• The Journal of Korean Physical Therapy
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• v.23 no.2
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• pp.37-43
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• 2011

Purpose: The purpose of this study was to determine the effects of chest resistance exercise on Forced Expiratory Volume per second and on fatigue in patients with chronic obstructive pulmonary disease (COPD). Methods: In all, 62 male patients with COPD were included in this study. The experimental group included 32 patients who were treated with chest resistance exercise using the PNF technique with medication. The control group included 30 patients who were treated only with medication. Subjects were stratified into the 2 groups by randomized clinical sampling. Before the start of the experiment, forced expiratory volume at the first second (FEV1) and lactic acid were tested in both experimental and control groups. The experimental group did chest resistance exercise for 6 weeks, 4 times per week, 30 min per day, and the effects of this exercise in patients with COPD was determined by comparing the results of FEV1 and lactic acid tests before and after the experiment between and within the experimental and control groups. Results: There was a statistically significant within group difference for FEV1 MEAS and FEV1 %PRED. There was statistically significant control group of FEV1 MEAS and FEV1 %PRED There was a statistically significant difference in the experimental group for fatigue, comparing scores before and after the test. There was a statistically significant control group of fatigue, in comparison of between the groups of FEV1 MEAS, FEV1 %PRED, fatigue(p<0.01)(p<0.05). Conclusion: More research on COPD will be necessary for improving pulmonary function and reducing fatigue. Further studies on COPD will be required for improving pulmonary function and reducing of fatigue.

• Tuberculosis and Respiratory Diseases
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• v.40 no.6
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• pp.631-637
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• 1993

Background: In normal adults, ventilation is uneven and greater in the base than the apex of the lung in tidal volume breathing. However infants have fragile chest wall and reduced elastic recoil, resulting in easy closure of peripheral airways especially in the dependent portion of the lung. So ventilation in infants is greater in the apex than the base of the lung. We assumed that in adults whose closing volume is increased, dependent portion could be easily collapsed during tidal breathing and ventilation could be greater in the uppear than than the lower portion of the lung. Methods: We measured spirometry and closing volume(CV) in normal controls and in patients with chronic lung disease. Also we measured fractional distribution of ventilation at supine, left lateral and right lateral decubitus with $^{133}Xe$ ventilation scan in normal controls, patients with normal closing volume and patients with increased closing volume. Results: The subjects consisted of 7 normal controls(mean $age{\pm}SD$, $62.9{\pm}6.1$ years). 6 patients with normal CV($62.8{\pm}8.2$ years) and 7 patients with increased CV($63.0{\pm}15.3$ years). 1) Normal controls have mean(${\pm}SD$) FVC $104{\pm}11%$ of predicted value, $FEV_1\;120{\pm}16%,\;FEV_1/FVC\;112{\pm}5%$ and CV $86.9{\pm}12.5%$. Patients with normal CV have FVC $62{\pm}11%,\;FEV_1\;54{\pm}17%,\;FEV_1/FVC\;84{\pm}23%$ and CV $92.6{\pm}15.5%$. Patients with increased CV, have FVC $53{\pm}9%,\;FEV_1\;38{\pm}13,\;FEV_1/FVC\;69{\pm}16%$ and CV $176.1{\pm}36.6%$, CV was significantly different between two patient groups(p<0.02) 2). In normal controls mean fractional ventilation to left lung was $48.1{\pm}5.3%$ at supine, $54.1{\pm}9.8%$ at dependent and $40.9{\pm}6.5%$ at left uppermost position. In patients with normal CV mean fractional ventilation to left lung was $44.6{\pm}2.1%$ at supine, $59.7{\pm}5.6%$ at left dependent and $31.7{\pm}8.3%$ at left uppermost position. In patients with increased CV mean fractional ventilation to left lung was $48.7{\pm}4.5%$ at supine, $41.7{\pm}6.6%$ at left dependent and $60.9{\pm}15.7%$ at left uppermost position. In normal controls and patients with normal CV, ventilation to left lung at left dependent position tends to be higher than that at supine position but without statisitical significance and it was significantly lower at left uppermost than at left lung dependent position. In patients with increased CV, ventilation to left at left dependent position tends to be higher than that at supine position but without significance and it was significantly higher at left uppermost than that at left dependent position. Conclusion: These data suggest that in patients with increased CV ventilation to one side of lung could be higher at uppermost than at dependent position on lateral decubitus during tidal breathing and this fact should be taken into account in positioning of patients with unilateral lung disease.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.4
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• pp.77-83
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• 2021

