Purpose : The purpose of the study was to examine if a respiratory muscle strengthening training in patients with stroke can improve their pulmonary function. Methods : Volunteers were included for the study if a patient diagnosed stroke more than 6 months and had 24 points or higher in MMSE-K scores. Twenty-eight subjects participated in this study and were randomly divided into two groups; a breathing exercise group(n=14) and a control group(n=14). The intervention for all subjects was conducted for 20minutes, three times a week for 4 weeks. Subjects for the breathing exercise group had the respiratory muscle strengthening training using spiro-tigers, where-as subjects in the control group got their usual treatment ie a postural training. The six-minute walking test(6MWT) and the pulmonary function tests(FVC, $FEV_1$, $FEV_1$/FVC, VC, Vt, IRV and ERV) were employed to assess treatment effects at baseline and after their intervention. Results : Twenty-four subjects finished their 4-week treatment programs. The general characteristics between groups were found to be similar (p>0.05). The pulmonary function between groups were also observed no difference across groups at the baseline measurement (p>0.05). In the post treatment group comparison, subjects in the breathing exercise group showed an increase in lung function with VC ($2.73{\pm}0.80{\ell}$) and Vt ($0.87{\pm}0.38{\ell}$) than those in the control group ($1.91{\pm}0.80{\ell}$ and $0.48{\pm}0.22{\ell}$ respectively) (p<0.05). However, there was no difference found in 6MWT, FVC, $FEV_1$, $FEV_1$/FVC, IRV, and ERV across groups (p>0.05). Conclusion : A significant increase in VC and Vt was found in subjects with stroke, who had four-week training on respiratory muscle strengthening. However, respiratory muscle strengthening showed no effect on walking speed and FVC, $FEV_1$, $FEV_1$/FVC, IRV, and ERV in patients with stroke.
Park, je wan;Kim, min su;Um, ki cheon;Choi, seong hoon;Song, heung kwon;Yoon, in ha
The Journal of Korean Society for Radiation Therapy
/
v.33
/
pp.25-33
/
2021
Purpose : The purpose of this study is to evaluate the accuracy and usefulness of the Trigger mode for the Respiratory Gated Radiation Therapy (RGRT) Materials and methods : A QUASAR respiratory phantom that inserted a 3 mm fiducial marker (a gold marker) was used to estimate the accuracy of the Trigger mode. And the 20 bpm was used as reference respiration rate in this study. The marker that placed at the center of the phantom was contoured, and the lower threshold of a gating window was fixed at 2.0 mm using an OBI with Truebeam STxTM. The upper threshold was measured every 0.5 mm from 1.0 mm to 3.0 mm. The respiration rates were changed every 10 bpm from 10 bpm to 60 bpm. We repeatedly measured five times to check the error rate of the trigger mode in the same condition. Result : The differences of a distance from a peak phase to upper threshold, 1.0 to 3.0 mm at a 20 bpm as a reference for 3 days in a row were 0.68±0.05 mm, 0.91±0.03 mm, 1.23±0.03 mm, 1.42±0.04 mm, and 1.66±0.06 mm, respectively. Measurement result of changes in respiratory rate compared to baseline respiratory rate in maximum absolute difference. The coefficient of determination (R2) to estimate the correlation between the respiration velocity and variation of absolute difference was on average 0.838, 0.887, 0.770, 0.850, and 0.906. The p-values of all the variables were below 0.05. Conclusion : Using Trigger mode during respiratory gated radiation therapy (RGRT), accuracy and usefulness of trigger mode at reference breathing rate were confirmed. However, inaccuracies depending on the rate of breathing it could be uncertain in case of respiration rate is faster than 20 bpm as a standard respiration rate compared to slower than 20 bpm. Consequently, when conducting a RGRT using the trigger mode, real time monitoring is required with well educated respiration.
Background: Studies on the effect of abdominal or thoracic breathing therapy on sleep or blood oxygen concentration are still scarce. Purpose: This study was to examine the effect on blood oxygen saturation and pulse variability, changes in the severity of insomnia, changes in wakefulness before sleep, and dysfunctional beliefs and attitudes toward the Korean version of sleep in women in their 50s after healing with abdominal breathing and thoracic breathing. We investigated the effect. Methods: Subjects were investigated before and after the change of breathing (breathing) therapy for 12 weeks, 3 times a week, and 36 breaths perweek. Results: It wa evaluated respiratory healing as having no significance in the pulse rate change. However, oxygen saturation was significant in the experimental group, increasing to 93.60 SpO2% before the respiratory rally and 96.5 SpO2% after respiratory recovery (p < .002). In addition, the insomnia severity scale and dysfunctional beliefs about sleep significantly decreased after respiratory rally than before (p < .000). Conclusions: It evaluated that respiratory therapy for the subjects is beneficial to health as it is effective for insomnia, pulse, and oxygen saturation.
