Purpose: This study investigated effects of deep abdominal muscle strengthening exercises on pulmonary function and the ability to balance in stroke patients and was conducted to propose an exercise program for improving cardiovascular function. Methods: Study subjects were 20 patients with hemiplegia due to stroke, who were divided into the deep abdominal muscle strengthening exercise group (experimental group), 10, and the control group, 10. Pulmonary function tests measured FVC and FEV1, dynamic balance ability was measured using TUG. Static and dynamic balance ability was measured using BBS. The experimental group performed exercises during a period of 6 weeks, 5 times a week for 40 minutes, whereas the control group did not participate in regular exercise. The difference before and after the exercise was compared using paired t-test, difference in exercise before and after between groups was ANCOVA and level of significance was set at ${\alpha}=0.05$. Results: The changes in FVC and FEV1 within the group showed a significant difference only in the experimental group (p<0.001) (p<0.01), between-group difference was statistically significant only in FVC and FEV1 changes in the experimental group (p<0.001). The TUG changes within the group showed a significant difference in the experimental group and control group (p<0.001) (p<0.05), while BBS changes showed a significant difference only in the experimental group. Between-group difference was statistically significant only in TUG and BBS changes in the experimental group. The experimental group showed a more effective significant difference than the control group (p<0.001). Conclusion: Can exercise involving a deep abdominal muscle strengthening program be applied in patients with stroke with difficulty in control of trunk and decreased breathing ability?
Purpose: The aim of this study was to evaluate functional gait and pulmonary function of patients with subacute or chronic stroke for aperiod after the onset of stroke. Healthy people of similar ages served as a control group. The study focused on the clinical importance of intervention with cardiopulmonary rehabilitation treatment in patients with stroke. Methods: The standard time period used to differentiate the subacute and the chronic stroke groups was six months. Each group, including the control, was allocated 11 subjects. Vital capacity (VC), forced vital capacity (FVC), and forced expiratory volume at one second ($FEV_1$) were measured with a spirometer for each subject. Walk tests (10 m and 6 min) and functional gait tests were then conducted. Results: Significant differences were noted for VC, FVC, and $FEV_1$ between the subacute stroke group and the normal group and between the chronic stroke group and the normal group (p<0.05), but no significant difference was evident between the subacute stroke group and the chronic stroke group (p>0.05). No significant difference was seen between the subacute stroke group and the chronic stroke group in the 6min walk test (p>0.05), whereas a significant difference was observed between the subacute stroke group and the chronic stroke group in the 10 m walk test (p<0.05). Conclusion: The general rehabilitation treatment is effective with respect to functional aspects, but it has limited effect in improving pulmonary function and muscular endurance. Therefore, additional intervention of cardiopulmonary rehabilitation is necessary in the rehabilitation treatment process of patients with stroke.
Interstitial lung diseases (ILDs) are a diverse collection of lung disorders sharing similar features, such as inflammation and fibrosis. The diagnosis and management of ILD require a multidisciplinary approach using clinical, radiological, and pathological evaluation. Progressive pulmonary fibrosis (PPF) is a distinct form of progressive and fibrotic disease, occurring in ILD cases other than in idiopathic pulmonary fibrosis (IPF). It is defined based on clinical symptoms, lung function, and chest imaging, regardless of the underlying condition. The progression to PPF must be monitored through a combination of pulmonary function tests (forced vital capacity [FVC] and diffusing capacity of the lung for carbon monoxide), an assessment of symptoms, and computed tomography scans, with regular follow-up. Although the precise mechanisms of PPF remain unclear, there is evidence of shared pathogenetic mechanisms with IPF, contributing to similar disease behavior and worse prognosis compared to non-PPF ILD. Pharmacological treatment of PPF includes immunomodulatory agents to reduce inflammation and the use of antifibrotics to target progressive fibrosis. Nintedanib, a known antifibrotic agent, was found to be effective in slowing IPF progression and reducing the annual rate of decline in FVC among patients with PPF compared to placebos. Nonpharmacological treatment, including pulmonary rehabilitation, supplemental oxygen therapy, and vaccination, also play important roles in the management of PPF, leading to comprehensive care for patients with ILD. Although there is currently no cure for PPF, there are treatments that can help slow the progression of the disease and improve quality of life.
