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The Study on Respiratory Function, Spirometric Lung Pattern and Fatigue of Elderly in a Facility

  • Shin, Hee Joon;Kim, Ji Sung;Wang, Joong San;Choi, Yoo Rim;Kim, Hong Rae;Park, Si Eun;An, Ho Jung;Min, Kyung Ok
    • Journal of International Academy of Physical Therapy Research
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    • v.4 no.1
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    • pp.488-493
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    • 2013
  • The purpose of this study was to investigate spirometric lung pattern, respiratory function and degree of fatigue by lung function tests and fatigue tests of 39 elderly people in a care facility aged 65 and over. The respiratory function tests were used to the Spirovit SP-1 and fatigue tests were used modified Piper fatigue scale(mPFS). Regarding the respiratory function, the FVC was $1.41{\pm}0.36$l, the FVC % predicted was $69.10{\pm}14.98$%, the $FEV_1$ was $1.02{\pm}0.31$l, the $FEV_1$ % predicted was $63.27{\pm}16.05$%, the $FEV_1$/FVC was $72.77{\pm}13.40$%, and the fatigue score was $5.83{\pm}1.09$. As for the spirometric lung pattern, 19 patients had a restrictive pattern(48.7%), followed by 11 with a mixed pattern(28.2%), 5 with an obstructive pattern( 12.8%), and 4 with a normal pattern(10.3%). Regarding the respiratory function and fatigue by spirometric lung pattern, the FVC and the FVC % predicted of patients with a normal pattern or an obstructive pattern were greater than other groups at a statistically significant level. As for the $FEV_1$, that of patients with a normal pattern was significantly higher than others, and for the $FEV_1$ % predicted, that of patients with a normal pattern or a restrictive pattern was significantly higher(p<.001). Fatigue score by patients with a normal pattern was significantly less than patients of other patterns(p<.001). Therefore, pulmonary physical therapy is considered necessary to improve respiratory function and fatigue degradation of elderly in a facility.

How Does the Filter on the Mask Affect Your Breathing?

  • Kum, Dong-Min;Shin, Won-Seob
    • Physical Therapy Rehabilitation Science
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    • v.10 no.4
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    • pp.438-443
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    • 2021
  • Objective: The purpose of this study was to determine the effect of the difference in mask filters on the respiration rate of healthy people. Design: A randomized cross-over design. Methods: A total of 15 subjects were selected for this study (n=15). After filling out the Physical Activity Readiness Questionnaire, the selected participants abstained from caffeinated beverages and meals 30 minutes before and sat in a chair 10 minutes before stabilizing their breathing. Afterwards, the lung function test was performed 3 times for each mask, and the maximum value was used. The provided masks were Mask Free, Dental Mask, KF80, and KF94. Exhalation was measured for 6 seconds for each mask, and breathing was stabilized by repeating inhalation and exhalation until the next time. Results: In this study, the difference in respiratory function according to the mask type was statistically significant except for FEV1 and FVC (p<0.05). As a result of post-hoc analysis, FVC, FEV1, PEF, and FEF values were significantly lower than those of the control group not wearing a mask (p<0.05). When wearing KF94, FVC, FEV1, PEF25-25%, and FEF were significantly lower than when wearing a dental mask (p<0.05). When wearing a KF80 mask, it was significantly lower in FVC and FEV1 than when wearing a dental mask (p<0.05). In FEV1/FVC, the difference by mask type was not statistically significant (p<0.05), but it was lower than the spirometry standard of COPD patients (FEV1/FVC<0.7). Conclusions: As Now that wearing a mask is essential, it has been confirmed that the mask affects the respiratory rate.Therefore, in the case of healthy adults, it is recommended to rest after wearing a mask if attention deficit or headache occurs. People with low breathing capacity are recommended to have low-intensity activities and frequent rest periods after wearing a mask.

