• The Journal of Korean Physical Therapy
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• v.27 no.5
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• pp.287-291
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• 2015

Purpose: This study was conducted to determine the influence of inspiratory muscle exercise using visual biofeedback and inspiratory muscle exercise with diaphragm breathing retraining in stroke patients in regard to inspiratory muscle activity and respiratory function and to provide fundamental information on intervention for improvement of pulmonary function in stroke patients. Methods: The current study measured and analyzed inspiratory muscle activity and pulmonary function of 15 randomly selected subjects in a Biofeedback inspiratory muscle exercise (BIE) group that uses visual feedback and 15 subjects in the Diaphragm breathing exercise (DBE) group that uses breathing retraining before and after intervention. Intervention was performed for 30 minutes, 5 times a week, for 8 weeks. Subjects were measured for muscle activity of upper trapezius muscle and lattisimus dorsi muscle using a surface electromyography system and maximum inspiratory pressure was measured using a respiratory measurement device. For homogeneity test of subjects, independent t-test was performed and ANCOVA was performed for comparison of inspiratory muscle activity and pulmonary function between groups. Results: In the study results, the BIE group showed more significant muscle activity than the DBE group in upper trapezius muscle and lattisimus dorsi muscle (p<0.001). In addition, the BIE group showed more pressure than the DBE group in maximum inspiratory pressure (p<0.001). Conclusion: Based on the current study, performing biofeedback respiration exercise simultaneously with breathing retraining in stroke patients can provide more efficient respiratory physical therapy. In addition, it is considered that consistent study on the effectiveness is necessary to further improve clinical availability.

• Journal of Chest Surgery
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• v.11 no.1
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• pp.92-96
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• 1978

Congenital diaphragmatic eventration is a rare disease and generally accepted as an abnormally high position of part or all of the diaphragm, usually associated with a marked decrease in muscle fibers and a membranous appearance of the abnormal area. There were 4 cases of the congenital diaphragmatic eventration at the Dept. of Thoracic Surgery, Seoul National University Hospital, from 1957 to 1977. They were two boys and two girls and ranging from 1 day to 3 years of age. They were all repaired by surgical operation and one was expired postoperatively, another one was dead one year later due to complication. The ratio between right and left was 1:3 and their symptoms were cyanosis, dyspnea and frequent respiratory disease. In physical examination there was noted decreased breathing sound on the affected lung field and bowel sound was audible in some cases. Diagnosis was done by Chest X-ray and plication of the affected diaphragm was usually done in operation. There were noted atelectasis and cystic change of the affected side lung. And the liver, colon, spleen and small intestine were found in the dome of the eventrated diaphragm.

• The Transactions of The Korean Institute of Electrical Engineers
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• v.57 no.1
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• pp.142-147
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• 2008

Abdominal circumference changes due to breathing by the respiratory muscle activity such as diaphragm, which would partially represent the lung volume variation. The present study introduced conductive rubber molded in a cord shape incorporated with a patient's pants. The conductive rubber cord operated as a displacement transducer to measure the lung or abdominal volume changes. Signal extraction circuitry was developed to obtain the volume and its derivative(or the flow) signals followed by wireless transmission based on the Zigbee communication protocol in a size of $65mm{\times}105mm$ easily put in pocket. Breathing frequency was accurately evaluated and breath pattern analysis seemed feasible, since respiratory behaviours such as maximal inspiration and cough were well identified. Remote wireless receiver module also enabled to monitor both volume and flow signals during resting breathing on a PC terminal.

• Physical Therapy Korea
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• v.25 no.1
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• pp.12-21
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• 2018

Background: Research efforts to improve the pulmonary function of children with cerebral palsy (CP) need to focus on their decreased diaphragmatic ability compared to normal children. Real-time ultrasonography is appropriate for demonstrating diaphragmatic mechanisms. Objects: This study aimed to compare diaphragm movement, pulmonary function, and pulmonary strength between normal children and children with CP by using ultrasonography M-mode. The correlation between general characteristics, diaphragm movement, pulmonary function, and pulmonary strength was also studied. Methods: The subjects of this study were 25 normal and 25 CP children between five and 14 years of age. Diaphragm movement was measured using real-time ultrasonography during quiet and deep breathing. Pulmonary function (such as forced expiratory volume in one second; FEV1 and peak expiratory flow; PEF) and pulmonary strength (such as maximum inspiratory pressure; MIP and maximum expiratory pressure; MEP) were measured. A paired t-test and Spearman's Rho test, with a significance level of .05, were used for statistical analysis. Results: The between-group comparison revealed that normal children had significantly greater diaphragm movement, FEV1, PEF, MIP, and MEP (p<.05) than CP children. The results showed that general characteristics were significantly related to FEV1, PEF, MIP, and MEP (p<.05). Conclusion: In clinical settings, clinicians need to concern decreased diaphragm movement, pulmonary function, and pulmonary strength in CP group compared to normal children.

