• Tuberculosis and Respiratory Diseases
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• v.54 no.4
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• pp.395-402
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• 2003

Background : Patients with chronic obstructive pulmonary disease (COPD) are at increased risk for osteoporosis, which has implications for mobility and even mortality. The goal of this pilot study was to evaluate bone mineral density (BMD) and risk factors for osteoporosis in a limited number of men with COPD. Methods : We checked BMD, $FEV_1$(% of predicted) and investigated risk factors for osteoporosis in 44 male patients with COPD who visited our hospital from January to August 2002. Results : Mean(${\pm}$) age was $69{\pm}9$ yrs, body mass index(BMI) $21{\pm}3kg/m^2$, $FEV_1$ $50{\pm}18%$ of predicted, lumbar spine T-score $-3.0{\pm}1.2$, lumbar spine Z-score $-2.0{\pm}1.2$, and lumbar spine BMD $0.76{\pm}0.13g/cm^2$. Osteoporosis(T-score below -2.5) was present in 27 patients(61.4%) and osteopenia(T-score between -1 and -2.5) in 17(38.6%). None of the patients had normal BMD. There was no relationship between BMD and $FEV_1$(% of predicted). There were significant differences in smoking, alcohol consumption, exercise, cumulative steroid dose, BMI and BMD among the three groups according to $FEV_1$(% of predicted) (group1 : ${\geq}65%$, group2 : 50-64%, group3 : ${\leq}49%$), except age. However, there were no significant differences in these variables between the osteopenia and osteoporosis groups, except BMI. Linear Regression(Stepwise) analysis showed that lumbar BMD was correlated with BMI & exercise. Conclusion : BMD is significantly reduced in men with COPD. There was no relationship between BMD and pulmonary function.

• Tuberculosis and Respiratory Diseases
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• v.41 no.5
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• pp.521-530
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• 1994

Background : The past studies on prediction formulas of pulmonary function parameters in healthy nonsmoking Korean adults have been performed in relatively small number of subjects and the reported results were restricted on a few parameters. Also there was no systematic investigation into the effect of smoking on pulmonary function parameters in smokers who have no respiratory symptoms. Therefore we attempted to establish prediction formulas of pulmonary function parameters and examined the effect of smoking on pulmonary function parameters. Methods We analyzed the result of parameters derived from the forced expiratory spirogram in 1,067 nonsmoking subjects from June in 1990 to December in 1991. They consisted of 306 males and 761 females and had neither respitatory symptoms nor history of respiratory disease. We derived prediction formulas by multiple linear regression method from their age, heights, and weights in each sex. To examine the effect of smoking on pulmonary function parameters, we classified 383 smoking men into three groups according to the past amount of smoking as follows : i.e. group of smokers who have smoked below 10 pack-years, 10-20 pack-years and above 20 pack-years. Regarding each group of past smoking as an independent dummy variable, we analyzed pulmonary function parameters including nonsmoking men as a baseline by multiple linear regression. We evaluated the smoking effect on pulmonary function parameters according to estimated p-value. Result : 1) Prediction formulas for pulmonary function parameters in each sex were derived. 2) The past smoking less than 10 pack-years does not give any effect on pulmonary function parameters. The past smoking of 10~20 pack-years showed significant negative correlation with $FEV_1$/FVC and FEF 25~75%, and the smoking above 20 pack years showed negative correlation with $FEV_1$ and $FEV_1$/FVC. Conclusion : We have got prediction formulas of pulmonary function parameters which is driven from forced expiratory spirogram in nonsmoking Korean adults by multiple linear regression from age, heights and weights of subjects. The past smoking more than 10 pack-years showed negative correlation with some pulmonary function parameters of airflow obstruction.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.33-39
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• 2016

PURPOSE: The purpose of this study was to investigate whether a circuit aerobic exercise program positively affects pulmonary function and gait endurance in chronic stroke patients. METHODS: Twenty-four chronic stroke patients were allocated equally and randomly to an experimental group (n=12) or a control group (n=12). All participants received 60 minutes of comprehensive rehabilitation treatment, the experimental group additionally performed a circuit aerobic exercise for 30 minutes, while the control group additionally performed a general aerobic exercise, i.e., gait training on the treadmill for 30 minutes. These 30-minute exercise sessions were held three times per week for six weeks. Pulmonary function was assessed using forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximal voluntary ventilation (MVV), and gait endurance was assessed using the 6-minute walk test (6MWT). RESULTS: In the both groups, FVC, FEV1, MVV, and 6MWT were significantly increased after training. Members of the experimental group showed significant improvements in FVC, FEV1, and MVV, and significantly greater improvements than controls (p<.05). However, 6MWT improvements were not significantly different in the two groups (p>.05). CONCLUSION: The devised circuit aerobic exercise program offers an effective rehabilitation aerobic exercise for improving pulmonary function and gait endurance in patients after chronic stroke.

