• The Journal of Korean Physical Therapy
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• v.34 no.1
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• pp.1-5
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• 2022

Purpose: The impact of prolonged sitting in a cross-legged posture on physiological factors has not been extensively studied. We therefore attempted to evaluate whether prolonged sitting in a cross-legged posture affects pulmonary function in normal young adults. Methods: Twenty-four participants were recruited in this study, and the participants were equally allocated to the normal sitting posture group (NSP group, n=12) or sitting posture with the cross-legs group (SPCL group, n=12). The NSP group sat on chairs without crossing their legs for 30 minutes, and the SPCL group sat on the chair with legs crossed (the right knee on the left knee or the left knee on the right knee) for 30 minutes. The pulmonary function of the subjects was evaluated based on forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FVC/FEV1, and peak expiratory flow (PEF) measured using a spirometer. Results: In the intra-group comparison, the SPCL group showed significant differences in FVC and FEV1 before and after sitting (p<0.05), but no significant differences (p>0.05) were observed in the NSP group. However, there were no significant differences between the two groups in the pulmonary function parameters measured before and after sitting (p>0.05). Conclusion: Our results confirmed that prolonged sitting in a cross-legged posture could have a negative influence on pulmonary function. Therefore, if a sitting position is maintained for a long time, the correct sitting posture should be maintained to prevent musculoskeletal disorders as well as to maintain normal pulmonary function.

• Tuberculosis and Respiratory Diseases
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• v.46 no.5
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• pp.628-635
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• 1999

Background : Maximal expiratory flow rate is determined by the size of airway, elastic recoil pressure and the collapsibility of airway in the lung. The obstruction of expiratory flow is one of the major functional impairments of emphysema, which represents COPD. Nevertheless, expiratory narrowing of upper airway may be recruited as a mechanism for minimizing airway collapse, and maintaining lung volume and hyperinflation by an endogenous positive end-expiratory pressure in patients with airflow obstruction. We investigated the physiologic role of trachea in respiration in emphysema. Method : We included 20 patients diagnosed as emphysema by radiologic and physiologic criteria from January to August in 1997 at Seoul Municipal Boramae Hospital. Chest roentgenogram, high resolution computed tomography(HRCT), and pulmonary function tests including arterial blood gas analysis and body plethysmography were taken from each patient. Cross-sectional area of trachea was measured according to the respiratory cycle on the level of aortic arch by HRCT and calibrated with body surface area. We compared this corrected area with such parameters of pulmonary function tests as $PaCO_2$, $PaO_2$, airway resistance, lung compliance and so on. Results : Expiratory cross-sectional area of trachea had significant correlation with $PaCO_2$ (r=-0.61, p<0.05), $PaO_2$ (r=0.6, p<0.05), and minute ventilation (r=0.73, p<0.05), but inspiratory cross-sectional area did not (r=-0.22, p>0.05 with $PaCO_2$, r=0.26, p>0.05 with $PaO_2$, and r=0.44, p>0.05 with minute ventilation). Minute ventilation had significant correlation with tidal volume (r=0.45, p<0.05), but it had no significant correlation with respiratory frequency (r=-0.31, p>0.05). Cross-sectional area of trachea had no significant correlation with other parameters of pulmonary function including $FEV_1$, FVC, $FEV_1$/FVC, peak expiratory flow, residual volume, diffusing capacity, airway resistance, and lung compliance, whether the area was expiratory or inspiratory. Conclusion : Cross-sectional area of trachea narrowed during expiration in emphysema, and its expiratory area had significant correlation with $PaCO_2$, $PaO_2$, and minute ventilation.

• Journal of Korean Physical Therapy Science
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• v.30 no.3
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• pp.49-58
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• 2023

Background: This study aims to examine the useful- ness of the portable spirometer "The Spirokit" as a clinical diagnostic device through technology introduction, precision test, and correction. Design: Technical note Methods: "The Spirokit" was developed using a propeller-type flow rate and flow rate measurement method using infrared and light detection sensors. The level of agreement between the Pulmonary Waveform Generator and the measured values was checked to determine the precision of "The Spirokit", and the correction equation was included using the Pulmonary Waveform Generator software to correct the error range. The analysis was requested using the ATS 24/26 waveform recognized by the Ministry of Food and Drug Safety and the American Thoracic Society for the values of Forced Voluntary Capacity (FVC), Forced Expiratory Volume in 1second (FEV1), and Peak Expiratory Flow (PEF), which are used as major indicators for pulmonary function tests. All tests were repeated five times to derive an average value, and FVC and FEV1 presented accuracy and PEF presented accuracy as the result values. Results: FVC and FEV1 of 'The Spirokit' developed in this study showed accuracy within ± 3% of the error level in the ATS 24 waveform. The PEF value of 'The Spirokit' showed accuracy within the error level ± 12% of the ATS 26 waveform. Conclusion: Through the results of this study, the precision of 'The Spirokit' as a clinical diagnosis device was identified, and it was confirmed that it can be used as a portable pulmonary function test that can replace a spirometer.