Sabzehei, Mohammad Kazem;Basiri, Behnaz;Shokouhi, Maryam;Ghahremani, Sajad;Moradi, Ali
Clinical and Experimental Pediatrics
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v.65
no.4
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pp.188-193
/
2022
Background: Respiratory distress syndrome (RDS) is a common cause of hospitalization and death in preterm infants who require surfactant treatment and respiratory support. Purpose: This study aimed to compare the clinical outcomes of minimally invasive surfactant therapy (MIST) and the INtubation, SURfactant administration, and Extubation (INSURE) technique in preterm infants with RDS. Methods: In this clinical trial, 112 preterm infants born at 28-36 weeks of gestation and diagnosed with RDS randomly received 200-mg/kg surfactant by MIST or the INSURE method. In the MIST group, surfactant was administered using a thin catheter (5F feeding tube); in the INSURE group, surfactant was administered after intubation using a feeding tube and the tracheal tube was removed after positive pressure ventilation was started. Nasal continuous positive airway pressure was applied in both groups for respiratory support and the postprocedure clinical outcomes were compared. Results: The mean hospitalization time was shorter for infants in the MIST group than for those in the INSURE group (9.19±1.72 days vs. 10.21±2.15 days, P=0.006). Patent ductus arteriosus was less frequent in the MIST group (14.3% vs. 30.4%, P=0.041). Desaturation during surfactant administration occurred less commonly in the MIST group (19.6% vs. 39.3%, P=0.023). There were no significant intergroup differences in other early or late complications. Conclusion: These results suggest that surfactant administration using MIST could be a good replacement for INSURE in preterm infants with RDS since its use reduced the hospitalization time and the number of side effects.
Journal of the Korean Society of Physical Medicine
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v.17
no.2
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pp.75-82
/
2022
PURPOSE: This study examined the correlation between the pulmonary function and respiratory muscle strengthening training on an unstable support surface and a stable support surface in stroke patients. METHODS: The study subjects were 22 stroke patients undergoing central nervous system developmental rehabilitation treatment. After excluding six dropouts, eight people in the experimental group and eight people in the control groups were classified by random sampling. Both groups performed central nervous system developmental rehabilitation therapy and were provided a 10-minute break. The experimental group was provided with an unstable support surface using Togu, and the control group was trained to strengthen the respiratory muscle in a stable support surface. Respiratory muscle strengthening training was conducted three times per week for 20 minutes. Before and after each group of experiments, a nonparametric test Wilcoxon signed rank test, and a Mann Whitney U-test analysis were used to analyze the variations between the two groups. All statistical significance levels (α) were set at 0.05. RESULTS: Both groups showed increases in the pulmonary function but showed significant differences only in the experimental group. There was a significant difference in the peak expiratory flow between the two groups. CONCLUSION: Central nervous system development rehabilitation treatment for patients with an impaired nervous system and respiratory muscle strengthening training on unstable support surfaces are effective in improving the pulmonary function of stroke patients. Therefore, they are expected to be applied to physical therapy programs to help various functional activities.
The Journal of Korean Society for Radiation Therapy
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v.26
no.1
/
pp.29-35
/
2014
Purpose : This study has already started commercial Gated RapidArc automation equipment which was not previously in the Gated radiation therapy can be performed simultaneously with the VMAT Gated RapidArc radiation therapy to the accuracy of the analysis to evaluate the usability, Amplitude mode applied to the patient. Materials and Methods : The analysis of the distribution of radiation dose equivalent quality solid water phantom and GafChromic film was used Film QA film analysis program using the Gamma factor (3%, 3 mm). Three-dimensional dose distribution in order to check the accuracy of Matrixx dosimetry equipment and Compass was used for dose analysis program. Periodic breathing synchronized with solid phantom signals Phantom 4D Phantom and Varian RPM was created by breathing synchronized system, free breathing and breath holding at each of the dose distribution was analyzed. In order to apply to four patients from February 2013 to August 2013 with liver cancer targets enough to get a picture of 4DCT respiratory cycle and then patients are pratice to meet patient's breathing cycle phase mode using the patient eye goggles to see the pattern of the respiratory cycle to be able to follow exactly in a while 4DCT images were acquired. Gated RapidArc treatment Amplitude mode in order to create the breathing cycle breathing performed three times, and then at intervals of 40% to 60% 5-6 seconds and breathing exercises that can not stand (Fig. 5), 40% While they are treated 60% in the interval Beam On hold your breath when you press the button in a way that was treated with semi-automatic. Results : Non-respiratory and respiratory rotational intensity modulated radiation therapy technique absolute calculation dose of using computerized treatment plan were shown a difference of less than 1%, the difference between treatment technique was also less than 1%. Gamma (3%, 3 mm) and showed 99% agreement, each organ-specific dose difference were generally greater than 95% agreement. The rotational intensity modulated radiation therapy, respiratory synchronized to the respiratory cycle created Amplitude mode and the actual patient's breathing cycle could be seen that a good agreement. Conclusion : When you are treated Non-respiratory and respiratory method between volumetric intensity modulated radiation therapy rotation of the absolute dose and dose distribution showed a very good agreement. This breathing technique tuning volumetric intensity modulated radiation therapy using a rotary moving along the thoracic or abdominal breathing can be applied to the treatment of tumors is considered. The actual treatment of patients through the goggles of the respiratory cycle to create Amplitude mode Gated RapidArc treatment equipment that does not automatically apply to the results about 5-6 seconds stopped breathing in breathing synchronized rotary volumetric intensity modulated radiation therapy facilitate could see complement.
