• Title/Summary/Keyword: Breathing resistance

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Diagnostic and Clinical Differences in Obstructive Sleep Apnea Syndrome and Upper Airway Resistance Syndrome (폐쇄성 수면 무호흡 증후군과 상기도 저항 증후군의 진단적 및 임상적 차이)

  • Choi, Young-Mi
    • Sleep Medicine and Psychophysiology
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    • v.18 no.2
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    • pp.63-66
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    • 2011
  • It has been controversial whether upper airway resistance syndrome (UARS) is a distinct syndrome or not since it was reported in 1993. The International Classification of Sleep Disorders classified UARS under obstructive sleep apnea syndrome (OSAS) in 2005. UARS can be diagnosed when the apnea-hypopnea index (AHI) is fewer than 5 events per hour, the simultaneously calculated respiratory disturbance index (RDI) is more than 5 events per hour due to abnormal non-apneic non-hypopneic respiratory events accompanying respiratory effort related arousals (RERAs), and oxygen saturation is greater than 92% at termination of an abnormal breathing event. Although esophageal pressure measurement remains the gold standard for detecting subtle breathing abnormality other than hypopnea and apnea, nasal pressure transducer has been most commonly used. RERAs include phase A2 of cyclical alternating patterns (CAPs) associated with EEG changes. Symptoms of OSAS can overlap with UARS, but chronic insomnia tends to be more common in UARS than in OSAS and clinical symptoms similar with functional somatic syndrome are also more common in UARS. In this journal, diagnostic and clinical differences between UARS and OSAS are reviewed.

Effect of Depending on the Location of Applying Chest Expansion Resistance Exercise on Respiratory Muscles Strength in Stroke Patients (뇌졸중 환자에게 가슴우리 확장 저항 운동의 적용 위치가 호흡근력에 미치는 영향)

  • Lee, Ji-Won;Cho, Yong-Ho
    • Journal of the Korean Society of Physical Medicine
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    • v.17 no.2
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    • pp.95-100
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    • 2022
  • PURPOSE: The purpose of this study was to compare the effect of depending on the location of applying chest expansion resistance exercise on the respiratory muscle strength stroke patients, and to suggest more effective interventions to improve respiratory function in stroke patients in clinical practice. METHODS: A total of 30 subjects were selected and divided into two groups, and chest cage extension resistance exercise was applied to the sternum and rib cage, respectively, and performed for 4 weeks, 3 times a week, for 20 minutes. In order to compare the general characteristics of the study subjects and the homogeneity of the group, the pre-experimental values were analyzed using the independent sample t-test. Paired-sample t-test was used for pre-post value comparison of maximum inspiratory pressure and maximum expiratory pressure in each group. Statistical significance was set to .05. RESULTS: Both the sternum application group and the rib cage application group showed a significant difference in the maximum inspiratory pressure according to the intervention. Also, there was a statistically significant difference in the maximum expiratory pressure in the sternum application group. CONCLUSION: As breathing exercise is important for stroke patients, based on the results of this study, if therapists perform sternal extension resistance exercise or rib extension resistance exercise according to the patient's condition and environment, it can help the breathing function of stroke patients.

Clinical Significance of Airway Resistance Curve by the Body Plethysmograph (Body Plethysmograph를 이용한 Airway Resistance Curve의 임상적 의의)