• Journal of Environmental Health Sciences
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• v.33 no.5
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• pp.365-371
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• 2007

To evaluate the effect of air pollution on respiratory health in children, We conducted a longitudinal study in which children were asked to record their daily levels of Peak Expiratory Flow Rate(PEFR) using potable peak flow meter(mini-Wright) for 4 weeks. The relationship between daily PEFR and ambient air particle levels was analyzed using a mixed linear regression models including gender, age in year, weight, the presence of respiratory symptoms, and relative humidity as an extraneous variable. The daily mean concentrations of $PM_{10}$ and $PM_{2.5}$ over the study period were $64.9{\mu}g/m^3$ and $46.1{\mu}g/m^3$, respectively. The range of daily measured PEFR in this study was $182{\sim}481\;l/min$. Daily mean PEFR was regressed with the 24-hour average $PM_{10}(or\;PM_{2.5})$ levels, weather information such as air temperature and relative humidity, and individual characteristics including sex, weight, and respiratory symptoms. The analysis showed that the increase of air particle concentrations was negatively associated with the variability in PEFR. We estimated that the IQR increment of $PM_{10}$ or $PM_{2.5}$ were associated with 1.5 l/min (95% Confidence intervals -3.1, 0.1) and 0.8 l/min(95% CI -1.8, 0.1) decline in PEFR. Even though this study showed negative findings on the relationship between respiratory function and air particles, it was worth noting that the findings must be interpreted cautiously because exposure measurement based on monitoring of ambient air likely resulted in misclassification of true exposure levels and this was the first Korean study that $PM_{2.5}$ measurement was applied as an index of air quality.

• Tuberculosis and Respiratory Diseases
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• v.70 no.1
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• pp.36-42
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• 2011

Background: Adaptive support ventilation (ASV), an automated closed-loop ventilation mode, adapts to the mechanical characteristics of the respiratory system by continuous measurement and adjustment of the respiratory parameters. The adequacy of ASV was evaluated in the patients with acute lung injury (ALI). Methods: A total of 36 patients (19 normal lungs and 17 ALIs) were enrolled. The patients' breathing patterns and respiratory mechanics parameters were recorded under the passive ventilation using the ASV mode. Results: The ALI patients showed lower tidal volumes and higher respiratory rates (RR) compared to patients with normal lungs ($7.1{\pm}0.9$ mL/kg vs. $8.6{\pm}1.3$ mL/kg IBW; $19.7{\pm}4.8$ b/min vs. $14.6{\pm}4.6$ b/min; p<0.05, respectively). The expiratory time constant (RCe) was lower in ALI patients than in those with normal lungs, and the expiratory time/RCe was maintained above 3 in both groups. In all patients, RR was correlated with RCe and peak inspiratory flow ($r_s$=-0.40; $r_s$=0.43; p<0.05, respectively). In ALI patients, significant correlations were found between RR and RCe ($r_s$=-0.76, p<0.01), peak inspiratory flow and RR ($r_s$=-0.53, p<0.05), and RCe and peak inspiratory flow ($r_s$=-0.53, p<0.05). Conclusion: ASV was found to operate adequately according to the respiratory mechanical characteristics in the ALI patients. Discrepancies with the ARDS Network recommendations, such as a somewhat higher tidal volume, have yet to be addressed in further studies.

• Tuberculosis and Respiratory Diseases
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• v.42 no.3
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• pp.342-350
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• 1995

Background: Although there are improvements of clinical symtoms after bronchodilator inhalation in COPD patients, it has been noted that there was no increase of $FEV_1$ in some cases. $FEV_1$ did not reflect precisely the improvement of ventilatory mechanics after bronchodilator inhalation in these COPD patients. The main pathophysiology of COPD is obstruction of airway in expiratory phase but in result, the load of respiratory system is increased in inspiratory phase. Therefore the improvement of clinical symptoms after bronchodilator inhalation may be due to the decrease of inspiratory load. So we performed the study which investigated the effect of bronchodilator on inspiratory response of vetilatory mechanics in COPD patients. Methods: In 17 stable COPD patients, inspiratory and expiratory forced flow-volume curves were measured respectively before bronchodilator inhalation. 10mg of salbutamol solution was inhaled via jet nebulizer for 4 minutes. Forced expiratory and inspiratory flow-volume curves were measured again 15 minutes after bronchodilator inhalation. Results: $FEV_1$, FVC and $FEV_1$/FVC% were $0.92{\pm}0.34L$($38.3{\pm}14.9%$ predicted), $2.5{\pm}0.81L$($71.1{\pm}21.0%$ predicted) and $43.1{\pm}14.5%$ respectively before bronchodilator inhalation. The values of increase of $FEV_1$, FVC and PIF(Peak Inspiratory Flow) were $0.15{\pm}0.13L$(relative increase: 17.0%), $0.58{\pm}0.38\;L$(29.0%) and $1.0{\pm}0.56L$/sec(37.5%) respectively after bronchodilator inhalation. The increase of PIF was twice more than $FEV_1$ in average(p<0.001). The increase of PIF in these patients whose $FEV_1$ was not increased after bronchodilator inhalation were 35.0%, 44.0% and 55.5% respectively. Conclusion: The inspiratory parameter reflected improvement of ventilatory mechanics by inhaled bronchodilater better than expiratory parameters in COPD patients.