PURPOSE: This study examined the changes in the respiratory function when PNF chopping and lifting patterns were used in chronic stroke patients METHOD: The subjects were 30 patients diagnosed with chronic stroke. The respiratory function (FVC, FEV₁, and FEV₁/FVC) were measured by spirometry. Thirty subjects were divided randomly into an experimental group to which 15 PNF chopping and lifting were applied and a control group to which chest breathing exercise was performed. The intervention was conducted three times a week for six 6 weeks. To examine the effects of intervention, the pre- and post-intervention values for each group were compared using a paired t-test. An independent t-test was used to compare the differences in the values of changes pre- and post-intervention in the two groups. Statistical significance was set to .05. RESULTS: Satistically significant differences in FVC and FEV₁ were observed in both the experimental group and control group according to the intervention (p < .05). A statistically significant difference was found in FVC and FEV₁ compared to values of changes pre- and post-intervnetion between the experimental and control groups. There was no difference in FEV₁/FVC. CONCLUSION: The results suggest that PNF chopping and lifting can be applied as an excellent respiratory intervention program compared to general chest breathing exercises to improve respiratory function in stroke patients.

• Journal of Korean Physical Therapy Science
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• v.6 no.2
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• pp.997-1005
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• 1999

To evaluate the effect of winter intensive training on pulmonary function in high school baseball players, comparisons of various ventilatory parameters were made before and 3-3.5 months of winter intensive tranining. The subjects were 18 members of a high school baseball players with mean age and career of 6.3 and 7.3 years, respectively. The following were mainly observed by spirometry for the study ; respiratory rate, vital capacity(VC), maximum voluntary ventilation(MVV), forced vital capacity (FEV1%) and forced mid-expiratory flow (FEF25-75%). The result obtained are summarized as follow. 1) Resipratory rate, tidal volume, forced vital capacity, 1FEV%, FEF50% and FEF75% showed no significant difference between before and after. 2) MVV in after was significantly(p<0.001) increased to 166 L/min comparing with 136L/min in before. 3) 1FEV in after was significantly(p<0.05) increased to 4.46L comparing with 3.76L in before. 4) PEF in after was significantly(p<0.05) increased to 10.40 L/sec comparing with 9.18 L/sec in before.

• Tuberculosis and Respiratory Diseases
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• v.72 no.3
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• pp.302-309
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• 2012

Background: Korean regression models for spirometric reference values are different from those of Americans. Using spirometry results of Korean adults, goodness-of-fits of the Korean and the USA Caucasian regression models for forced vital capacity (FVC) and forced expiratory volume in one second ($FEV_1$) were compared. Methods: The number of study participants was 2,360 (1,124 males and 1,236 females). Spirometry was performed under the guidelines of the American Thoracic Society and the European Respiratory Society. After excluding unsuitable participants, spirometric data for 729 individuals (105 males and 624 females) was included in the statistical analysis. The estimated FVC and $FEV_1$ values were compared with those measured. Goodness-of-fits for Korean and USA Caucasian models were compared using an F-test. Results: In males, the expected values of FVC and $FEV_1$ using the Korean model were 12.5% and 5.7% greater than those measured, respectively. The corresponding values for the USA Caucasian model were 3.5% and 0.6%. In females, the difference in FVC and $FEV_1$ were 13.5% and 7.7% for the Korean model, and 6.3% and 0.4% for the USA model, respectively. Goodness-of-fit for the Korean model regarding FVC was not good to the study population, but the Korean regression model for $FEV_1$, and the USA Caucasian models for FVC and $FEV_1$ showed good fits to the measured data. Conclusion: These results suggest that the USA Caucasian model correlates better to the measured data than the Korean model. Using reference values derived from the Korean model can lead to an overestimation regarding the prevalence of abnormal lung function.