Effects of Breathing Exercise in the Water on Pulmonary Function and Maximum Phonation Time of Children with Cerebral Palsy (수중에서 호흡운동이 뇌성마비 아동의 폐기능 및 최대발성시간에 미치는 영향)

  • Lee, Je-Wook;Hwangbo, Gak
    • Journal of the Korean Society of Physical Medicine
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    • v.14 no.3
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    • pp.91-107
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    • 2019
  • PURPOSE: This study examined the effects of breathing exercise in the water on the pulmonary function and maximum phonation time in children with cerebral palsy. METHODS: The subjects were 24 children with cerebral palsy at GMFCS levels I-III, who were allocated randomly to either the aquatic breathing exercise group or general breathing exercise group 12 subjects per group. Each subject was required to complete 40 minutes of exercise twice a week for eight weeks. Those in the aquatic breathing exercise group performed aquatic breathing exercise, whereas those in the general breathing exercise group performed general aquatic exercise. RESULTS: Significant differences in $FEV_1$, PEF, VC, TV, ERV, and maximum phonation time were observed in the aquatic breathing exercise group after intervention, but there were no significant differences in either FVC, $FEV_1/FVC$, IC, or IRV. In the general breathing exercise group, there were no significant differences in the FVC, $FEV_1$, $FEV_1/FVC$, PEF, VC, IC, TV, IRV, ERV, and maximum phonation time after intervention. In terms of the pulmonary function, the two groups showed a significant difference in the change in $FEV_1$, PEF, and TV after intervention, but not in the FVC, $FEV_1/FVC$, VC, IC, ERV, IRV, and maximum phonation time. CONCLUSION: These results above show that aquatic breathing exercise training in water is more effective in improving the pulmonary function than general breathing exercise training.

Prediction Equations of Pulmonary Function Parameters Derived from the Forced Expiratory Spirogram for Healthy Adults over 50 years old in rural area (농촌지역 50세 이상 인구의 노력성호기곡선을 이용한 폐활량측정법 검사지표의 추정정상치)

  • Kim, Won-Young;Kim, Kwang-Hyun;Youn, Boung-Han;Lee, Seung-Uk;Cho, Chul-Hyun;Choi, Jin-Su;Kim, Hun-Nam
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.3
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    • pp.536-545
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    • 1998
  • Background: The studies on prediction equations of pulmonary function parameters for adults in Korea have been performed in a reference population mainly consisted of young and middle ages. So they included a relatively few elderly who conducted pulmonary function test frequently in clinic. We established prediction equations of pulmonary function parameters for healthy adults over 50 years old in rural area and compared this results with those of other studies. Therefore we attempted to consider normative values of pulmonary function tests for elderly in Korea. Method: Five hundred thirty-three women and men over 50 years old in rural area were participated. A "healthy" subgroup of 110 women and 32 men were identified by excluding those who had conditions that negatively influenced pulmonary function. We derived prediction equations for FVC, $FEV_1$ and $FEV_1%$ by multiple linear regression method from their age, heights and weights in each sex. Results: Prediction equations for FVC and $FEV_1$ in each sex were derived as follows Male; FVC (L)=0.02488Height(cm)-0.0269Age(years)+0.493 $FEV_1(L)$=0.01874Weight(kg)-0.0282Age(years)+2.906 Female; FVC(L)=0.02160Height(cm)-0.0192Age(years)-0.0125 $FEV_1(L)$=0.01720Height(cm)-0.0194Age(years)+0.3890 Prediction equations for $FEV_1%$ were not derived because $FEV_1%$ didn't have statistically significant terms. Comparing Predicted values that were calculated by substitution into the equations of various studies of mean values of age, heights and weights from this study, FVC and $FEV_1$ values in men of this study were lower than those of other studies. In women, FVC and $FEV_1$ values of this study were as similar as or lower than those of the study conducted for healthy elderly blacks in U.S.A respectively. Conclusion: We have got prediction equations of pulmonary function parameters which were driven from forced expiratory spirogram in adults over 50 years old in rural area. Predicted values of this study were lower than those of other studies which were conducted in Korea. So we consider that the study for spirometry reference values for elderly Korean using the method compatible with ATS recommendation need to be conducted more frequently forward.