• The Journal of Korean Physical Therapy
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• v.29 no.2
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• pp.50-54
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• 2017

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.

• Tuberculosis and Respiratory Diseases
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• v.60 no.4
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• pp.397-403
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• 2006

Background: Chronic obstructive pulmonary disease(COPD) is categorized by the percentage of the predicted $FEV_1$(Forced expiratory volume in 1 second) result which is highly correlated with disease severity(morbidity and mortality). In COPD patients, dyspnea seems to be different from disease severity. We investigated whether dyspnea is correlated with disease severity, as measured by $FEV_1$, quality of life(QoL), occupation, and supporting level of family members and neighbors. Method: Thirty-six clinically stable patients with chronically irreversible airflow limitation were enrolled. We used the Medical Research Council(MRC) dyspnea scale to assess the level of dyspnea and the Korean St. Goerge's respiratory questionnaire(SGRQ) as measure the QoL. Result: The mean percentage of the predicted $FEV_1$ was 32.0%. Dyspnea was not correlated with GOLD stage using $FEV_1$(p=0.114). With deteriorating level of dyspnea the scores of symptoms(p=0.041), activity(p=0.004), impact(p=0.001), and total SGRQ score(p<0.001) were significantly increased. Dyspnea was not correlated with the level of occupation(p=0.259). The supporting level of family members and neighbors was significantly negatively correlated with dyspnea scale(p=0.011). Conclusion: In the management of COPD patients, we have to remember that the level of subjective dyspnea is correlated with QoL(symptom, activity and impact on society) and social supporting level as well as GOLD stage($FEV_1$).

• The Journal of Korean Physical Therapy
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• v.26 no.3
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• pp.169-174
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• 2014

Purpose: This study demonstrated a postural alignment exercise as conservative management strategy for a woman with excessive thoracic kyphosis presenting decreased chest function, and reports its results. Methods: A 21-year-old woman with thoracic kyphosis presenting limited chest function. The exercise program underwent for 30 min in the intervention phase, which consisted of exercises to improve the strength of back extensor and to stretch anterior chest region. Outcome measures comprised the severity of thoracic kyphosis and chest function (vital capacity [VC], forced expiratory volume in a second [FEV1], and chest expansion length). Results: The thoracic kyphotic angle decreased by 23.6% ($9.38^{\circ}$) and 25.4% ($10.58^{\circ}$) in the intervention and follow-up phases respectively. Also, chest function was improved in the intervention (VC: 3.7% [$0.10{\ell}$], FEV1: 17.1% [$0.39{\ell}$], and chest expansion length: 17.1% [0.96 cm]), and the improvement was maintained during the follow-up phase (VC: 4.8% [$0.13{\ell}$], FEV1: 17.1% [$0.39{\ell}$], and chest expansion length: 64.3% [1.81 cm]). Conclusion: These findings suggest that the postural alignment exercise was favorable for improving chest function of a woman with thoracic kyphosis.

• Journal of Chest Surgery
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• v.28 no.5
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• pp.464-470
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• 1995

From Jan 1988 to Dec 1993, 196 consecutive patients with various pulmonary diseases underwent pneumonectomy. Mean age was 54.0 years[range:7-74 . The underlying diseases were lung cancer[154 cases , destroyed lung[29 cases with pulmonary tuberculosis or empyema thoracis and others[13 cases . The overall mortality and complication rate were 5.6% and 14.8%. In the groups of more than and less than 60 years of age, there was significant differences in mortality rate[P=0.004 . In the group of pneumonectomy and pleuropneumonectomy, there was no significant differences in mortality[P=0.164 and complication rate[P=0.052 . In the group of normal and abnormal EKG, there was no significant differences in mortality[P=0.560 and complication rate[P=0.693 . In the preoperative FEV1, preoperative FVC and predicted postoperative FEV1, prognostic cut-off points were 1800cc, 2600cc and 1300cc, and at points, positive predicted value were 12.3%, 10.5%.and 7.7% and negative predicted value were 97.8%, 98.3% and 96.2% respectively. The preoperative FEV1 is the most reliable indicator in assessment of prognosis of pneumonectomy.