• The Journal of Korean Physical Therapy
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• v.31 no.6
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• pp.351-357
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• 2019

Purpose: This study sought to investigate the effects of the McKenzie exercise program on forward head posture and respiratory function. Methods: Thirty adult men and women with forward head posture, aged 20-29 years, were randomly assigned to the experimental group (N=15) or the control group (N=15). Subjects in the experimental group performed the McKenzie exercises three times a week for four weeks, while subjects in the control group did not receive any intervention. Craniovertebral angle (CVA) was measured to quantify forward head posture, and forced vital capacity (FVC), FVC % predicted, forced expiratory volume at one second (FEV₁), and FEV₁ % predicted were measured to determine changes in respiratory function. The Mann-Whitney U-test was used to analyze pre-test differences in forward head posture and respiratory function between the two groups, and the Wilcoxon signed-rank test was used to analyze differences in forward head posture and respiratory function within the groups before and after intervention. The significance level (α) was set to 0.05. Results: A comparison of pre- and post-test measures showed that CVA significantly increased in the experimental group (p=0.001) denoting postural improvement, whereas no significant difference was found in the control group (p=0.053). All respiratory measures, i.e.,FVC, FVC %pred, FEV₁, and FEV₁ %pred, were significantly improved in the experimental group, whereas there were no significant differences in the control group. Conclusions: McKenzie exercise can be effective in improving forward head posture and respiratory function.

• Tuberculosis and Respiratory Diseases
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• v.69 no.2
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• pp.108-114
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• 2010

Background: The aim was to estimate the differences between pulmonary disability grades according to the spirometry reference equations (the Korean equation and the Morris equation). Methods: Spirometry was performed on 16,916 male and 1,353 female special examination for pneumoconiosis, in the period of 2007~2009. Changes in predictive values for forced expiratory volume in one second ($FEV_1$), forced vital capacity (FVC) and $FEV_1$/FVC and in disability grade were evaluated using both equations. Results: Mean FVCs for men and women were 4,218.7 mL and 2,801.5 mL in predictive values after the application of the Korean equation, and 3,763.9 mL and 2,395.6 mL after the Morris equation, respectively. Compared with the Morris equation, the Korean equation showed 10.8% and 14.5% of excesses for men and women (p<0.001). Mean $FEV_1s$ for men and women were 3,102.5 mL and 2,107.1 mL in the Korean equation, and 2,667.8 mL and 1,699.6 mL in the Morris equation, respectively. Compared with the Morris equation, the Korean equation showed 14.0% and 19.3% of excesses for men and women (p<0.001). Men and women who showed the changes of disability grades using the Korean equation in place of the Morris equation were 23.9% (4,052/16,916) and 22.9% (311/1,353) on FVC, and 23.1% (3,913/16,916) and 10.7% (145/1,353) on $FEV_1$. Conclusion: Applying different reference equations for spirometry has resulted in changes for disability grades in special examination for pneumoconiosis.

• Journal of The Korean Society of Integrative Medicine
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• v.12 no.1
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• pp.27-39
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• 2024

Purpose : Smoking is a major factor in chronic obstructive pulmonary disease (COPD), but the effect of electrical cigarette smoking on COPD development is still uncertain. This study aimed to compare the functions of airways and lungs exposed to combustible cigarettes and electrical cigarettes based on the pulmonary function test (PFT) results from the Korean National Health and Nutrition Examination Survey (NHANES). Methods : This study used data from 8,942 participants with PFT results out of 47,309 total subjects from the 6th to 8th Korean NHANES (2014-2015, 2016-2018, and 2019, respectively). Individuals with diseases such as cancer, ex-smokers, and dual tobacco users were excluded. The PFT results were analyzed according to the COPD diagnostic criteria. After adjusting for confounding variables, a complex sample generalized linear model ANOVA test was performed to investigate the association between PFT results and combustible smoker or electrical cigarette user groups. Results : In an analysis based on the obstructive ventilatory disorders (forced expiratory volume in 1 second[FEV₁]/forced vital capacity[FVC]<.7), combustible cigarette smokers showed a 3.46 times higher risk of COPD compared to non-smokers, while electrical cigarette smokers exhibited no significant difference in terms of COPD-related risks compared to non-smokers. FEV₁ showed a negative relation with combustible cigarette smokers as reported elsewhere (B=-.07, p<.001). FEV₁/FVC was negatively related to both combustible cigarette smokers (B=-.03, p<.001) and electrical cigarette smokers (B=-.02, p<.001). Conclusion : FEV₁/FVC decreases were observed in the long-term exposure to both combustible and electrical cigarettes. The lower FEV₁ in the combustible cigarette group implies the worsening of the severity of COPD, suggesting more damage to the airways and lungs in the short term. Therefore, the temporary electrical cigarettes use for the transition period in order to smoking cessation potentially aids to reduce the harmful effect of combustible cigarettes in COPD development.