In respiratory-induced proton therapy, the accuracy of tracking system and beam controlling is more important than photon therapy. Therefore, a high accuracy motion tracking system that can track internal marker and external surrogate is needed. In this research, our team has installed internal and external marker tracking system at our institution's proton therapy system, and tested the scanning with gating according to the position of marker. The results demonstrate that the developed in-house external/internal marker based gating system can be clinically used for proton therapy system for moving tumor treatment.
Patients with immune-mediated inflammatory diseases (IMIDs) are increasingly being treated with anti-tumor necrosis factor (TNF) agents and are at increased risk of developing tuberculosis (TB). Therefore, diagnosis and treatment of latent TB infection (LTBI) is recommended in these patients due to the initiation of anti-TNF therapy. Traditionally, LTBI has been diagnosed on the basis of clinical factors and a tuberculin skin test. Recently, interferon-gamma releasing assays (IGRAs) that can detect TB infection have become available. Considering the high-risk of developing TB in patients on anti-TNF therapy, the use of both a tuberculin skin test and an IGRA should be considered to detect and treat LTBI in patients with IMIDs. The traditional LTBI treatment regimen consisted of isoniazid monotherapy for 9 months. However, shorter regimens such as 4 months of rifampicin or 3 months of isoniazid/rifampicin are increasingly being used to improve treatment completion rates. In this review, the screening methods for diagnosing latent and active TB before anti-TNF therapy in patients with IMIDs will be briefly described, as well as the current LTBI treatment regimens, the recommendations for managing TB that develops during anti-TNF therapy, the necessity of regular monitoring to detect new TB infection, and the re-initiation of anti-TNF therapy in patients who develop TB.
Objective: The purpose of this study was to investigate the effect of 3-dimensional posture correction(3DPC) exercise program incorporating PNF respiratory muscle strengthening(RMS) exercise on spinal alignment and trunk expansion in patients with idiopathic scoliosis and the difference in intervention effect by type of idiopathic scoliosis. Design: Comparative study using paired t-test and analysis of variance measures. Methods: The subjects of this study were 5 men and 24 women diagnosed with idiopathic scoliosis with a Cobb angle greater than 10 degrees and less than 45 degrees. A 3DPC exercise program incorporating PNF RMS exercise was conducted twice a week for 1 hour per session for 6 weeks, and Cobb angle, Angle of trunk rotation, and trunk expansion were measured before and after the intervention. Results: After the intervention, Cobb angle and trunk rotation angle showed a statistically significant decrease, and trunk expansion showed a statistically significant increase. In the effect difference by type, there was a statistically significant difference in the angle of trunk rotation of the thoracic in 3C and Single Lumbar. Conclusions: In conclusion, it is thought that a 3DPC exercise program incorporating PNF RMS exercise can be effectively used in clinical practice to improve spinal alignment and trunk expansion in patients with idiopathic scoliosis.
Although recent advances in molecular targeted therapy and immuno-oncology have revolutionized the landscape of lung cancer therapeutics, cytotoxic chemotherapy remains an essential component of lung cancer treatment. Extensive evidence has demonstrated the clinical benefit of chemotherapy, either alone or in combination with other treatment modalities, on survival and quality of life of patients with early and advanced lung cancer. Combinational approaches with other classes of anti-neoplastic agents and new drug-delivery systems have revealed promising data and are areas of active investigation. Chemotherapy is recommended as a standard of care in patients that have progressed after tyrosine kinase inhibitors or immune checkpoint inhibitors. Chemotherapy remains the fundamental means of lung cancer management and keeps expanding its clinical implication. This review will discuss the current position and future role of chemotherapy, and specific consideration for its clinical application in the era of precision medicine.
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