DOI QR코드

DOI QR Code

Effect of the High Frequency Chest Wall Oscillation (HFCWO) on Pulmonary Function and Walking Ability in Stroke Patients

  • Kim, Beom-Ryong (Department of Physical Therapy, The Graduate School, Sahmyook University) ;
  • Park, Jin (Department of Physical Therapy, The Graduate School, Daegu University)
  • 투고 : 2017.02.19
  • 심사 : 2017.04.30
  • 발행 : 2017.04.30

초록

Purpose: This investigation aimed to determine the effects of treadmill training (TT) and high frequency chest wall oscillation (HFCWO) on pulmonary function and walking ability in stroke patients as well as propose an exercise program to improve cardiovascular function. Methods: Twenty hemiplegic stroke patients were randomized to either the control group (CG) (n=10) or the experimental group (EG), which received TT and HFCWO (n=10). Pulmonary function was quantitated using patient forced vital capacity (FVC) and forced expiratory volume at one second (FEV1) while walking speed was assessed by the 10m walking test (10MWT). Further, walking endurance was determined utilizing the 6-minute walk test (6MWT). Subjects of the EG performed the study protocol for 60 minutes, five times a week for six weeks; CG patients did not participate in regular exercise. To determine significance for the differences observed before and after exercise, within-group and between-group comparisons were conducted utilizing paired and independent t-tests, respectively, with the level of significance set at ${\alpha}=0.05$. Results: Within-groups, significant differences were observed in both FVC and FEV1 (p<0.01) following completion of the study protocol. Further, between-group comparisons demonstrated significant differences in both FVC (p<0.05) and FEV1 (p<0.01). Post-exercise, significant changes in the 10MWT and 6MWT score were observed between the EG and CG (p<0.01). Further, statistically significant differences were observed in 6MWT scores between-groups (p<0.05). Conclusion: The TT and HFCWO effectively improved pulmonary function and walking ability in subjects with stroke. The proposed program can be applied to stroke patients as a useful therapy.

