• Annals of Rehabilitation Medicine
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• v.42 no.6
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• pp.798-803
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• 2018

Objective To investigate the relationship between peak cough flow (PCF), pulmonary function tests (PFT), and severity of dysphagia in patients with ischemic stroke. Methods This study included patients diagnosed with ischemic stroke, who underwent videofluoroscopic swallowing study (VFSS), PCF and PFT from March 2016 to February 2017. The dysphagia severity was assessed using the videofluoroscopic dysphagia scale (VDS). Correlation analysis of VDS, PFT and PCF was performed. Patients were divided into three groups based on VDS score. One-way ANOVA of VDS was performed to analyze PCF, forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and age among the different groups. Results The correlation coefficients of VDS and PCF, VDS and FVC, and VDS and FEV1 were -0.836, -0.508, and -0.430, respectively, all of which were statistically significant at the level of p<0.001. The one-way ANOVA indicated statistically significant differences in PCF, FVC, FEV1, and age among the VDS groups. Statistically significant differences in VDS and age were observed between aspiration pneumoia and non-aspiration pneumonia groups. Conclusion Coughing is a useful factor in evaluating the risk of aspiration in dysphagia patients. Evaluation of respiratory and coughing function should be conducted during the swallowing assessment of patients with ischemic stroke.

• PNF and Movement
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• v.16 no.3
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• pp.461-473
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• 2018

Purpose: The purpose of this study was to evaluate and compare the effects of inspiratory muscle training with chest expansion exercises on pulmonary function, maximal inspiratory pressure, and gait in individuals with stroke. Methods: The participants in this study included 36 stroke patients. These patients were randomly divided into three groups: an inspiratory muscle training (IMT) with chest expansion (CE) group (n=12), an IMT group (n=12), and a control group (n=12). Participants in the IMT with CE group underwent IMT and CE exercises 5 times per week for 30 minutes over 4 weeks, whereas those in the CE group and the control group received IMT and conventional physical therapy, respectively, for the same duration. The investigator measured the patients' pulmonary function, maximal inspiratory pressure, and gait endurance. Results: After the intervention, the change values for the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), and six-minute walk test (6MWT) in the IMT with CE group and the control group were significantly greater than those of the control group (p<0.05). Similarly, after the intervention, the change values of the FVC, FEV1, PEF, MIP, and 6MWT in the IMT with CE group were significantly greater than those in the IMT group (p<0.05). Conclusion: These findings suggest that IMT with CE could be used to increase pulmonary function, maximal inspiratory pressure, and gait endurance in stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.1
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• pp.101-110
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• 2019

PURPOSE: This study was conducted to analyze the effects of virtual reality inspiratory muscle training and conventional inspiratory muscle training on diaphragm movement and pulmonary function in patients with thoracic restriction. METHODS: This study measured diaphragm movement, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), and thoracic mobility (upper, middle, and lower trunk) under two different conditions. Forty young women between 19 and 24 years of age who had no history of orthopedic symptoms for the last 6 months were divided into experimental and control groups. The experimental group performed virtual reality inspiratory muscle training and diaphragm breathing, and the control group performed conventional inspiratory muscle training and diaphragm breathing. RESULTS: The control group showed a significant increase in all dependent variables except for lower trunk mobility and PEF. The experimental group showed a significant increase in all dependent variables except for lower trunk mobility. Particularly, the experimental group showed significant increases in diaphragm movement (p<.05), FVC (p<.05), FEV1 (p<.05), and PEF (p<.05) relative to the control group. CONCLUSION: We recommend inspiratory muscle training with a virtual reality program over conventional training to improve diaphragm movement and pulmonary function in patients with thoracic restriction.

• The Journal of Korean Physical Therapy
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• v.31 no.2
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• pp.122-128
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• 2019

Purpose: This study examined the effects of sagittal spinopelvic alignment on the clinical parameters, motor symptoms, and respiratory function in patients with mild to moderate Parkinson's disease (PD). Methods: This study was a prospective assessment of treated patients (n=28, Hoehn and Yahr (H&Y) stage 2-3) in a PD center. Twenty-eight subjects ($68.5{\pm}5.7yrs$) participated in this study. The clinical and demographic parameters, including age, sex, symptoms duration, treatment duration, and H&Y stage, were collected. Kinematic analysis was conducted in the upright standing posture with a motion capture system. A pulmonary function test (PFT) was performed in the sitting position using a spirometer. The motor symptoms were assessed on part III of the movement disorder society sponsored version of the unified Parkinson's disease rating scale (MDS-UPDRS). SPSS 18.0 was used to analyze the collected data. Results: The exceeding 12 degrees group of the lower trunk showed significantly higher on the clinical parameters than the below 12 degrees group. In addition, the exceeding 12 degrees group of the lower trunk showed a significantly lower forced expiratory volume at one second (FEV1) / forced vital capacity (FVC) (%) and 25-75% forced mid-expiratory flow (FEF) (L/s) than in the below group. On the other hand, there was no difference in the upper trunk and the cervical pelvis between the groups. Conclusion: These findings suggest that the sagittal balance in the lower trunk is related to the clinical parameters and respiratory function, but not the motor symptoms in patients with mild to moderate PD.