• Tuberculosis and Respiratory Diseases
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• v.45 no.6
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• pp.1188-1198
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• 1998

Background : The purpose of the present study was to determine the protective effect of antiasthmatic activity of inhaled heparin, cromolyn sodium, budesonide, furosemide in exercise-induced asthma(EIA). The other important considerable point of this study was the mechanism of bronchoconstriction on EIA. Methods : Eight subjects with a history of EIA were studied on 5 different experiment days. After obtaining baseline $FEV_1$ and FVC, subjects performed a standardized exercise challenge. EIA was assessed by measurement of $FEV_1$ before and after exercise. On experiment day 4, the exercise challenge was performed after the subjects inhaled either heparin (1,000 units/kg/day for 5 days), furosemide (1mg/kg for 5 days), cromolyn (4mg/day for 5 days), or budesonide ($400{\mu}g/day$ for 5 days). On experiment day 5, the methacholine bronchial provocation test was performed. On experiment day 3, activated partial thromboplastine time(aPTI) was checked. Results : Maximum decrements of $FEV_1$ (mean${\pm}$SE) among 0 to 120 minutes after exercise were as follows : heparin was $83.1{\pm}4.81%$ (p=0.010), furosemide was $80.5{\pm}6.87%$ (p=0.071), cromolyn was $86.8{\pm}6.53%$ (p=0.340), and budesonide was $79.4{\pm}7.31%$ (p=0.095). Above medications were compared to the control value ($72.5{\pm}18.2%$) by paired t-test. No medications had effect on $PD_{20}$ of methacholine bronchial provocation test The results were control $1.58{\pm}0.49{\mu}mol$), heparin ($4.17{\pm}1.96{\mu}mol$), furosemide ($1.85{\pm}0.86{\mu}mol$), cromolyn ($2.19{\pm}0.89{\mu}mol$), and budesonide ($3.38{\pm}1.77{\mu}mol$), respectively(p>0.05). The inhaled heparin had no effect of anticoagulation. Conclusion : These data demonstrate that inhaled heparin has a protective effect on EIA. The effect of inhaled cromolyn was statistically absent with manufacture's recommended dosage on EIA. So, the dosage of cromolyn should be carefully evaluated in future. Although inhalation of budesonide and furosemide have no statistical significance compared to control, these drugs also have some protective effects on EIA.

• Tuberculosis and Respiratory Diseases
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• v.43 no.6
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• pp.976-986
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• 1996

BACKGROUND : Dyspnea is common among patients with cardiopulmonary disease, and "daily disability" is defined as a functional impairment resulting from exercise intolerance. The maximal oxygen uptake(VO2max) during exhausting work is not only the best single physical indicator of the capacity of a man for sustaining hard muscular work, but also the most objective method by which one can determine the physical fitness of an individual as reflected by his cardiovascular system. However, the expense, time and personnel requirements make this procedure prohibitive for testing large group. The walking test is well-known type of exercise and it cost nothing to perform and have good reproducibility. Thus we performed the walking test and investigated correlations with spirometry, ABG and exercise test. METHOD: We observed the walking test and exercise test by cycle ergometer in 37 patients who visited our hospital because of dyspnea. Arterial blood gas analysis and spiromety, dyspnea index were performed, too. RESULT : (1) The VO2max was significantly lower in patients with COPD and cardiovascular disease than asthma and dyspnea on exertion group(p<0.05). The walking test distance was also lower in former. (2) The 12 minute walking test was significantly correlated with VO2max, PaCO2, FVC(%), FEV1(%) in all patients(p<0.05), and the walking test was only conelated with VO2max in patients with COPD(p<0.05). (3) In COPD patients, the VO2max was best correlated with FEV1(%) and FVC(%) and significantly correlated with walking test. But there was no correlation between walking test and FEV1(%) & FVC(%). (4) The 6 minute walking test was well correlated with 12 minute walking test(r=0.92. p<0.01). CONCLUSION : The walking test is the simple method for assessing exercise performance in patient with cardiopulmonary disease and a reliable indicator for VO2max. And the walking test is practical method for assessing on everyday disability rather than maximal exercise capacity. The 6 minute walking test is highly correlated with 12 minute walking test and a less exhausting for the patients and a time-saving for the investigator.