• Tuberculosis and Respiratory Diseases
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• v.44 no.2
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• pp.298-308
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• 1997

Background : Portable devices for measuring peak expiratory flow(PEF) are now of proved value in the diagnosis and management of asthma and many lightweight PEF meters have become available. However, it is necessary to determine whether peak expiratory flow rate(PEFR) measurements measured with peak flowmeters is accurate and reproducible for clinical application. The aim of the present study is to define accuracy, agreement, and precision of mini-Wright peak flow meter(MPFM) against standard pneumotachygraph. Methods : The lung function tests by standard pneumotachygraph and PEFR measurement by MPFM were performed in a random order for 2 hours in 22 normal and 17 asthmatic subjects and also were performed for 3 successive days in 22 normals. Results : The PEFR measured with MPFM was significantly related to the PEFR and $FEV_1$ measured with standard pneumotachygraph in normal and asthmatics(for PEFR, r = 0.92 ; p < 0.001 ; for $FEV_1$, r = 0.78 ; p < 0.001). The accuracy of MPFM was within 100(limits of accuracy recommeded by NAEP) in all the subjects or 22 normal, mean difference from standard pneumotachygraph being 16.5L/min(percentage of difference being 2.90%) or 10.6L/min(percentage of difference being 1.75%), respectively. According to the method proposed by Bland and Altman, the 95% limits of the distribution of differences between MPFM and standard pneumotachygraph after correction of PEFR using our regression equation were +38.2 and -71.5L/min in all the subjects or 20.49~+9.49L/min in 22 normal and was similar to the intraindividual agreements for 3 successive days in normal. There was no statistically significant difference of PEFR measured with MPFM and standard pneumotachygraph among three days(p > 0.05) and the coefficient of variation($2.4{\pm}1.2%$) of PEFR measured with MPFM was significantly lower than that($5.2{\pm}3.5%$) with standard pneumotachygraph in normal (p < 0.05). Conclusion : This results suggest that the MPFM was as accurate and reproducible as standard pneumotachygraph for monitoring of PEFR in the asthmatic subjects.

• 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.

• The Journal of Korean Physical Therapy
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• v.21 no.3
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• pp.25-32
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• 2009

Purpose: This study examined whether breathing exercises might increase the chest expansion and pulmonary function of stroke patients. Methods: Twenty four patients with stroke were assigned randomly into two groups: a combination of diaphragmatic resistive breathing and pursed-lip breathing exercise (CB) group (n=10) and control group (n=14). The CB group completed a 4-week program of diaphragmatic resistive breathing and pursed-lip breathing exercise. The subjects were assessed using the pre-test and post-test measurements of the chest expansion (length for resting, deep inspiration, deep expiration, deep expiration-inspiration) and pulmonary function (forced vital capacity (FVC), forced expiratory volume at one second (FEV1), FEV1/FVC, peak expiratory flow (PEF), vital capacity (VC), tidal volume (TV), expiratory reserve volume (ERV), inspiratory reserve volume (IRV)). Results: A comparison of the chest expansion between the pre and post tests revealed similar rest, deep inspiration, deep expiration, and deep expiration-inspiration lengths in the CB and control groups (p>0.05). A comparison of the pulmonary function between pre and post tests, revealed significant improvements in the FVC, FEV, PEF, VC, IRV, and ERV in the CB group (p<0.05). There was a significant difference in the FVC, FEV1, PEF, VC and IRV between the 2 groups (p<0.05). Conclusion: These findings suggest that breathing exercise should help improve the pulmonary function, such as the volume and capacity. This suggests that the pulmonary functions of stroke patients might be improved further by a continued respiratory exercise program.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.1
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• pp.121-128
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• 2018

PURPOSE: This study assessed the effect of exercise intervention methods on diaphragm movement, pulmonary function, and pulmonary strength in children with cerebral palsy (CP). METHODS: A total of 28 children with CP were randomly allocated to the general exercise group (n=9, GEG), respiratory exercise group (n=10, REG), and intensive exercise group (n=9, IEG). The exercise intervention was performed for 12 weeks. This study measured diaphragm movement, pulmonary function, and pulmonary strength under two different conditions before and after each exercise. Ultrasonography was used for measuring diaphragm movement, and Pony Fx was used to measure the forced expiratory volume in one second ($FEV_1$), peak expiratory flow (PEF), maximum inspiratory pressure (MIP), and maximum expiratory pressure (MEP). A Mann-Whitney test and ANOVA with a significance level of .05 were used for statistical analysis. RESULTS: Significant change was observed between the REG and the IEG as well as between the GEG and the IEG (p<.05). No significant difference was observed between the GEG and the REG. The diaphragm movement, $FEV_1$ PEF, MIP, and MEP were most improved in the IEG (p<.01). CONCLUSION: This study confirmed that intensive exercise is the most effective treatment method for improving diaphragm movement and respiratory function in CP children.