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Effects of Chest Resistance Exercise on Forced Expiratory Volume in One Second and Fatigue in Patients with COPD (흉곽저항운동이 만성폐쇄성폐질환 환자의 1초간 노력성 호기량과 피로도에 미치는 영향)

  • Kang, Jeong-Il;Jeong, Dae-Keun;Park, Seung-Kyu;Lee, Jun-Hee
    • The Journal of Korean Physical Therapy
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    • v.23 no.2
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    • pp.37-43
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    • 2011
  • Purpose: The purpose of this study was to determine the effects of chest resistance exercise on Forced Expiratory Volume per second and on fatigue in patients with chronic obstructive pulmonary disease (COPD). Methods: In all, 62 male patients with COPD were included in this study. The experimental group included 32 patients who were treated with chest resistance exercise using the PNF technique with medication. The control group included 30 patients who were treated only with medication. Subjects were stratified into the 2 groups by randomized clinical sampling. Before the start of the experiment, forced expiratory volume at the first second (FEV1) and lactic acid were tested in both experimental and control groups. The experimental group did chest resistance exercise for 6 weeks, 4 times per week, 30 min per day, and the effects of this exercise in patients with COPD was determined by comparing the results of FEV1 and lactic acid tests before and after the experiment between and within the experimental and control groups. Results: There was a statistically significant within group difference for FEV1 MEAS and FEV1 %PRED. There was statistically significant control group of FEV1 MEAS and FEV1 %PRED There was a statistically significant difference in the experimental group for fatigue, comparing scores before and after the test. There was a statistically significant control group of fatigue, in comparison of between the groups of FEV1 MEAS, FEV1 %PRED, fatigue(p<0.01)(p<0.05). Conclusion: More research on COPD will be necessary for improving pulmonary function and reducing fatigue. Further studies on COPD will be required for improving pulmonary function and reducing of fatigue.

Comparison of Single-Breath and Intra-Breath Method in Measuring Diffusing Capacity for Carbon Monoxide of the Lung (일산화탄소 폐확산능검사에서 단회호흡법과 호흡내검사법의 비교)

  • Lee, Jae-Ho;Chung, Hee-Soon;Shim, Young-Soo
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.4
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    • pp.555-568
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    • 1995
  • Background: It is most physiologic to measure the diffusing capacity of the lung by using oxygen, but it is so difficult to measure partial pressure of oxygen in the capillary blood of the lung that in clinical practice it is measured by using carbon monoxide, and single-breath diffusing capacity method is used most widely. However, since the process of withholding the breath for 10 seconds after inspiration to the total lung capacity is very hard to practice for patients who suffer from cough, dyspnea, etc, the intra-breath lung diffusing capacity method which requires a single exhalation of low-flow rate without such process was devised. In this study, we want to know whether or not there is any significant difference in the diffusing capacity of the lung measured by the single-breath and intra-breath methods, and if any, which factors have any influence. Methods: We chose randomly 73 persons without regarding specific disease, and after conducting 3 times the flow-volume curve test, we selected forced vital capacity(FVC), percent of predicted forced vital capacity, forced expiratory volume within 1 second($FEV_1$), percent of forced expiratory volume within 1 second, the ratio of forced expiratory volume within 1 second against forced vital capacity($FEV_1$/FVC) in test which the sum of FVC and $FEV_1$ is biggest. We measured the diffusing capacity of the lung 3 times in each of the single-breath and intra-breath methods at intervals of 5 minutes, and we evaluated which factors have any influence on the difference of the diffusing capacity of the lung between two methods[the mean values(ml/min/mmHg) of difference between two diffusing capacity measured by two methods] by means of the linear regression method, and obtained the following results: Results: 1) Intra-test reproducibility in the single-breath and intra-breath methods was excellent. 2) There was in general a good correlation between the diffusing capacity of the lung measured by a single-breath method and that measured by the intra-breath method, but there was a significant difference between values measured by both methods($1.01{\pm}0.35ml/min/mmHg$, p<0.01) 3) The difference between the diffusing capacity of the lung measured by both methods was not correlated to FVC, but was correlated to $FEV_1$, percent of $FEV_1$, $FEV_1$/FVC and the gradient of methane concentration which is an indicator of distribution of ventilation, and it was found as a result of the multiple regression test, that the effect of $FEV_1$/FVC was most strong(r=-0.4725, p<0.01) 4) In a graphic view of the difference of diffusing capacity measured by single-breath and intra-breath method and $FEV_1$/FVC, it was found that the former was divided into two groups in section where $FEV_1$/FVC is 50~60%, and that there was no significant difference between two methods in the section where $FEV_1$/FVC is equal or more than 60% ($0.05{\pm}0.24ml/min/mmHg$, p>0.1), but there was significant difference in the section, less than 60%($-4.5{\pm}0.34ml/min/mmHg$, p<0.01). 5. The diffusing capacity of the lung measured by the single-breath and intra-breath method was the same in value($24.3{\pm}0.68ml/min/mmHg$) within the normal range(2%/L) of the methane gas gradient, and there was no difference depending on the measuring method, but if the methane concentration gradients exceed 2%/L, the diffusing capacity of the lung measured by single-breath method became $15.0{\pm}0.44ml/min/mmHg$, and that measured by intra-breath method, $11.9{\pm}0.51ml/min/mmHg$, and there was a significant difference between them(p<0.01). Conclusion: Therefore, in case where $FEV_1$/FVC was less than 60%, the diffusing capacity of the lung measured by intra-breath method represented significantly lower value than that by single-breath method, and it was presumed to be caused largely by a defect of ventilation-distribution, but the possibility could not be excluded that the diffusing capacity of the lung might be overestimated in the single-breath method, or the actual reduction of the diffusing capacity of the lung appeared more sensitively in the intra-breath method.