• PNF and Movement
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• v.21 no.2
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• pp.151-158
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• 2023

Purpose: This study aimed to examine the immediate effects of different breathing training techniques on diaphragm excursion and vital capacity in healthy adults. Specifically, the study focused on comparing respiratory exercise without PNF, bilateral pattern respiratory exercise, and bilateral pattern with spiral pattern respiratory exercise. Methods: Twenty-seven healthy adults in their 20s participated in the study. Diaphragm excursion and vital capacity were evaluated under three different conditions. A one-way repeated ANOVA was used to analyze the differences in diaphragm excursion and vital capacity among the interventions. Results: Statistically significant differences were observed in diaphragm excursion among the interventions, comparing respiratory exercise without PNF, bilateral pattern respiratory exercise, and bilateral pattern with spiral pattern respiratory exercise. Similarly, statistically significant differences were found in vital capacity among the interventions without PNF respiratory exercise, bilateral pattern respiratory exercise, and bilateral pattern with spiral pattern respiratory exercise. Conclusion: The study demonstrated that incorporating the spiral technique in respiratory exercise led to increased diaphragm excursion and lung capacity compared to other interventions. These findings suggest that PNF respiratory exercise combined with the spiral pattern may have clinical implications for the treatment of respiratory diseases. Further research is warranted to explore the long-term effects and clinical application of these approaches.

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.46-52
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• 1997

Diaphragm is thought to play the most important role in breathing and has a substantially greater proportion of slow oxidative and fast glycolytic fibers, and low proportion of fast oxidative fibers. The respiratory muscle, diaphragm, has the functional characteristics of slow speed of contraction, high resistance to fatigue and the ability to respond to intermittent ventilatory loads, for example of exercise. In the present study, the characteristics of the metabolism (depletion and repletion) of glycogen and the structural changes of diaphragm during depletion and repletion of glycogen were observed in rats. For comparison, the red gastrocnemius muscle which has a greater proportion of fast oxidative glycolytic (FOG) and slow oxidative (SO) fibers, and low proportion of fast glycolytic (FG) fiber, was also studied. The glycogen concentration of diaphragm in overnight fasted rats was $2.30{\pm}0.14mg/gm$ wet weight. The values of glycogen concentration at 60, 90 and 120minutes of treadmill exercise loaded rats was significantly decreased compared to that of the overnight fasted rats. There was no significant difference among the glycogen concentrations of diaphragm at 60, 90 and 120minutes of exercises. The glycogen concentration of diaphragm was decreased to $1.12{\pm}0.17$ from $2.30{\pm}0.14mg/gm$ wet weight by treadmill exercise. The glycogen depletion rate of diaphragm during exercise was faster than that of red gastrocnemius in both of the first 60minutes and 120minutes duration of exercise. The glycogen repletion of diaphragm after intragastric glucose administration by stomach tube was studied in control and exercise groups. The glycogen concentration was significantly increased after glucose administration in both of control and exercise groups. All of the concentration of exercise group at 60, 120 and 180minutes after glucose administration was significantly higher than those of control group. In conclusion, one of the characteries of diaphragm in glycogen metabolism is fast glycogen depletion during exercise, and slowness of glycogen repletion after glucose ingestion in rats.

• Korean Journal of Radiology
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• v.20 no.1
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• pp.50-57
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• 2019

In pediatric thoracic CT, respiratory motion is generally treated as a motion artifact degrading the image quality. Conversely, respiratory motion in the thorax can be used to answer important clinical questions, that cannot be assessed adequately via conventional static thoracic CT, by utilizing four-dimensional (4D) CT. However, clinical experiences of 4D thoracic CT are quite limited. In order to use 4D thoracic CT properly, imagers should understand imaging techniques, radiation dose optimization methods, and normal as well as typical abnormal imaging appearances. In this article, the imaging techniques of pediatric thoracic 4D CT are reviewed with an emphasis on radiation dose. In addition, several clinical applications of pediatric 4D thoracic CT are addressed in various thoracic functional abnormalities, including upper airway obstruction, tracheobronchomalacia, pulmonary air trapping, abnormal diaphragmatic motion, and tumor invasion. One may further explore the clinical usefulness of 4D thoracic CT in free-breathing children, which can enrich one's clinical practice.

