful respiratory exercise on the gait parameters in hemiplegic patients. Daegu University. Dissertation of Doctorate Degree. 2004.
  28. de Andrade AD, Silva TN, Vasconcelos H et al. Inspiratory muscular activation during threshold therapy in elderly healthy and patients with COPD. J Electromyogr Kinesiol. 2005;15(6):631-9. https://doi.org/10.1016/j.jelekin.2005.06.002
  29. Gosselink RA, Wagenaar RC, Rijswijk H et al. Diaphragmatic breathing reduces efficiency of breathing in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1995;151(4):1136-42.
  30. Kim YR, Lee SJ, Kim HJ et al. The significance of posture on assessment of pulmonary function after pulmonary rehabilitation in tetraplegia. J Korean Acad Rehabil Med. 2003;27(4):513-8.
  31. Han TR, Kim JH, Bang MS et al. Motor evoked potentials of diaphragm in stroke patients. J Korean Acad Rehabil Med. 1998;22(4):793-7.
  32. Pyun SB, Kwon HK, Kim KH. Improved pulmonary function in the cervical cord injured after respiratory muscle training. J Korean Acad Rehabil Med. 1994;18(2):302-10.
  33. Kim MC, Kwon KB, Yim DH et al. The normal predicted value of peak expiratory flow (PEF) measured by the peak flow meter and correlation between PEP and other ventilatory parameters. Tuberc Respir Dis. 1998;45(5):1000-11.
  34. Shin SY, Yoon JH, Kim SJ et al. The relationship between FEV1 and PEFR in the classification of the severity in COPD patients. Tuberc Respir Dis. 2005;58(5):507-14.
  35. Liaw MY, Lin MC, Cheng PT et al. Resistive inspiratory muscle training: its effectiveness in patients with acute complete cervical cord injury. Arch Phys Med Rehabil. 2000;81(6):752-6.
  36. Van Houtte S, Vanlandewijck Y, Gosselink R. Respiratory muscle training in persons with spinal cord injury: a systematic review. Respir Med. 2006;100(11):1886-95. https://doi.org/10.1016/j.rmed.2006.02.029
  37. Estenne M, Knoop C, Vanvaerenbergh J et al. The effect of pectoralis muscle training in tetraplegic subjects. Am Rev Respir Dis. 1989;139(5):1218-22. https://doi.org/10.1164/ajrccm/139.5.1218
  38. Enright SJ, Unnithan VB, Heward C et al. Effect of highintensity inspiratory muscle training on lung volumes, diaphragm thickness, and exercise capacity in subjects who are healthy. Phys Ther. 2006;86(3):345-54.