Purpose: This study was to investigate the effects of respiratory rehabilitation training on the respiratory functions of hospitalized cervical spinal cord injury patients. Methods: One group pre and post test design was used. Subjects were 20 cervical spinal cord injury inpatients of the national rehabilitation center. Training program consisted of air cumulation training, manual assisted coughing training, and abdominal breathing. Trained rehabilitation nurse implemented 20 minutes program twice a day for 4 weeks. Respiratory function was measured as peak coughing flow rate, and perceived respiratory difficulty after activity on wheel chair for 30 minutes and during speaking and singing. Perceived respiratory difficulty was measured with modified Borg scale. Also content analysis was done with the result of open ended question about subjective feeling about training. All variables were measured 3 times before, 2weeks and 4 weeks after the program. Results: Peak coughing flow rate significantly improved after compared to before training. Also all three perceived respiratory difficulty variables decreased significantly after training. In the content analysis, 'it's easier to cough up phlegm' was the most frequent answered subjective feeling. 'Sound at speaking and coughing became louder', 'respiratory volume increased', and 'comfortable chest feeling' were frequent answered subjective feeling, in order. Conclusion: Although it is preliminary since no control group, respiratory rehabilitation training was found to be effective to improve respiratory function in terms of peak coughing flow rate, perceived respiratory difficulty, and subjective feeling. It is necessary further systemic research to investigate the effects of respiratory rehabilitation training.
It is known that a pulmonary rehabilitation program improves dyspnea and exercise tolerence in patients with chronic obstructive pulmonary disease. However, it is also known that although it does not improve pulmonary function. This study was performed to evaluate the effect of a 4 week pulmonary rehabilitation on pulmonary function, gas exchange, and exercise tolerance in patients with chronic obstructive pulmonary disease. The pulmonary rehabilitation programs included breathing exercises, such as pursed-lip breathing and diaphragmatic breathing, upper-limb exercises, and inspiratory muscle training. These activities were performed for 4 weeks in twenty one patients with chronic obstructive pulmonary disease. Pre and post-rehabilitation pulmonary function and exercise capacities were compared after the 4 week period. Results are as follows: 1) Before the rehabilitation, the predicted value of FVC and FEV1 of the patients were 70.3$\pm$16.7% and 41.1$\pm$11.9% respectively. These pulmonary functions did not change after pulmonary rehabilitation. 2) Aloility of walking a 6 minute distance (325.29$\pm$122.24 vs 363.03$\pm$120.01 p=.01) and dyspnea (p=.00) were significantly improved after rehabilitation. Thus showing that pulmonary rehabilitation for 4 weeks can improve exercise performance and dyspnea in patients with chronic obstructive pulmonary disease.
Kim, Sang Hun;Jeong, Jong Hwa;Lee, Byeong Ju;Shin, Myung-Jun;Shin, Yong Beom
Physical Therapy Rehabilitation Science
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v.9
no.2
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pp.82-89
/
2020
Objective: The purpose of this study was to assess the effect of hospital-based pulmonary rehabilitation (PR) on exercise capacity and quality of life as well as barriers to participation in persons with chronic obstructive pulmonary disease (COPD) in South Korea. Design: One-group pretest-posttest design. Methods: A total of 14 patients were enrolled in this study in an 8-week PR program with two 60-minute sessions per week. The program included: flexibility exercises, breathing techniques, strengthening exercises, and aerobic exercises. The outcomes were defined as changes in the variables before and after the PR program. A change in the 6-minute walk distance (6MWD) was defined as the primary outcome, and changes in pulmonary function test, respiratory and grip strength, and the St. George's Respiratory Questionnaire (SGRQ) about quality-of-life results were secondary outcomes. A dropout was defined as missing >3 of the 16 sessions. Results: Patients who completed the program showed a significant improvement of 43.57±39.43 m in the 6MWD (p<0.05), but no significant differences were noted for the other function tests. The SGRQ showed a significant improvement in the activity and total score (p<0.05). The total dropout rate was 53.3%. Newly developed symptoms, exacerbation of COPD, transport problems, and lack of motivation were major barriers to PR. Conclusions: Our study showed that an 8-week hospital-based PR program improved exercise capacity and quality of life but had a high dropout rate in individuals with COPD. Since comprehensive PR has only recently been established in South Korea, patient motivation and education are critical.
