• Journal of Korean Biological Nursing Science
• /
• v.19 no.1
• /
• pp.38-47
• /
• 2017

Purpose: This study was undertaken to examine the relationship between airflow obstruction and subjective health status reported by stable patients with chronic obstructive pulmonary disease (COPD) residing in the community. Methods: A cross-sectional descriptive study was conducted with 78 stable COPD patients aged 69.7 years old on average and selected by a convenient sampling from an outpatient department of pulmonology in tertiary hospitals. They completed a constructed questionnaire including general characteristics, smoking history, dyspnea by modified medical research council (mMRC) scale, and health status by COPD assessment test (CAT). Anthropometric measurements were performed for body mass index (BMI) and pulse oxymetry for $O_2$ saturation (Sat $O_2$). Medical records were reviewed to obtain disease-related characteristics including duration of the disease, cardiovascular comorbidity, and forced expiratory volume in 1 second ($FEV_1$). Data were analyzed using PASW statistics 20.0. Results: Mean $FEV_1%$ and CAT scores were 55.11% and 17.73, respectively. Those in the lower stage of mMRC showed significantly higher $FEV_1$ and lower CAT. $FEV_1$ and CAT showed significant negative correlations; age and BMI with $FEV_1$, and Sat $O_2$ with CAT. Conclusion: The findings suggest that the less airway obstruction was, the better health status was, and provide the support for using subjective measures in clinical practices for COPD patients.

• Korean Journal of Adult Nursing
• /
• v.20 no.1
• /
• pp.163-175
• /
• 2008

Purpose: This study aimed to define the relationship among self-care, symptom experiences, and health-related quality of life(HRQoL) according to the severity of disease in chronic obstructive pulmonary disease(COPD) patients. Methods: The participants, 195 COPD patients, were recruited at a pulmonology clinic of a universityaffiliated medical center in B metropolitan city. Inclusion criteria were patients who were diagnosed as COPD and had less than 0.7 of $FEV_1$/FVC(Forced Expiratory Volume for 1 second/Forced Vital Capacity) ratio. The severity was classified with GOLD(Global initiative for Obstructive Lung Disease) stages, $FEV_1%$ predicted value from mild to very severe. The data were gathered by the medical records and self-reported questionnaires. Results: The self-care, symptom experience, and HRQoL were all significantly different by COPD severity based on pulmonary function(p<.05). There were significant moderate negative relationships between symptom experiences and self-care(r=-.54, p<.001) and between symptom experiences and HRQoL(r=-.64, p<.001). There was a moderate positive correlation between self-care and HRQoL(r=.63, p<.001). Conclusion: It suggests that the assessment of disease severity based on pulmonary function and subjective symptom experience in patients with COPD may be a key component to develop a tailored self-management program and to improve their quality of life.

• Journal of Korean Academy of Nursing
• /
• v.29 no.6
• /
• pp.1273-1283
• /
• 1999

This study was done to explore the effects of dance therapy on pulmonary and cognitive functions in the elderly. The design of this study was a non-equivalent pre-post test experiment. The subjects consisted of elderly persons living in a facility located in Kyoungi-Do. Fifty eight subjects had normal cognition, sensory function and resting blood pressure. They underwent tests of pulmonary and cognitive function as baseline data before dance therapy, and at 6th week and at the end of 12nd week after following dance therapy. Twenty seven elderly persons were assigned to the experimental group and participated with the dance therapy. This therapy was based on the Marian Chace's dance therapy and Korean traditional dance with music. The dance therapy consisted of 50 minutes session, 3 times a week for 12 weeks. One session consisted of warming-up, expression, catharsis, sharing and closing stage. the intensity of the dance therapy was at the 40% of age-adjusted maximum heart rates. Data were analyzed with mean, standard deviation, Chi-square test, unpaired t-test, repeated measures ANOVA, and Bonferroni multiple regression using SAS program. The results were as follows : 1. Pulmonary function(forced expiratory volume at one second and forced vital capacity) of the experimental subjects significantly increased over time more than that of the control subjects. 2. The experimental group had significantly higher score for pulmonary function than the control group at the 12nd week after dance therapy. 3. Cognitive function of the experimental subjects significantly increased over time more than that of the control subjects. 4. The experimental group had significantly higher score for cognitive function than the control group at the 6th week and 12nd week after dance therapy. The findings showed the dance therapy could be effective in improving the pulmonary and cognitive function of the elderly.