• The Journal of Korean Physical Therapy
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• v.27 no.4
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• pp.234-239
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• 2015

Purpose: This study is not a fragmentary study on characteristics of respiratory synergist when breathing, however it was intended to determine the effect of currently available respiratory exercise and to provide basic clinical information through investigation of oxygen demand and respiratory synergist that mobilizes for respiration during application of respiratory exercise. Methods: Experimental group I was selected from second grade of severity classification of GOLD, which has the highest percentage among patients with COPD, and experimental group II was selected from third grade of severity classification as a clinical sampling. After respiration pursing up lips and diaphragm respiration exercise were mediated together for six weeks, activity of respiratory muscles and oxygen saturation were measured and analyzed. Results: In comparison of change of respiratory synergist and oxygen saturation, activity of respiratory synergist in sternocleidomastoid muscle and scalene muscle showed a meaningful decrease in experimental group I. And, in comparison of change of respiratory synergist and oxygen saturation, activity of respiratory synergist in rectus abdominis muscle showed a meaningful increase in experimental group II. In comparison of change of respiratory synergist and oxygen saturation, activity of respiratory synergist in sternocleidomastoid muscle, scalene muscle, and rectus abdominis muscle showed a meaningful difference between experimental groups. Conclusion: Respiratory synergists work mainly as agonist of chest and upper limbs. Therefore it is very important to lower mobilization of respiratory synergist when breathing. It is considered that a multilateral approach and continued clinical research for improvement of respiratory function for patients with COPD will be needed in the future.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.2
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• pp.133-139
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• 2019

Purpose : This study aims to investigate the rating of perceived exertion (RPE) and muscle activity of the inspiratory primary and accessory muscle during breathing exercise with different air hole diameters of the inspiratory muscle trainer (IMT). Methods : The Borg's scale and surface electromyography (EMG) was used to collect data of the RPE and muscle activity of the inspiratory primary the external intercostal (EI) and diaphragm (DIA) and accessory muscles anterior scalene (AS), sternocleidomastoid (SCM), pectoralis major (PM), and upper trapezius (UT) muscles during breathing exercise with different air hole diameters (6 mm, 4 mm, and 2 mm) of the IMT in healthy young male subjects. Results : The RPE and muscle activities of the AS, SCM, and UT are increased significantly in accordance to the decreasing diameter of air hole of air tip in IMT. However, there are no differences in the muscle activities of the PM, EI, and DIA based on differences of diameters of air hole of air tip in IMT. Conclusion : The smaller the diametr of IMT air-hole, RPE and muscle activities of AS, SCM and UT were increased. Therefore, further study would be necessary to investigate the proper intensity and relaxation posture for the exercise protocol to strengthen the inspiratory primary muscles.

• PNF and Movement
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• v.15 no.2
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• pp.159-166
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• 2017

Purpose: This study attempts to determine the effects of applying three kinds of breathing exercises for four weeks on the neck muscle activation of subjects with a forward head posture. Methods: A total of 30 adults aged in their twenties (15 men and 15 women) with a forward head posture who voluntarily agreed to participate after listening to the purpose and procedure of this research were chosen as the subjects of this study. The subjects were randomly divided into either the diaphragmatic breathing exercise (DBE) group, the abdominal drawing-in maneuver (ADIM) group, or the abdominal expansion method (AEM) group according to the breathing intervention scheme. Each group included ten subjects. The muscle activity of the sternocleidomastoid, scalenus anterior, and splenius capitis was measured in all the groups prior to the intervention, two weeks after the intervention, and four weeks after the intervention. All the interventions were implemented for 30 minutes a day, three times a week, for a total of four weeks. Results: No significant between-group difference was observed in terms of the change in neck muscle activity according to the four-week intervention scheme. Further, there was no interaction between the intervention period and the intervention scheme in relation to the change in neck muscle activity. Conclusion: The results of this study suggest that abdominal expansion exercise is as effective as other breathing exercise methods for subjects with a forward head posture. We therefore expect that abdominal expansion exercise can be used as a scheme for the prevention of symptoms as well as therapy for patients with a forward head posture.