Objective: The purpose of this study was to investigate the effect of high-intensity complex exercise program using whole-body vibration (WBV) and respiratory resistance on pain and dysfunction, psychosocial level, balance ability, and pulmonary function in low back pain (LBP) patients with high obesity. Design: A randomized controlled trial Methods: A total of 44 LBP patients withhigh obesity (body mass index, BMI≥30kg/m2) were randomly assigned to an experimental group (n=22) and a control group (n=22). Both groups underwent a lumbar stabilization exercise program. In addition, the experimental group implemented the high-intensity complex exercise program combined with WBV and respiratory resistance. In order to compare the effects depending on the intervention methods, numeric pain rating scale (NRPS), Roland-Morris disability questionnaire (RMDQ), fear-avoidance beliefs questionnaire (FABQ), balance ability, and pulmonary function were used for measurement. Results: Both groups showed significant differences in NRPS, RMDQ, FABQ, balance ability before and after intervention (p<0.05). In addition, the experimental groupshowed significant difference in the amount of change in RMDQ, balance ability and pulmonary function values than the control group (p<0.05). Conclusions: High-intensity complex exercise program using WBV and respiratory resistance has been proven to be an effective and clinically useful method to decrease dysfunction, increase balance ablilty, and pulmonary function for LBP patients with high obesity.
Purpose: The purpose of this study is to exam the effects of a short-term pulmonary program on lung function, exercise tolerance, and quality of life in chronic lung patients. Method: Randomized controlled pre-post test design was used. The outcome measures were forced expiratory volume in one second (FEV1, % predicted), 6 min walking distance (6MWD), Borg score after 6MWD, and Chronic Respiratory Disease Questionnaire (CRDQ). Experimental group performed the 4-week home-based pulmonary rehabilitation program composed of inspiratory muscle training, upper and lower extremity exercise, relaxation, and telephone visit. Patients in control group were only given education about self-management strategies. Thirty four patients with moderate-to-severe respiratory impairment were recruited, and 28 patients (19 in experiments, 15 in control) completed the study. Result: Significant improvements in lung function, exercise tolerance, and health related quality of life were found only in the experiment group. Conclusion: This study yielded evidence for the potential and beneficial effects of home-based pulmonary rehabilitation program in patients with moderate to severe chronic lung disease. The program could be adequately utilized for improvement of health related quality of life in chronic lung patients.
Wanho Yoo;Myung Hun Jang;Sang Hun Kim;Soohan Kim;Eun-Jung Jo;Jung Seop Eom;Jeongha Mok;Mi-Hyun Kim;Kwangha Lee
Tuberculosis and Respiratory Diseases
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v.86
no.2
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pp.133-141
/
2023
Background: The present study evaluated the association between participation in a rehabilitation program during a hospital stay and 1-year survival of patients requiring at least 21 days of mechanical ventilation (prolonged mechanical ventilation [PMV]) with various respiratory diseases as their main diagnoses that led to mechanical ventilation. Methods: Retrospective data of 105 patients (71.4% male, mean age 70.1±11.3 years) who received PMV in the past 5 years were analyzed. Rehabilitation included physiotherapy, physical rehabilitation, and dysphagia treatment program that was individually provided by physiatrists. Results: The main diagnosis leading to mechanical ventilation was pneumonia (n=101, 96.2%) and the 1-year survival rate was 33.3% (n=35). One-year survivors had lower Acute Physiology and Chronic Health Evaluation (APACHE) II score (20.2±5.8 vs. 24.2±7.5, p=0.006) and Sequential Organ Failure Assessment score (6.7±5.6 vs. 8.5±2.7, p=0.001) on the day of intubation than non-survivors. More survivors participated in a rehabilitation program during their hospital stays (88.6% vs. 57.1%, p=0.001). The rehabilitation program was an independent factor for 1-year survival based on the Cox proportional hazard model (hazard ratio, 3.513; 95% confidence interval, 1.785 to 6.930; p<0.001) in patients with APACHE II scores ≤23 (a cutoff value based on Youden's index). Conclusion: Our study showed that participation in a rehabilitation program during hospital stay was associated with an improvement of 1-year survival of PMV patients who had less severe illness on the day of intubation.