  • Cheon, Seon-Hee
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.2
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    • pp.218-225
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    • 1995
  • Background: Airway resistance(Raw) is measured with the body plethysmograph by displaying the relationship between airflow and alveolar pressure($V/P_A$). If the resistance curve on $V/P_A$ tracing is curved or looped, the estimation of Raw is difficult. This study was designed to examine wheather there is any correlation between the shape of resistance curve and the clinical status and the pulmonary function of patients. Methods: The 146 pulmonary disease patients with increased Raw were included in this study. The shapes of resistance curves on $V/P_A$ tracing with body plethysmograph during quiet breathing were analyzed and compared with pulmonary function. Results: The results were as follows ; 1) The shapes of resistance curves were summarized in 5 categories; type 1: linear, type 2: ovoid, type 3: sigmoid, type 4: scoop, type 5: paisley. The type 3 except 1 case, type 4 and type 5 were found to have loop mainly in expiratory phase. 2) Although the shapes of resistance curves were not typical for specific disease, the resistance curves of acute disease tended to belong to type 1 or 2 and those of chronic airflow obstruction tended to belong to type 3, 4 or 5. But resistance curves of bronchial asthma and destructive lung with tuberculosis showed all types in proportion to degree of airflow obstruction or destruction of parenchyme. 3) In the cases of resistance curves going to type 5 rather than type 1 and those with looping, airflow obstuction tended to be severe and airway resistance and residual volume tended to increase. Conclusions: Analysis of resistance curve on $V/P_A$ tracing measuring airway resistance is helpful for judging degree of airflow obstruction and air trapping. Although the shape of resistance curve is not typical for specific disease, there is a close association between looping and airway obstruction.

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The Comparison of Work of Breathing Between Before Extubation and After Extubation of Endotracheal Tube (기계 호흡 치료후 기관내관 제거 전후 호흡 일(Work of Breathing)의 비교)

  • Jung, Bock-Hyun;Koh, Youn-Suck;Lim, Chae-Man;Choe, Kang-Hyeon;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.329-337
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    • 1997
  • Background : Since endotracheal tube is the most important factor involved in the imposed work of breathing during mechanical ventilation, extubation of endotracheal tube is supposed to reduce respiratory work of patient. However, some patients show labored breathing after extubation despite acceptable blood gases. We investigated the changes of work of breathing before and after extubation and the factors involved in the change of WOB after extubation. Methods : The subjects were 34 patients(M : F = 20 : 14, mean age = $61{\pm}17yre$) who recovered from respiratory failure after ventilatory support and were considered to be ready for extubation. The patients with clinical or radiologic evidences of upper airway obstruction before endotracheal intubation for mechanical ventilation were excluded. Vital sign, physical examination, chest X-ray, work of breathing and other respiratory mechanic indices were measured prior to, immediately, 6, 24 and 48 hours after extubation serially. Definition of weaning failure after extubation was resumption of ventilatory support or reintubation of endotracheal tube within 48 hour after extubation because of respiratory failure. The patients were classified into group 1(decreased work of breathing), group 2(unchanged work of breathing) and group 3(increased work of breathing) depending on the statistical difference in the change of work of breathing before and after extubation. Results : Work of breathing decreased in 33%(11/34, group 1), unchanged in 41%(14/34, group 2) and increased in 26%(9/34, group 3) of patients after extubation compared with before extubation. Weaning failure occurred 9%(1/11) of group, 1, 28.6%(4/14) of group 2 and 44%(4/9) of group 3 after extubation(p = 0.07). The change of work of breathing after extubation was positively correlated with change of mean airway resistance(mRaw). (r = 0.794, p > 0.01). In three cases of group 3 whose respiratory indices could be measured until 48 hr after extubation, the change in work of breathing paralleled with the sequential change of mRaw. The work of breathing was peaked at 6 hr after extubation, which showed a tendency to decrease thereafter. Conclusions : Reversible increase of work of breathing after extubation may occur in the patients who underwent extubation, and the increase in mRaw could be responsible for the increase in work of breathing. In addition, the risk of weaning failure after extubation may increase in the patients who have increased WOB immediately after extubation.

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The Efficacy of Respiratory Exercise Programs in the Elderly Persons with Hemiplegia (고령 편마비 환자에 대한 호흡운동 적용의 효과)