키워드

참고문헌

  1. Cho KH, Kim YS, Bae HS et al. Clinical observation on the admitted patients of department of cardiac internal medicine of oriental hospital. J Kyung Hee Univ Med Cent. 1996;12(2):200-13.
  2. Epstein SK. Late complications of tracheostomy. Respir Care. 2005; 50(4):542-9.
  3. 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
  4. Son SK. A review of literature an chest physiotherapy for application to nursing. The New Medical Journal. 1994;37(1):129-34.
  5. Hasani A, Pavia D, Agnew JE et al. Regional lung clearance during cough and forced expiration technique (FET): effects of flow and viscoelasticity. Thorax. 1994;49(6):557-61. https://doi.org/10.1136/thx.49.6.557
  6. McKoy NA, Saldanha IJ, Odelola OA et al. Active cycle of breathing technique for cystic fibrosis. Cochrane Database Syst Rev. 2012;12:CD007862.
  7. Borka P, Gyurkovits K, Bodis J. Comparative study of PEP mask and Flutter on expectoration in cystic fibrosis patients. Acta Physiol Hung. 2012;99(3):324-31. https://doi.org/10.1556/APhysiol.99.2012.3.9
  8. Esguerra-Gonzales A, Ilagan-Honorio M, Kehoe P et al. Effect of high-frequency chest wall oscillation versus chest physiotherapy on lung function after lung transplant. Appl Nurs Res. 2014;27(1):59-66. https://doi.org/10.1016/j.apnr.2013.11.005
  9. Anderson CA, Palmer CA, Ney AL et al. Evaluation of the safety of high-frequency chest wall oscillation (HFCWO) therapy in blunt thoracic trauma patients. J Trauma Manag Outcomes. 2008;2(1):8. https://doi.org/10.1186/1752-2897-2-8
  10. Tomkiewicz RP, Biviji A, King M. Effects of oscillating air flow on the rheological properties and clearability of mucous gel simulants. Biorheology. 1994;31(5):511-20. https://doi.org/10.3233/BIR-1994-31501
  11. Kluft J, Beker L, Castagnino M, et al. A comparison of bronchial drainage treatments in cystic fibrosis. Pediatr Pulmonol. 1996;22(4):271-4. https://doi.org/10.1002/(SICI)1099-0496(199610)22:4<271::AID-PPUL7>3.0.CO;2-P
  12. Lange DJ, Lechtzin N, Davey C, et al. High-frequency chest wall oscillation in ALS: an exploratory randomized, controlled trial. Neurology. 2006;67(6):991-7. https://doi.org/10.1212/01.wnl.0000237439.78935.46
  13. Fink JB, Mahlmeister MJ. High-frequency oscillation of the airway and chest wall. Respir Care. 2002;47(7):797-807.
  14. Hase K, Suzuki E, Matsumoto M et al. Effects of therapeutic gait training using a prosthesis and a treadmill for ambulatory patients with hemiparesis. Arch Phys Med Rehabil. 2011;92(12):1961-6. https://doi.org/10.1016/j.apmr.2011.07.005
  15. Pohl M, Mehrholz J, Ritschel C et al. Speed-dependent treadmill training in ambulatory hemiparetic stroke patients: a randomized controlled trial. Stroke. 2002;33(2):553-8. https://doi.org/10.1161/hs0202.102365
  16. Wada Y, Kondo I, Sonoda S et al. Preliminary trial to increase gait velocity with high speed treadmill training for patients with hemiplegia. Am J Phys Med Rehabil. 2010;89(8):683-7. https://doi.org/10.1097/PHM.0b013e3181e29d27
  17. Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-81.
  18. Osman LP, Roughton M, Hodson ME et al. Short-term comparative study of high frequency chest wall oscillation and European airway clearance techniques in patients with cystic fibrosis. Thorax. 2010;65(3): 196-200. https://doi.org/10.1136/thx.2008.111492
  19. Deathe AB, Miller WC. The L test of functional mobility: measurement properties of a modified version of the timed “up & go” test designed for people with lower-limb amputations. Phys Ther. 2005;85(7):626-35.
  20. Dean CM, Richards CL, Malouin F. Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial. Arch Phys Med Rehabil. 2000;81(4):409-17. https://doi.org/10.1053/mr.2000.3839
  21. Dobkin BH. Short-distance walking speed and timed walking distance: redundant measures for clinical trials? Neurology. 2006;66(4):584-6. https://doi.org/10.1212/01.wnl.0000198502.88147.dd
  22. Swisher A, Goldfarb A. Use of the 6-minute walk/run test to predict peak oxygen uptake in older adults. Cardiopulm Phys Ther J. 1998; 9(3):3-5.
  23. Kosak M, Smith T. Comparison of the 2-, 6-, and 12-minute walk tests in patients with stroke. J Rehabil Res Dev. 2005;42(1):103-7.
  24. Fulk GD, Reynolds C, Mondal S et al. Predicting home and community walking activity in people with stroke. 2010;91(10):1582-6. https://doi.org/10.1016/j.apmr.2010.07.005
  25. Woo MS. High frequency chest compression and PEP. Pediatr Pulmonol Suppl. 2004;26:152-3.
  26. Allan JS, Garrity JM, Donahue DM. High-frequency chest-wall compression during the 48 hours following thoracic surgery. Respir Care. 2009;54(3):340-3.
  27. Oermann CM, Sockrider MM, Giles D et al. Comparison of high-frequency chest wall oscillation and oscillating positive expiratory pressure in the home management of cystic fibrosis: a pilot study. Pediatr Pulmonol. 2001;32(5):372-7. https://doi.org/10.1002/ppul.1146
  28. Dosman CF, Jones RL. High-frequency chest compression: a summary of the literature. Can Respir J. 2005;12(1):37-41. https://doi.org/10.1155/2005/525813
  29. Chatburn RL. High-frequency assisted airway clearance. Respir Care. 2007;52(9):1224-35.
  30. Nicolini A, Cardini F, Landucci N et al. Effectiveness of treatment with high-frequency chest wall oscillation in patients with bronchiectasis. BMC Pulm Med. 2013;4(1)13-21.
  31. Park H, Park J, Woo SY et al. Effect of high-frequency chest wall oscillation on pulmonary function after pulmonary lobectomy for non-small cell lung cancer. Crit Care Med. 2012;40(9):2583-9. https://doi.org/10.1097/CCM.0b013e318258fd6d
  32. Kang JI, Kim BR, Park SK, et al. Effects of deep abdominal muscle strengthening exercises on pulmonary function and the ability to balance in stroke patients. J Kor Phys Ther. 2015;27(4):258-63. https://doi.org/10.18857/jkpt.2015.27.4.258
  33. Kim SD. Comparing the effects of chest expansion exercise and aerobic exercise on gait, pulmonary function, and activities of daily living in stroke patients. DaeJeon University Dissertation of Master's Degree. 2013.
  34. Kim JS, Shin WS. The effects of respiratory muscle strengthening training on pulmonary function and gait ability in subacute stroke patients. J Korean Soc Phys Med. 2013;8(4):489-96. https://doi.org/10.13066/kspm.2013.8.4.489
  35. Macko RF, Ivey FM, Forrester LW et al. Treadmill exercise rehabilitation improves ambulatory function and cardiovascular fitness in patients with chronic stroke: a randomized, controlled trial. Stroke. 2005;36(10): 2206-11. https://doi.org/10.1161/01.STR.0000181076.91805.89
  36. Park, GA, Hong JR. Correlation between respiratory function and performance of activities of daily living in stroke patients. J Rehebil Res. 2014;18(3):309-21.

피인용 문헌

  1. The Effects of Resting Physical Factors on Distance and Intensity of Six-Minute Walk Test in Healthy Female Subjects vol.29, pp.5, 2017, https://doi.org/10.18857/jkpt.2017.29.5.281
  2. Effects of Respiratory Muscle Training on the Respiratory Function, Balance, and Activities of Daily Living in Patients with Stroke vol.30, pp.2, 2017, https://doi.org/10.18857/jkpt.2018.30.2.58