Journal of the Korean Society of Physical Medicine
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v.9
no.4
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pp.399-406
/
2014
PURPOSE: The purpose of this study was to examine the effects of respiratory muscle training on respiratory function, respiratory muscle strength, and cough capacity in stroke patients. METHODS: This study used a nonequivalent control group pre-post test design. We recruited thirty-four stroke patients(16male, 18female), who were assigned to intervention (n=17), or control (n=17) groups. Both groups participated in a conventional stroke rehabilitation program, with the intervention groups also receiving respiratory muscle training 20 minutes a day, three times a week, for 4 weeks. Respiratory function (forced vital capacity) and respiratory muscle strength (maximal inspiratory pressure, maximal expiratory pressure) were assessed by spirometry. Cough capacity (peak expiratory flow) was assessed using a peak flow meter. The collected data were analyzed by independent and paired t-tests. RESULTS: The intervention group showed a significant increase in the forced vital capacity (FVC), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP) and peak expiratory flow (PEF) at the end of the program, while the control group showed no significant changes. CONCLUSION: This study showed that respiratory muscle training increased respiratory function, respiratory muscle strength, and cough capacity in stroke patients and prevented a decrease in cough capacity. These findings suggest that respiratory muscle training effect on respiratory function, respiratory muscle strength and cough capacity for rehabilitation in patients with stroke.
Purpose: This study is aimed to analyze the trend of research on pulmonary rehabilitation of patients with COPD (Chronic Obstructive Pulmonary Disease), and to suggest a direction for future research of pulmonary rehabilitation of COPD. Method: A total of 39 studies published from 1991 to 2002 were examined according to the year of publication, type of journal, characteristics of patients, rehabilitation program, research design, and instruments and research findings. Results: 1) The number of studies related to pulmonary rehabilitation of COPD patients has rapidly increased since 1996's (87.18%) 2) There were 10 studies published in the chest. There were 6 studies published in domestic journals and 33 studies published in international journals. 3) The samples in the studies were mostly outpatients whose lung function was moderate. 4) The total period of the pulmonary rehabilitation program shown in the literature was 5 to 12 weeks. The programs included exercise interventions, educational interventions and psychosocial interventions. 5) The outcomes of the pulmonary rehabilitation were measured with lung function, 6-minute walk test, dyspnea, and chronic respiratory disease questionnaire. Research findings were found to be effective on 6-minute walk test, dyspnea, and chronic respiratory disease questionnaire but not on lung function. Conclusion: Based on these findings, pulmonary rehabilitation should be further emphasized, and standardized protocols and community based pulmonary rehabilitation programs need to be provided. More qualitative research should also be conducted in the future to describe the experiences of the pulmonary rehabilitation of patients with COPD.
Arnold, Michael T.;Dolezal, Brett A.;Cooper, Christopher B.
Tuberculosis and Respiratory Diseases
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v.83
no.4
/
pp.257-267
/
2020
Patients with chronic obstructive pulmonary disease receive a range of treatments including but not limited to inhaled bronchodilators, inhaled and systemic corticosteroids, supplemental oxygen, and pulmonary rehabilitation. Pulmonary rehabilitation is a multidisciplinary intervention that seeks to combine patient education, exercise, and lifestyle changes into a comprehensive program. Programs 6 to 8 weeks in length have been shown to improve health, reduce dyspnea, increase exercise capacity, improve psychological well-being, and reduce healthcare utilization and hospitalization. Although the use of pulmonary rehabilitation is widely supported by the literature, controversy still exists regarding what should be included in the programs. The goal of this review was to summarize the evidence for pulmonary rehabilitation and identify the areas that hold promise in improving its utilization and effectiveness.
Purpose: The purpose of this study was to examine the effects of an inpatient pulmonary rehabilitation program on dyspnea, exercise capacity, and health related quality of life in inpatients with chronic lung disease. Method: This quasi experimental study was designed with a nonequivalent control group pre-post test time series. Twenty three patients were assigned to the experimental group and nineteen to the control group. The inpatient pulmonary rehabilitation program was composed of upper and lower extremity exercise, breathing retraining, inspiratory muscle training, education, relaxation and telephone contacts. This program consisted of 4 sessions with inpatients and 4 weeks at home after discharge. The control group was given a home based pulmonary rehabilitation program at the time of discharge. The outcomes were measured by the Borg score, 6MWD and the Chronic Respiratory Disease Questionnaire(CRQ). Results: There was a statistically significant difference in dyspnea between the experimental group and control group, but not among time sequence, or interaction between groups and time sequence. Also significant improvements in exercise capacity and health related quality of life were found only in the experimental group. Conclusions: An Inpatient pulmonary rehabilitation program may be a useful intervention to reduce dyspnea, and increase exercise capacity and health related quality of life for chronic lung disease patients.
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