대한물리의학회지 (Journal of the Korean Society of Physical Medicine)

  • 제14권1호
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  • Pages.43-51
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  • 2019
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  • 1975-311X(pISSN)
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  • 2287-7215(eISSN)
대한물리의학회 (The Korean Society of Physical Medicine)
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Pulmonary Function Index Comparisons Depending on Various Postures of Stroke Patients

  • Lee, Kyung-Soo (Department of Physical Therapy, Graduate School of Health and Medicine, Daejeon University) ;
  • Lee, Myung-Mo (Department of Physical Therapy, Daejeon University)
  • 투고 : 2018.11.27
  • 심사 : 2018.12.17
  • 발행 : 2019.02.28
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초록

PURPOSE: To prevent secondary complications from decreased pulmonary functions and promote neurological recovery, identification of respiratory capacity change patterns depending on different postures of stroke patients and investigation of their properties are needed for active rehabilitation. Therefore, this study was conducted to investigate the changes in vital capacity in response to different positions and to implement the results as clinical data. METHODS: A respiratory function test was administered to 52 patients with stroke in the sitting, supine, paretic side lying, and non-paretic side lying positions. Pulmonary function indexes used for comparison were forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), forced expiratory flow 25-75% (FEF 25-75%), and maximum voluntary ventilation (MVV). One-way repeated ANOVA was used for analysis, and post hoc analysis was conducted using least significant difference (LSD). RESULTS: All pulmonary function indexes were measured in the order of sitting, paretic side lying, supine, and non-paretic side lying positions. Excluding the FEF25-75% and MVV of the supine compared with the paretic side lying position, all other pulmonary function indexes differed significantly (p<.05). CONCLUSION: There are differences in pulmonary function indexes depending on different postures of stroke patients, and the study showed that the non-paretic side lying position yielded the greatest effect on lung ventilation mechanisms. Based on these results, appropriate postures need to be considered during physical therapy interventions for stroke patients.