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Comparison of Inhalation Scan and Perfusion Scan for the Prediction of Postoperative Pulmonary Function (수술후 폐기능 변화의 예측에 대한 연무 흡입스캔과 관류스캔의 비교)

  • Cheon, Young-Kug;Kwak, Young-Im;Yun, Jong-Gil;Zo, Jae-Ill;Shim, Young-Mog;Lim, Sang-Moo;Hong, Sung-Woon;Lee, Choon-Taek
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.2
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    • pp.111-119
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    • 1994
  • Background: Because of the common etiologic factor, such as smoking, lung cancer and chronic obstructive pulmonary disease are often present in the same patient. The preoperative prediction of remaining pulmonary function after the resectional surgery is very important to prevent serious complication and postoperative respiratory failure. $^{99m}Tc$-MAA perfusion scan has been used for the prediction of postoperative pulmonary function, but it may be inaccurate in case of large V/Q mismatching. We compared $^{99m}Tc$-DTPA radioaerosol inhalation scan with $^{99m}Tc$-MAA perfusion scan in predicting postoperative lung function. Method: Preoperative inhalation scan and/or perfusion scan were performed and pulmonary function test were performed preoperatively and 2 month after operation. We predicted the postoperative pulmonary functions using the following equations. Postpneurnonectomy $FEV_1$=Preop $FEV_1x%$ of total function of lung to remain Postlobectomy $FEV_1$=Preop $FEV_1{\times}$(% of total 1-function of affected lung${\times}$$\frac{Number\;of\;segments\;to\;be\;resected}{Number\;of\;segments\;of\;affected\;lung})$ Results: 1) The inhalation scan showed good correlations between measured and predicted $FEV_1$, FVC and $FEF_{25-75%}$. (correlation coefficiency; 0.94, 0.91, 0.87 respectively). 2) The perfusion scan also showed good correlations between measured and predicted $FEV_1$, FVC and $FEF_{25-75%}$. (correlation coefficiency; 0.86, 0.72, 0.87 respectively). 3) Among three parameters, $FEV_1$ showed the best correlations in the prediction by lung scans. 4) Comparison between inhalation scan and perfusion scan in predicting pulmonary function did not show any significant differneces except FVC. Conclusion: The inhalation scan and perfusion scan are very useful in the prediction of postoperative lung function and don't make a difference in the prediction of pulmonary function a1though the former showed a better correlation in FVC.

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The Normal Predicted Value of Peak Expiratory Flow(PEF) Measured by the Peak Flow Meter and Correlation Between PEF and Other Ventilatory Parameters (Peak Flow Meter로 측정한 최대호기류속도(PEF)의 추정정상치 및 가타 환기기능검사와의 상관관계)