To determine the period and degree of full recovery of postoperative pulmonary function, the author performed seiral pulmonry function test with spirometry at preoperative period and 1st, 2nd, 3rd, 4th, 6th and 8th postoperative week in 64 patients who underwent chest surgery form 1990. 1. to 1990. 8. at Dep. of Thoracic & Cardiovascular surgery, Pusan National University Hospitcal, Pusan, Korea 28 patients underwent lung resection[Group A], 14 patients mediastinal and other thoracic surgery[Group B], and 22 patients heart surgery with cardiopulmonary bypass[Group C]. Al of them recovered normally and discharged without any complications. Their serial changes of pulmonary function test were compaired and its results was as follows; l. Over all mean recovery time of restrictive ventilatory function tests[ie, VC, ERV, IC, FEF1, FVC, FEF200-1200, MVV] were 4th & 6th postoperative week, and that of obstructive ventilatory function tests[ie., EFE25-75%, Vmax50] were 2nd postoperative week. 2. In patient who underwent lung resection surgery[Group A], FEF1 recovered in 4th~6th postoperative week and its ratio to preoperative value was 70% in pneumonectomy, and 75% in lobectomy. FVC recovered in 4th~6th postoperative week and its ratio to preoperative value was 65% in pneumonectomy, and 80% in lobectomy. MVV was recovered in 4th~8th postoperative week and recovery ratio was 80%, FEF200-1200 was recovered at 4th~6th postoperative week and its recovery ratio was 70%, FEF25-75% and Vmax50 was recovered in 2nd~4th postoperative week and recovered nearly to preoperative level. 3. In patient who underwent mediastinal and other thoracic surgery[Group B], FEV1 and FVC and recovered in 4th~6th postoperative week and the recovery ratio of FVC in blebectomy was 90%. MVV reached preoperative level in 4th~8th postoperative week. FEF200-1200, FEF25-75% and Vmax50 were recovered in 2nd~4th postoperative week and the recovery of FEF25-75% and Vmax50 in blebectomy was prominant. 4. In patient who underwent heart surgery[Group C], FEV1 and FVC were recovered in 4th~6th postoperative week. The recover ratio of FEF25-75% and Vmax50 was delaied to 6th~8th postoperative week From the above results we concluded that the recovery time of posoperative restrictive ventilatory disorder was 4th postoperative week and pulmonary complication would possibly occure during that period. So more intensive observations will be needed.
Park, Sung-Woo;Baek, Ae Rin;Lee, Hong Lyeol;Jeong, Sung Whan;Yang, Sei-Hoon;Kim, Yong Hyun;Chung, Man Pyo;Korean Interstitial Lung Diseases Study Group
Tuberculosis and Respiratory Diseases
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v.82
no.4
/
pp.269-276
/
2019
Idiopathic interstitial pneumonia (IIP) is a histologically identifiable pulmonary disease without a known cause that usually infiltrates the lung interstitium. IIP is largely classified into idiopathic pulmonary fibrosis, idiopathic non-specific interstitial pneumonia, respiratory bronchiolitis-interstitial lung disease (ILD), cryptogenic organizing pneumonia, desquamative interstitial pneumonia, and acute interstitial pneumonia. Each of these diseases has a different prognosis and requires specific treatment, and a multidisciplinary approach that combines chest high-resolution computed tomography (HRCT), histological findings, and clinical findings is necessary for their diagnosis. Diagnosis of IIP is made based on clinical presentation, chest HRCT findings, results of pulmonary function tests, and histological findings. For histological diagnosis, video-assisted thoracoscopic biopsy and transbronchial lung biopsy are used. In order to identify ILD associated with connective tissue disease, autoimmune antibody tests may also be necessary. Many biomarkers associated with disease prognosis have been recently discovered, and future research on their clinical significance is necessary. The diagnosis of ILD is difficult because patterns of ILD are both complicated and variable. Therefore, as with other diseases, accurate history taking and meticulous physical examination are crucial.
Objective: This study was conducted to identify the clinical usefulness, validity, and reliability of the Spirokit, a device that combines the pulmonary function test (PFT) and respiratory muscle strength (RMS) test. Design: Cross-sectional study. Methods: Forty young adults (male: 23, female: 17) participated in a PFT and a RMS test. The concurrent validity for pulmonary function was assessed by comparing data obtained from MicroQuark and the Spirokit and the agreements between the MicroRPM and the Spirokit for RMS were compared. The test-retest reliability of the Spirokit was determined by comparing data obtained from the first and second sessions. The test and retest were performed at the same time after one day for the PFT and RMS test. Validity was estimated using intraclass correlation coefficients (ICCs), and by calculating 95% limits of agreement (LoA). To estimate interrater reliability, ICCs were calculated. Results: The Spirokit showed a high agreement intra class coefficient (ICC [2, 1]): 0.978-0.999, 95% limits of agreements (95% LOA): -0.798 to 0.847 with MicroQuark. It also showed a high level of concordance ICC (2, 1): 0.992 to 0.993, 95% LOA: -9.313 to 11.169 with MicroRPM. The test-retest reliability of the Spirokit was analyzed using ICC (2, 1), and showed a high level of reliability (ICC [2,1]=0.960 to 0.998). Standard error of measurement % (SEM%) was 0.12% to 3.39%, and minimum detectable change% (MDC%) was 0.02% to 3.79%, indicating high level of reliability. Conclusions: The Spirokit is a device with high validity and reliability that can be used to simultaneously measure PFT and RMS tests.