• The Korean Journal of Pain
• /
• v.9 no.1
• /
• pp.135-139
• /
• 1996

Intercostal nerve blockade with local anesthetics has been used extensively in the past to provide pain relief following thoracotomy. Its popularity fell, for a period, probably due to increasing use of epidural analgesia. More recently, interest has focused on intercostal nerve block with the introduction of variously sited catheters. Two epidural catheters were placed under direct vision, in the intercostal spaces just above and below the wound by feeding the catheters posteriorly from the wound edges, superficial to the parietal pleura. Bupivacaine 0.25%. Was infused continuously at a rate of 5 ml/hour through each of the two intercostal catheters. Each catheter was primed with 10 ml/hour through each of the two intercostal catheters. Each catheter was primed with 10 ml of 0.25% bupivacaine. Postoperative vital signs resembled preoperation data. Arterial carbon dioxide pressure ($PaCO_2$) was unchanged and arterial oxygen pressure ($PaO_2$) was increased during two days after surgery because oxygen was administered at 21/min. Forced vital capacities (FVC) and forced expiratory volume in 1 second ($FEV_1$) were decreased the day of operation but restored to preoperative value from second operation day. VAS were increased on operation day but decreased from second operation day. Motion range of arms were not impaired. We concluded that continuous intercostal nerve block through catheters placed during thoracotomy in the adjacent intercostal spaces is a simple and effective method for management of the post-thoracotomy pain.

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

• Radiation Oncology Journal
• /
• v.35 no.1
• /
• pp.55-64
• /
• 2017

Purpose: The outcomes and toxicities of locoregionally recurrent non-small-cell lung cancer (NSCLC) patients treated with curative radiotherapy were evaluated in the modern era. Materials and Methods: Fifty-seven patients receiving radical radiotherapy for locoregionally recurrent NSCLC without distant metastasis after surgery from 2004 to 2014 were reviewed. Forty-two patients were treated with concurrent chemoradiotherapy (CCRT), and 15 patients with radiotherapy alone. The median radiation dose was 66 Gy (range, 45 to 70 Gy). Lung function change after radiotherapy was evaluated by comparing pulmonary function tests before and at 1, 6, and 12 months after radiotherapy. Results: Median follow-up was 53.6 months (range, 12.0 to 107.5 months) among the survivors. The median overall survival (OS) and progression-free survival (PFS) were 54.8 months (range, 3.0 to 116.9 months) and 12.2 months (range, 0.8 to 100.2 months), respectively. Multivariate analyses revealed that single locoregional recurrence focus and use of concurrent chemotherapy were significant prognostic factors for OS (p = 0.048 and p = 0.001, respectively) and PFS (p = 0.002 and p = 0.026, respectively). There was no significant change in predicted forced expiratory volume in one second after radiotherapy. Although diffusing lung capacity for carbon monoxide decreased significantly at 1 month after radiotherapy (p < 0.001), it recovered to pretreatment levels within 12 months. Acute grade 3 radiation pneumonitis and esophagitis were observed in 3 and 2 patients, respectively. There was no chronic complication observed in all patients. Conclusion: Salvage radiotherapy showed good survival outcomes without severe complications in postoperative locoregionally recurrent NSCLC patients. A single locoregional recurrent focus and the use of CCRT chemotherapy were associated with improved survival. CCRT should be considered as a salvage treatment in patients with good prognostic factors.