  • Kim, Soo-Min
    • PNF and Movement
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    • v.5 no.2
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    • pp.63-71
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    • 2007
  • Objective : Respiratory muscle weakness and decreased chest mobility has been suggested to result from the deconditioning that accompanied activity level in chronic elderly stokes. The benefits of respiratory exercise programmes on exercise capacity and muscle strength in hemiplegia. This study aimed to determine the effects of selective inspiratory and expiratory muscles training and chest mobility exercise on patients with strokes to establish if an improved exercise capacity can be obtained in patients that are not limited in their daily activities. Methods & Intervention : Twelve patients were assigned to the intensive respiratory exercise group participated in a measures design that evaluated the subjects with pre-treatment and post-treatment. Thirteen subjects who were assigned to a control group received training with breathing exercise and resistance exercise of skeletal muscles. The subjects performed spirometry then undertook a 6-week programme of respiratory muscle and chest mobility training. Training for the two groups was carried out 2 times a week for 6 weeks. Measurements and Results : Spirometry(Forced Vital Capacity: FVC and Closed Circuit Spiromety: CCS) and thoracic mobility were measured before and after the 6 weeks. The experimental group improved significantly compared to control group in FVC, $FEV_1$, MVV, IRV and ERV, and upper chest wall expansion(p<0.05). No significant improvement was seen in thoracic mobility or lung function in control group(p>0.05). Conclusion : The major findings in this study were that a intensive 6week exercise programme of resistive breathing and chest mobility in patients with hemiplegia led to an increase in lung capacity. The resistive breathing exercise programme used here resulted in a significant increase in the chest excursion during breathing.

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Modern Interpretation on Kinesiology of Yangsaeng-Doinbub Presented in "Zhu-Bing-Yuan-Hou-Lun.Yao-Bei-Bing-Zhu-Hou" ("제병원후론(諸病源候論).요배병제후(腰背病諸侯)"에서 제시된 양생도인법(養生導引法)의 현대운동학적 이해)

  • Kim, Se-Jun;Kim, Soon-Joong
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.2
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    • pp.115-130
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    • 2014
  • Objectives The objective of this study is to interpretate Yangsaeng-Doinbub presented in "Zhu-Bing-Yuan-Hou-Lun Yao-Bei-Bing-Zhu-Hou" in a modern kineologic approach Methods Based on the interpretation of "Zhu-Bing-Yuan-Hou-Lun Yao-Bei-Bing-Zhu-Hou" and implementation of its kinesiology, this study presents similar kineologies and their purposes, with the reference to various documents on modern kinesiology. Results 1) Yangsaeng-Doinbub presented in "Zhu-Bing-Yuan-Hou-Lun Yao-Bei-Bing-Zhu-Hou" is similar to stretching, active exercise and resistance exercise. 2) Exercises in Yangsaeng-Doinbub presented in "Zhu-Bing-Yuan-Hou-Lun Yao-Bei-Bing-Zhu-Hou", which are similar to resistance exercise, can be used for isometic exercise of cervical extensor. 3) Exercises in Yangsaeng-Doinbub presented in "Zhu-Bing-Yuan-Hou-Lun Yao-Bei-Bing-Zhu-Hou", which are similar to Stretching exercise, has its purpose to stretch quadratus Lumborum, lateral side of body, gluteus Maximus, quadriceps femoris, shoulder extensor, hamstrings, hip joint, ankle dorsi flexor, thoracic rotator,inferior shoulder joint. 4) Exercises in Yangsaeng-Doinbub presented in "Zhu-Bing-Yuan-Hou-Lun Yao-Bei-Bing-Zhu-Hou", which are similar to active exercise, can be used for strengthen exteral oblique. 5) Doctors can make various applications of Yansaeng-Doinbub. For example, it can be used to correct improper low back and neck exercise patterns. 6) Yangsaeng-Doinbub also describes breathing methods, which help normalization of breathing exercises and increase the efficiency of spine exercises. Conclusions The modern interpretation on kinesiology of Yangsaeng-Doinbub presented in "Zhu-Bing-Yuan-Hou-Lun Yao-Bei-Bing-Zhu-Hou" leads to a conclusion that Yangsaeng-Doinbub consists of numourous exercises for various body parts. In particular, breathing methods increase efficiency of such exercises. Plus, the exercises in Yangsaeng-Doinbub can be applied to various uses by doctors.