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참고문헌

  1. Harvey R, Roth E, Yu D. Rehabilitation in stroke syndromes. PM&R. Philadelphia: Saunders Elsevier. 2007:1175-12.
  2. Geyh S, Cieza A, Schouten J, et al. ICF Core Sets for stroke. J Rehabil Med. 2004(44 Suppl):135-41.
  3. 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
  4. de Almeida IC, Clementino AC, Rocha EH, et al. Effects of hemiplegy on pulmonary function and diaphragmatic dome displacement. Respir Physiol Neurobiol. 2011;178(2):196-201. https://doi.org/10.1016/j.resp.2011.05.017
  5. Andrews AW, Bohannon RW. Distribution of muscle strength impairments following stroke. Clin Rehabil. 2000;14(1):79-87. https://doi.org/10.1191/026921500673950113
  6. Richards CL, Malouin F, Wood-Dauphinee S, et al. Task-specific physical therapy for optimization of gait recovery in acute stroke patients. Arch Phys Med Rehabil. 1993;74(6):612-20. https://doi.org/10.1016/0003-9993(93)90159-8
  7. Grotta JC, Lo EH. Stroke: pathophysiology, diagnosis, and management. Elsevier Health Sciences. 2015.
  8. Manning F, Dean E, Ross J, et al. Effects of side lying on lung function in older individuals. Phys Ther. 1999;79(5):456-66. https://doi.org/10.1093/ptj/79.5.456
  9. Georges R, Saumon G, Loiseau A. The relationship of age to pulmonary membrane conductance and capillary blood volume. Am Rev Respir Dis. 1978;117(6):1069-78.
  10. Zadai CC. Pulmonary physiology of aging: the role of rehabilitation. Top Geriatr Rehabil. 1985;1(1):49-57. https://doi.org/10.1097/00013614-198510000-00008
  11. Miner B, Gill TM, Vaz Fragoso CA. Physiology of the Aging Lung. The Aging Lungs: Mechanisms and Clinical Sequelae. World Scientific. 2016.
  12. Lanini B, Gigliotti F, Claudia C, et al. Dissociation between respiratory effort and dyspnoea in a subset of patients with stroke. Clin Sci. 2002;103(5):467-73. https://doi.org/10.1042/cs1030467
  13. Kim BR, Chun MH, Kang SH. Change of Respiratory Function following Rehabilitation in Acute Hemiplegic Stroke Patients. J Korean Acad Rehabil Med. 2009;33(1):21-8.
  14. Howard R, Rudd A, Wolfe C, et al. Pathophysiological and clinical aspects of breathing after stroke. Postgrad Med J. 2001;77(913):700-2. https://doi.org/10.1136/pmj.77.913.700
  15. Dean E. Effect of body position on pulmonary function. Phys Ther. 1985;65(5):613-8. https://doi.org/10.1093/ptj/65.5.613
  16. Estenne M, Gevenois PA, Kinnear W, et al. Lung volume restriction in patients with chronic respiratory muscle weakness: the role of microatelectasis. Thorax. 1993;48(7):698-701. https://doi.org/10.1136/thx.48.7.698
  17. MacKay-Lyons MJ, Makrides L. Longitudinal changes in exercise capacity after stroke. Arch Phys Med Rehabil. 2004;85(10):1608-12. https://doi.org/10.1016/j.apmr.2004.01.027
  18. Ito H, Kano O, Ikeda K. Different variables between patients with left and right hemispheric ischemic stroke. J Stroke Cerebrovasc Dis. 2008;17(1):35-8. https://doi.org/10.1016/j.jstrokecerebrovasdis.2007.11.002
  19. 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
  20. Harraf F, Ward K, Man W, et al. Transcranial magnetic stimulation study of expiratory muscle weakness in acute ischemic stroke. Neurology. 2008;71(24):2000-7. https://doi.org/10.1212/01.wnl.0000336927.30977.56
  21. Shin YA, Kim MJ, Ahn JH. The comparison of heart rate variability and blood pressure according to posture and exercise type. Exercise science. 2011;20(3):249-60. https://doi.org/10.15857/ksep.2011.20.3.249
  22. Seo KC, Cho MS. An analysis of pulmonary function in different lying positions in the 20's normal adults. J Phys Ther Sci. 2016;28(11):3063-5. https://doi.org/10.1589/jpts.28.3063
  23. Zack MB, Pontoppidan H, Kazemi H. The effect of lateral positions on gas exchange in pulmonary disease: a prospective evaluation. Am Rev Respir Dis. 1974;110(1):49-55.
  24. Chen C, Lien IN, Wu M. Respiratory function in patients with spinal cord injuries: effects of posture. Spinal Cord. 1990;28(2):81. https://doi.org/10.1038/sc.1990.10
  25. Pryor JA, Prasad AS. Physiotherapy for respiratory and cardiac problems: adults and paediatrics. Elsevier Health Sciences. 2008.
  26. Mori R, Bergsman A, Holmes M, et al. Role of the medial medullary reticular formation in relaying vestibular signals to the diaphragm and abdominal muscles. Brain research. 2001;902(1):82-91. https://doi.org/10.1016/S0006-8993(01)02370-8
  27. Galvin I, Drummond G, Nirmalan M. Distribution of blood flow and ventilation in the lung: gravity is not the only factor. Br J Anaesth. 2007;98(4):420-8. https://doi.org/10.1093/bja/aem036
  28. Ganapathi LV, Vinoth S. The estimation of pulmonary functions in various body postures in normal subjects. Int J Advances Med. 2015;2(3):250-4. https://doi.org/10.18203/2349-3933.ijam20150554
  29. McCool F, Leith D. Pathophysiology of cough. Clin Chest Med. 1987;8(2):189-95. https://doi.org/10.1016/S0272-5231(21)01014-5
  30. Cotes JE, Chinn DJ, Miller MR. Lung function: physiology, measurement and application in medicine. John Wiley & Sons. 2009.
  31. Kisner C, Colby LA, Borstad J. Therapeutic exercise: foundations and techniques. Fa Davis. 2017.
  32. Kera T, Maruyama H. The effect of posture on respiratory activity of the abdominal muscles. J Physiol Anthropol Appl Human Sci. 2005;24(4):259-65. https://doi.org/10.2114/jpa.24.259
  33. Kwon SE, Lee DY, Hong JH, et al. Effects of various angle on respiration function in adults. Indian J Sci Technol. 2015;8(26).
  34. Seo KC, Lee SE, Lee JH, et al. Comparison of Posture on Respiratory Function in the Stroke Patients according to Changes of Position. J Korean Soc Phys Med. 2011;6(4):381-9.
  35. Jenkins SC, Soutar SA, Moxham J. The effects of posture on lung volumes in normal subjects and in patients pre-and post-coronary artery surgery. Physiotherapy. 1988;74(10):492-6. https://doi.org/10.1016/S0031-9406(10)63381-0