• Journal of the Korean Society of Physical Medicine
• /
• v.10 no.1
• /
• pp.83-89
• /
• 2015

PURPOSE: The purpose of this study was to investigate the vital capacity and maximal voluntary ventilationin subjects with forward head posture (FHP). METHODS: Twenty-eight subjects participated in this study (normal 14, FHP 14) and were resident in B city. The mean age, height and weight of subjects was 22.80yrs, 169.36cm and 62.79kg. Subjects were asked to breath maximally for FVC and repeatedly for MVV during 12 seconds. The variables of data were collected as follows: Forced Vital Capacity(FVC), Forced Expiratory Volume in One Second($FEV_1$), $FEV_1$/FVC, Maximal Voluntary Ventilation(MVV). Each trial was performed by 3 times and we used the means to analyze the data. The mann-whitney U test and independent t-test were used to compare the vital capacity between normal and FHP subjects. All statistical analyses were performed using SPSS 21.0 for window versionand p-values less than 0.05 were used to identify significant differences. RESULTS: The FVC, $FEV_1$, $FEV_1$/FVC and MVV of FHP subjects were decreased more than that of normal subjects and the difference was statistically significant between two groups. CONCLUSION: The vital capacity of subjects with FHP was generally lower than normal subjects. This study shows that the vital capacityof subjectswith FHP could be decreased due to the bad neck posture that weakens the respiratory accessory muscles of neck.

• Journal of the Korean Society of Physical Medicine
• /
• v.15 no.4
• /
• pp.47-54
• /
• 2020

PURPOSE: This study compared two different techniques of treadmill gait training, and evaluated the outcomes on gait and respiratory function in patients with hemiplegic stroke. METHODS: This was a single-blinded, randomized, controlled, comparative study, enrolling a total of 21 stroke patients in a rehabilitation hospital. Subjects were randomly assigned to either the treadmill walking training group with gradual speed increase (GSI group, n = 10), or treadmill walking training group with random speed changing (RSC group, n = 11). All participants performed 60 min of comprehensive rehabilitation therapy (5 × / week for 6 weeks). In additional, each group received either GSI or RSC treadmill walking training for 20 min (5 × / week for 6 weeks, total 30 sessions). Gait and respiratory function were measured before and after the 6-week training. RESULTS: Both groups showed significant improvements in the 10-m walking test, 6-minute walking test, timed up and go test, forced vital capacity (FVC), forced expiratory volume in 1 second, and maximal voluntary ventilation after training (p < .05). The GSI group showed a significantly greater increase in the FVC than the RSC group (+14.8 L vs. +12.5 L, p < .05). CONCLUSION: Both training methods can be effective for improving the walking and respiratory functions of stroke patients. However, our results indicate that treadmill walking training with gradual speed increase might be a more effective method for improving the respiratory function (FVC) than treadmill walking training with random speed changing.

• Journal of Chest Surgery
• /
• v.44 no.3
• /
• pp.229-235
• /
• 2011

Background: Following major lung resection, patients have routinely been monitored in the intensive care unit (ICU). Recently, however, patients are increasingly being placed in a general thoracic ward (GTW). We investigated the safety and efficacy of the GTW care after lobectomy for lung cancer. Materials and Methods: 316 patients who had undergone lobectomy for lung cancer were reviewed. These patients were divided into two groups: 275 patients were cared for in the ICU while 41 patients were care for in the GTW immediately post-operation. After propensity score matching, postoperative complications and hospital costs were analyzed. Risk factors for early complications were analyzed with the whole cohort. Results: Early complications (until the end of the first postoperative day) occurred in 11 (3.5%) patients. Late complications occurred in 42 patients (13.3%). After propensity score matching, the incidence of early complications, late complications, and mortality were not different between the two groups. The mean expense was higher in the ICU group. Risk factors for early complications were cardiac comorbidities and low expected forced expiratory volume in one second. The location of postoperative care had no influence on outcome. Conclusion: Immediate postoperative care after lobectomy for lung cancer in a GTW was safe and cost-effective without compromising outcomes in low-risk patients.

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