  • Kim, Min-Chul;Kwon, Kee-Buem;Yim, Dong-Hyun;Song, Chang-Seuk;Jung, Yong-Seuk;Jang, Tae-Won;Yeu, Ho-Dae;Jung, Maan-Hong
    • Tuberculosis and Respiratory Diseases
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    • v.45 no.5
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    • pp.1000-1011
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    • 1998
  • Background: For the diagnosis or evaluation of airway obstruction in bronchial asthma and chronic obstructive lung disorders, various parameters derived from the forced expiratory volume curve and maximal expiratory flow volume curve have been used. Recently the peak expiratory flow(PEF) measured by the peak flow meter is widely used because of its simplicity and convenience. But there were still no data of the predicted normal values measured by the peak flow meter in Korea. This study was to obtain the predicted normal value of PEF and to know the accuracy of this value to predict $FEV_1$. Method: The measurements of PEF by the MiniWright peak flow meter and several parameters derived from the forced expiratory volume and maximal expiratory flow volume curves by the Microspiro HI 501(Chest Co.) were done in 129 men and 125 women without previous history of the respiratory diseases. The predicted normal values of parameters according to the age and the height were obtained, and the regression equation of $FEV_1$ by PEF was calculated. Results: The predicted normal values of PEF(L/min) were -2.45$\times$Age(year) +1.36 $\times$ Height(cm)+427 in men, and -0.96 $\times$ Age (year) + 2.01 $\times$ Height (cm) + 129 in women. FEFmax derived from the maximal expiratory flow volume curve was less than by 125 L/min in men and 118 L/min in women respectively compared to PEF. $FEV_1$(ml) predicted by PEF was 5.98 $\times$ PEF(L/min) + 303 in men, and 4.61 $\times$ PEF(L/min) + 291 in women respectively. Conclusion : The predicted normal value of PEF measured by the peak flow meter was calculated and it could be used as a standard value of PEF while taking care of patients with airway obstruction. $FEV_1$, the gold standard of ventilatory function, could be predicted by PEF to a certain extent.

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Prediction Formulas of Pulmonary Function Parameters Derived from the Forced Expiratory Spirogram for Healthy Nonsmoking and Smoking Adults and Effect of Smoking on Pulmonary Function Parameters (비흡연 및 흡연 성년 한국인에서의 노력성호기곡선을 이용한 폐활량측정법 검사지표들의 추정상치 및 이에 대한 흡연의 효과)

  • Cho, Won-Kyoung;Kim, Eun-Ok;Myung, Seung-Jae;Kwak, Seung-Min;Koh, Youn-Suck;Kim, Woo-Sung;Lee, Moo-Song;Kim, Won-Dong
    • 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.

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The Effect of Body Composition on Pulmonary Function

  • Park, Jung-Eun;Chung, Jin-Hong;Lee, Kwan-Ho;Shin, Kyeong-Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.5
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    • pp.433-440
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    • 2012
  • Background: The pulmonary function test is the most basic test method to diagnosis lung disease. The purpose of this study was to research the correlation of the body mass index (BMI), the fat percentage of the body mass (fat%), the muscle mass, the fat-free mass (FFM) and the fat-free mass index (FFMI), waist-hip ratio (WHR), on the forced expiratory volume curve. Methods: Between March and April 2009, a total of 291 subjects were enrolled. There were 152 men and 139 female (mean age, $46.3{\pm}9.92$ years), and they were measured for the following: forced vital capacity (FVC), forced expiratory volume at 1 second ($FEV_1$), and forced expiratory flow during the middle half of the FVC ($FEF_{25-75}$) from the forced expiratory volume curve by the spirometry, and the body composition by the bioelectrical impedance method. Correlation and a multiple linear regression, between the body composition and pulmonary function, were used. Results: BMI and fat% had no correlation with FVC, $FEV_1$ in male, but FFMI showed a positive correlation. In contrast, BMI and fat% had correlation with FVC, $FEV_1$ in female, but FFMI showed no correlation. Both male and female, FVC and $FEV_1$ had a negative correlation with WHR (male, FVC r=-0.327, $FEV_1$ r=-0.36; p<0.05; female, FVC r=-0.175, $FEV_1$ r=-0.213; p<0.05). In a multiple linear regression of considering the body composition of the total group, FVC explained FFM, BMI, and FFMI in order ($r^2$=0.579, 0.657, 0.663). $FEV_1$ was explained only fat% ($r^2$=0.011), and $FEF_{25-75}$ was explained muscle mass, FFMI, FFM ($r^2$=0.126, 0.138, 0.148). Conclusion: The BMI, fat%, muscle mass, FFM, FFMI, WHR have significant association with pulmonary function but $r^2$ (adjusted coefficient of determination) were not high enough for explaining lung function.