• Journal of Chest Surgery
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• v.26 no.1
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• pp.54-58
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• 1993

Simultaneous bilateral bleb resection was done through bilateral transaxillary thoracotomy in 10 patients with spontaneous pneumothorax during the period from May 1991 to Novemver 1992 in whom bilateral bulla or bleb was detected with using simple chest X-ray and chest CT scanning. To compare the effectiveness of bilateral transaxillary thoracotomy, we investigated 10 unilateral transaxillary thoracotomy patients with spontaneous pneumothorax and two clinical reports from other institutes which dealt the results of bilateral bleb or bulla resection through median sternotomy also. In bilateral transaxillary thoracotomy group,mean operation time was 115 minute,mean intraoperative bleeding was 329 cc, mean postoperative hospital stay was 7.5 days. Postoperative ABGA[Arterial Blood Gas Analysis] was in normal range and postoperative recovery rates of FVC[Forced Vital Capacity], FEV1[Forced Expiratory Volume at 1 second], TV[Tidal Volume] were 84.3%, 93.4%, 88.7%,respectively. In median sternotomy group,mean operation time was 129 minute,mean intraoperative bleeding was 490 cc, mean postoperative hospital stay was 12.4 days. Postoperative ABGA was in normal range and postoperative recovery rates of FVC, FEV1 were 97.3%, 97.4%, respectively. In unilateral transaxillary thoracotomy group, postoperative ABGA was in normal range also and postoperative recovery rates of FVC, FEV1, TV were 91.6%, 99.0%, 96.0%,respectively. In conclusion, simultaneous bilateral bleb resection through bilateral transaxillary thoracotomy should be considered in pneumothorax patients with bilateral bleb or bulla because of cost-effectiveness[reducing hospital days] and better cosmetic result without any impairment in recovery of respiratory function.

• Physical Therapy Rehabilitation Science
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• v.10 no.3
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• pp.328-336
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• 2021

Objective: The purpose of this study was to investigate the effect of cervical range of motion training on the change in respiratory function growth rate at the group and individual level in stroke patients and stroke patients with tracheostomy tube. Design: A Multilevel Growth Model Methods: 8 general stroke patients and 6 stroke patients who had a tracheostomy tube inserted were subjected to cervical range of motion training 3 times a week for 4 weeks. Force vital capacity (FVC), Forced expiratory volume in the first second (FEV1), Forced expiration ratio (FEV1/FVC) and Manual assist peak cough flow (MPCF) were measured. Data were analyzed using descriptive statistics and multilevel analysis with HLM 8.0. Results: A significant difference was found in the respiratory function analysis growth rate of the entire group (p<0.05), and two groups were added to the research model. The linear growth rate of respiratory function in patients with general stroke increased with the exception of FEV1/FVC (p<0.05). Stroke patients with tracheostomy tube showed a decreasing pattern except for FVC. In particular, MPCF showed a significantly decreased result (p<0.05). Conclusions: This study found that the maintenance of improved respiratory function in stroke patients with tracheostomy tube decreased over time. However, cervical range of motion training is still a useful method for respiratory function in general stroke patients and stroke patients with tracheostomy tube.

• Journal of Chest Surgery
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• v.33 no.3
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• pp.231-239
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• 2000

Background: This retrospective study tries to identify specific risk factors that may increase complication rates after the surgical treatment of tuberculous destroyed lung. Material and method: A retrospective study was performed on forty-seven patients, who received surgical treatment for tuberculous destroyed lung in the Department of Thoracic and Cardiovascular Surgery at Hanyang University Hospital from 1988 to 1998, to identify specific preoperative risk factors related to postoperative complications. Fisher's exact test was used to identify the correlations between the complications and right pneumonectomy, preoperative FEV1, predicted postoperative FEV1, massive hemoptysis, postoperative persistent empyema. Result: Hospital mortality and morbidity rates of the patients who received surgical treatment for tuberculous destroyed lung were 6.4% and 29.7%, respectively. In view of the hospital mortality and morbidity rates as a whole, predicted postoperative FEV1 less than 0.8L(p<0.005), preoperative FEV1 less than 1.8L(p=0.01), massive hemoptysis(p<0.005), postoperative persistent positive sputum cultures(p<0.0005), and the presence of multi drug resistant tuberculosis(p<0.05) presented statistically significant correlations. Among the postoperative complications, bronchopleural fistula, the most common complication, was found to have statistically significant corrleations with the preoperative empyema(p<0.05) and postoperative persistent positive sputum cultures(p<0.05). Conclusion: Although mortality and morbidity rates after surgical treatment of tuberculous destroyed lung were relatively low, when predicted postoperative FEV1 was less than 0.8L, when preoperative FEV1 was less than 1.8L, when massive hemoptysis was present, when postoperative sputum cultures were persistently positive, and when multi drug resistant tuberculosis was present, the rates were significantly higher.