Durability Improvement of Engine Bulkhead by Adjusting Design Parameters (설계인자변화에 따른 엔진 벌크헤드 내구성 향상)

  • Yang, Chull-Ho;Han, Moon-Sik
    • Transactions of the Korean Society of Automotive Engineers
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    • v.19 no.2
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    • pp.111-116
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    • 2011
  • Three-dimensional finite element analyses have been performed to improve the durability of bulkhead. To keep pace with design changes and concentrate on regions of interest, SUBMODEL technique in ABAQUS was used for analysis. An analysis was conducted with following load cases: 1) Cap press-fit, 2) Bearing crush, 3) Bolt assembly, 4) Hot assembly, 5) Firing load, 6) Alternating firing load, 7) 2nd hot assembly. Fatigue analysis was done using commercial software FEMFAT and fatigue factors at the interested regions such as bolt tip area, counter bore, breathing hole, honing clearance were calculated and compared to aid design validation. Finite element modeling in the area of thread engagement used a simple constraint equations. Increasing bolt length, to a minimum of 39 mm above joint face gives a better fatigue resistance to the bulkhead. Breathing hole helps not only circulate the air in the crankcase but also fatigue resistance of bulkhead by relieving the stress at the critical locations.

Improvement on Pressure Drop Performance of Flow Control Disk in Portable Resuscitator (CFD 해석을 통한 인공호흡기 유량조절디스크의 압력 강하 성능개선)

  • Kim, Young-Soo;Kim, Min-Wook;Park, Yong-Hwan
    • Fire Science and Engineering
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    • v.30 no.1
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    • pp.1-5
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    • 2016
  • Cases of cardiac arrests due to cardiovascular ailments have increased recently., portable Current portable resuscitators which can be automatically supply oxygen operated by the pressure of supplied oxygen without manual or electronic actuators are now widely used in emergency worldwide. However, reductions in Pressure drop characteristics through the extended use of this type of resuscitator, however, is are not well-known described. This paper describes the reduction in pressure loss drop performance of the various holes in within the flow control disc of with various hole size of the portable resuscitators using on breathing resistance through the CFD simulation, and suggests the an optimum optimal design of the hole shapes for the minimization of alteration in order to minimize this pressure drops.

Design of Respiratory Sensor System for polysomnography using Thermocouple (Polysomnography를 위한 열전대 호흡센서 시스템의 설계)

  • 우용규;정도언;박광석
    • Proceedings of the IEEK Conference
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    • 2000.06e
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    • pp.121-123
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    • 2000
  • Changes in breathing pattern and apnea both can be !he result of sleep disorders. The focus of this paper is to develop methodologies to monitor the breathing pattern and to detect apnea. An accurate recording of the respiratory phase can be carried out with different methods. One of these methods is the use of a thermocouple, which reacts to the variation in air temperature, placed in the nose and mouth of the patient. The K-type thermocouple was used because it has high reliability, thermo-stability, and good corrosion resistance. And also, it has a considerable long time constant that gives a low cut-off frequency, well below the respiratory frequency and thereby causing a large phase difference. The result showed that timing of respiration was accurately obtained with the AD595, amplifier for K-type thermocouple.

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Upper Airway Studies in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성 수면 무호흡증 환자의 상기도 검사법)

  • Kim, Jung-Soo;Lee, Kyu-Yup
    • Sleep Medicine and Psychophysiology
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    • v.11 no.1
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    • pp.5-9
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    • 2004
  • Obstructive sleep apnea (OSA) is a common disorder characterized by recurrent cessation of breathing due to complete or partial upper airway occlusion during sleep. The incompetent tone of palatal, pharngeal, and glossal muscles which fail to maintain airway patency during sleep causes narrowing of the airway dimension and increased resistance of breathing. The identification of the sites of upper airway obstruction in patients with OSA is important in understanding the pathogenesis and deciding the treatment modality of snoring and/or OSA. Various upper airway imaging modalities have been used to assess upper airway size and precise localization of the sites of upper airway obstruction during sleep. Dynamic imaging modalities enabled assessment of dimensional changes in the upper airway during respiration and sleep. This article focused on reviews of various upper airway imaging modalities, especially dynamic upper airway imaging studies providing important information on the pathogenesis of OSA.

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