• Physical Therapy Rehabilitation Science
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• v.7 no.4
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• pp.147-153
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• 2018

Objective: This study investigated the effects of air stacking training (AST) on pulmonary function, respiratory strength, and peak cough flow (PCF) in persons with cervical spinal cord injury (CSCI). Design: Randomized controlled trial. Methods: A total of 24 persons with CSCI were randomly allocated to the AST group (n=12) or the incentive spirometry training (IST) group (n=12). Patients with CSCI received AST or IST for 15 minutes, with 3 sessions per week for 4 weeks, and all groups performed basic exercises for 15 minutes. In the AST group, after the subject inhaled the maximal amount of air as best as possible, the therapist insufflated additional air into the patient's lung using an oral nasal mask about 2-3 times. In the IST group, patients were allowed to hold for three seconds at the maximum inspiration and then to breathe. The pre and post-tests measured forced vital capacity (FVC), forced expiratory volume one at second (FEV1), maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP) and PCF. Results: Both groups showed significant improvements in FVC, FEV1, MEP, MIP and PCF values after training (p<0.05). The FVC in the post-test and the mean change of FVC, FEV1, MIP were significantly higher in the AST group than the IST group (p<0.05). Conclusions: The findings of this study suggested that AST significantly improved pulmonary function, respiratory strength, and PCF in persons with CSCI. Therefore, AST should be included in respiratory rehabilitation programs to improve coughing ability, pulmonary function and respiratory muscle strength.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.23-31
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• 2021

Purpose : To compare the immediate effects of air stacking maneuver using resuscitator bags and balloons. Methods : Twenty healthy young adults participated in this study. Forced vital capacity (FVC) and peak cough flow (PCF) tests were performed at pre-intervention, and then, the maximum insufflation capacity (MIC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow (PEF), and peak cough flow (PCF) were measured using the air stacking maneuver via resuscitator bags and balloons. Interventions were randomly performed, and a 40-min break was provided between interventions. The evaluation process in this study was conducted in accordance with the guidelines of the American Thoracic Society (ATS) 2019. To compare the three outcomes measured at pre-and post-interventions, repeated measures analysis of variance was performed. Results : A significant difference was found in the MIC, FEV1, PEF, and PCF after the air stacking maneuver using resuscitator bags and balloons, whereas no significant difference was observed between resuscitator bags and balloons. Conclusion : No significant difference was found in the immediate effect of the air stacking maneuver using resuscitator bags and balloons in this study. Air stacking maneuver using balloons can increase the success rate of the techniques by providing visual feedback on the amount of air insufflation when performed with balloon blowing exercise. Balloons are cheaper and easier to buy compared to manual resuscitator bags; therefore, education on the air stacking maneuver using balloons will have a positive effect on pulmonary rehabilitation.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.1
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• pp.111-121
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• 2021

PURPOSE: This study examined the effects of core stability exercise on the strength, activation of the trunk muscle, and pulmonary function in a Guillain-Barre syndrome (GBS) patient. METHODS: A 38-year-old male with GBS was enrolled in the study. A core stability exercise program was implemented for four weeks with a duration of 30 min/day and a frequency of three days/week. The program consisted of abdominal crunch, Swiss ball crunch, bicycle crunch, medicine ball sit-up with a toss, medicine ball rotational chest pass, raised upper body and lower body, and dead bug. Measurements of the strength of the trunk muscle (trunk flexion and hip flexion), activation of trunk muscles (rectus femoris; RA, external oblique abdominal; EOA, internal oblique abdominal; IOA, erector spinae; ES), and pulmonary function (forced expiratory capacity; FVC, forced expiratory volume at one second; FEV1) were taken before and after four weeks of core stability exercise. RESULTS: The strength of trunk muscles increased in the trunk and hip flexion after four weeks of core stability exercise, respectively, compared to the baseline levels. Activation of the trunk muscles increased in RA, EOA, and IOA after four weeks of core stability exercise compared to baseline levels, but decreased in ES after four weeks of core stability exercise compared to the baseline levels. The pulmonary function increased in FVC and FEV1 after four weeks of core stability exercise compared to the baseline levels. CONCLUSION: These results suggest that core stability exercise improves strength, Activation of the trunk muscle, And pulmonary function in patients with GBS.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.1
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• pp.75-83
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• 2022