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.
Cardiac surgery is generally followed by a period of routine ventilator support. When the patient seems hemodynamically stable and relatively alert following surgery, respiratory adequacy is tested by the weaning trial. In this study, physiological and clinical prediction of postoperative respiratory adequacy, including values of pulmonary function tests, were examined in an attempt to identity those few variables which predicted the outcome of the ventilator weaning trial following surgery. Our series comprised 27 patients who underwent elective open intracardiac operations at the Department of Thoracic and Cardiovascular Surgery, School of Medicine, Kyungpook National University, from October 1979 to July, 1980. The pulmonary function tests performed on all patients included the following; forced vital capacity [FVC], forced expiratory volume [FEV1.0], forced expiratory flow [FEF 25--75~], residual volume [RV], and functional residual capacity [FRC], measured with a helium dilution technique. Of our 27 patients, 8 were successfully weaned within 20 hours of operation. All patients with cyanotic heart diseases or acquired heart diseases were unsuccessfully weaned. The bypass time in the successful weaning group was shorter in the mean value [82.8 minutes]than in the unsuccessful weaning group [120.5 minutes]. There was a relatively significant difference in the mean values for the two groups in arterial pressure, bleeding amounts and FiO2 among the postoperative monitoring variables, and in forced vital capacity [FVC]. The postoperative clinical assessments appeared vague but corresponded reasonably well to appraisal of success in weaning, especially in variables of cough and self-respiration efforts.
Journal of the Korean Society of Physical Medicine
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v.6
no.4
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pp.437-445
/
2011
Purpose : The purpose of this study was to analysis on diaphragm thickness and lung function of stroke patients by walking ability. Methods : We recruited thirty-five adults after stroke(20 male, 15 female) for our study. The subjects were divided into two groups; independent walking group(11 male, 9 female) and non-independent walking group(9 male, 6 female). Assessment of diaphragm thickness was performed using ultrasound in B-mode with a 7.5 MHz linea probe. During the experiment, the subject was seated in the chair. All subjects performed maximal expiratory flow maneuvers using a spirometer in order to determine the forced expiratory volume in 1 second ($FEV_1$), forced vital capacity(FVC), peak expiratory flow(PEF) and $FEV_1$/FVC. Chest expansion was measured with a tape-measure placed circumferentially around the chest wall at the xiphoid process. The collected data analyzed by independent t-test. Results : The diaphragm thickness were significant differences between the independent walking and nonindependent walking group. Values of forced vital capacity, forced expiratory volume at one second, peak expiratory flow in pulmonary function tests were significant differences between the independent walking and non-independent walking group. However, chest expansion were not significant differences in both of the group. Conclusion : This study showed that walking ability of stroke patients have influenced on diaphragm thickness and pulmonary function.
Sleeve lobectomy for bronchogenic carcinoma is an alternative to pneumonectomy. The extent and location of the tumor must be such that a sleeve procedure is feasible. The conservation of lung tissue benefits both compromised and uncompromised patients. From August 1988 to March 1989, five patients underwent sleeve lobectomy for bronchogenic carcinoma of the lung. The patients included four males and one female ranging in age from 52 years to 66 years. All patients were diagnosed as having squamous cell carcinoma. Operative procedures were right upper sleeve lobectomy in four cases and left upper sleeve lobectomy with pulmonary angioplasty in one case. Complications developed in one patient. An asthmatic attack necessitated ventilator support for one day. Bronchoscopic examinations were performed at two weeks and three months postoperatively in four patients. Anastomosis sites on all patients were intact, but in one case, nodules were noted. Pulmonary function tests were also checked at three months postoperatively, and showed good results. The reimplanted lobe or lobes contribute significantly to the overall remaining lung function. All patients are being followed up with satisfactory results, except one case of suspected local tumor recurrence. We think, therefore, that sleeve lobectomy is a safe and adequate procedure for patients with resectable lung cancer.
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