PURPOSE: This study was conducted to investigate the effect of the resistance respiratory muscle exercise with transcutaneous electrical nerve stimulation (TENS) on the respiratory muscle tone and pulmonary function of stroke patients. METHODS: Twenty stroke patients were divided into the TENS group (n = 7), placebo TENS group (n = 7), and control group (n = 6), and each intervention was performed on the three groups 5 times a week for 4 weeks. The assessment was carried out by measuring changes in the muscle tone of the latissimus dorsi and abdominal external obliques, and pulmonary function. RESULTS: In this study, the TENS group and the placebo TENS group had significant increases in the paretic side latissimus dorsi muscle tone, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF). There was no significant difference in changes in respiratory muscle tone between the three groups. The pulmonary function was significantly different between the three groups, and it was observed from the results of the post-hoc test that FVC showed a significant increase in the TENS group and the placebo TENS group compared to the control group. CONCLUSION: Through this study, it was found that the respiratory muscle resistance exercise was more effective as a method to increase respiratory muscle tone and pulmonary function in stroke patients than combined transcutaneous electrical nerve stimulation.

• Journal of Korean Physical Therapy Science
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• v.29 no.2
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• pp.57-65
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• 2022

Background: This study was to determine whether the diaphragmatic breathing exercise using a DiP Belt(Diaphragmatic Pressure Belt) is effective in increasing the diaphragmatic motion and forced vital capacity. Design: Pretest-Posttest design. Methods: A total of 44 subjects(15 male, 29 female) participated in this study. All subjects were measured the diaphragmatic motion with a sonography and the Forced Vital Capacity(FVC) was measured with a digital spirometer. After 4 weeks, the subjects were intervened the diaphragmatic breathing exercise using a DiP belt and were remeasured for diaphragm motion and FVC. Results: After exercise intervention, quiet breathing significantly increased with the change in diaphragmatic motion and showed a moderate effect size (p<.01, Cohen's d = -0.53). In addition, it was significantly increased in deep breathing and showed a high effect size (p<.001, Cohen's d = -1.32). The mean diaphragmatic contraction pressure increased, but there was no significant difference and the peak diaphragmatic contraction pressure increased significantly (p<.05). Both diaphragmatic contraction pressure showed small effect sizes (respectively Cohen's d = -0.28, -0.33). In spirometry, FVC, Forced Expiratory Volume in 1 second (FEV₁), and FEV₁/FVC% all increased, but there was no significant difference. Only peak expiratory flow increased significantly and showed a small effect size (p<.05, Cohen's d = -0.41). Conclusion: The DiP belt diaphragmatic breathing exercise that the principle of visual feedback can correct diaphragm breathing in a short time, so it is a useful breathing exercise device that can help the diaphragm breathing exercise in the right way in clinical practice.

• Tuberculosis and Respiratory Diseases
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• v.85 no.2
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• pp.175-184
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• 2022

Background: Post-tuberculosis (TB) sequelae is a commonly encountered clinical entity, especially in high TB burden countries. This may represent chronic anatomic sequelae of previously treated TB, with frequent symptomatic presentation. This pilot study was aimed to investigate the pulmonary functions and systemic inflammatory markers in patients with post-TB sequelae (PTBS) and to compare them with post-TB without sequelae (PTBWS) participants and healthy controls. Methods: A total of 30 participants were enrolled, PTBS (n=10), PTBWS (n=10), and healthy controls (n=10). Pulmonary function tests included spirometry and measurement of airway impedance by impulse oscillometry. Serum levels of matrix metalloproteinase (MMP)-1, transforming growth factor-β, and interferon-γ were estimated. Results: Slow vital capacity (SVC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), FEV₁/FVC, and peak expiratory flow were significantly lower in PTBS as compared to controls. SVC and FEV₁ were significantly less in PTBS as compared to PTBWS. Total airway impedance (Z₅), total airway resistance (R₅), central airway resistance (R₂₀), area of reactance (Ax), and resonant frequency (Fres) were significantly higher and respiratory reactance at 5 and 20 Hz (X₅, X₂₀) were significantly lower in PTBS as compared to PTBWS. Spirometry parameters correlated with impulse oscillometry parameters in PTBS. Serum MMP-1 level was significantly higher in PTBS as compared to other groups. Conclusion: Significant pulmonary function impairment was observed in PTBS, and raised serum MMP-1 levels compared with PTBWS and healthy controls. Follow-up pulmonary function testing is recommended after treatment of TB for early diagnosis and treatment of PTBS.