• Physical Therapy Rehabilitation Science
• /
• v.13 no.2
• /
• pp.179-186
• /
• 2024

Objective: This study aims to assess the reliability and validity of the new hand-held spirometer as a potential substitute for traditional pulmonary function testing (PFT) devices. Design: Cross-sectional study. Methods: In this study, thirty healthy adults underwent spirometry using both the new hand-held spirometer and the MIR spirometer, which is a standard PFT device. Parameters including peak expiratory flow (PEF), forced expiratory volume in one second (FEV₁), and forced vital capacity (FVC) were measured and analyzed for validity and reliability. Inter-rater reliability and validity were evaluated through 95% limits of agreement (LOA) and intraclass correlation coefficients (ICC). Statistical analyses, including the Bland-Altman plots and the ICC, were utilized to assess agreement between the two devices. Results: The new hand-held spirometer exhibited a good agreement with intra-class coefficient (ICC [2,1]) ranging 0.762 to 0.956 and 95% LOA of -1.94 to 1.80 when compared with MIR. The test-retest reliability of the hand-held spirometer analyzed using - ICC [2,1] demonstrated a good level of consistency (ICC [2,1] =0.849-0.934). Conclusions: In conclusion, the study aimed to assess the potential of the new hand-held spirometer as a viable alternative to traditional PFT devices, with a specific focus on its reliability and validity in spirometric measurements. The new hand-held spirometer exhibited good test-retest reliability across all measured variables, suggesting its potential as a valid and reliable tool for simultaneous PFT measurements.

• The Journal of Korean Physical Therapy
• /
• v.23 no.5
• /
• pp.23-28
• /
• 2011

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.

• Clinics in Shoulder and Elbow
• /
• v.26 no.3
• /
• pp.296-301
• /
• 2023

Background: A supervised physiotherapy program (SPP) is a standard regimen after surgical rotator cuff repair (RCR); however, the effect of a home-based exercise program (HEP), as an alternative, on postoperative functional recovery remains unclear. Therefore, the purpose of this meta-analysis was to compare the functional effects of SPP and HEP after RCR. Methods: We searched electronic databases including Central, Medline, and Embase in April 2022. The primary outcomes included the Constant score, American Shoulder and Elbow Surgeons score, University of California Los Angeles shoulder score, and pain score. Secondary outcomes included range of motion, muscle strength, retear rate, and patient satisfaction rate. A meta-analysis using random-effects models was performed on the pooled results to determine the significance. Results: The initial database search yielded 848 records, five of which met our criteria. Variables at 3 months after surgery were successfully analyzed, including the Constant score (mean difference, -8.51 points; 95% confidence interval [CI], -32.72 to 15.69; P=0.49) and pain score (mean difference, 0.02 cm; 95% CI, -2.29 to 2.33; P=0.99). There were no significant differences between the SPP and HEP. Other variables were not analyzed owing to the lack of data. Conclusions: Our data showed no significant differences between SSP and HEP with regard to the Constant and pain scores at 3 months after RCR. These results suggest that HEP may be an alternative regimen after RCR. Level of evidence: I.

• Tuberculosis and Respiratory Diseases
• /
• v.44 no.5
• /
• pp.1040-1050
• /
• 1997

Pulmonary rehabilitation has been known to improve dyspnea and exercise tolerance in patients with chronic lung disease, although it does not improve pulmonary function. The mechanism of this improvement is not clearly explained till now; however some authors suggested that the improvement in the skeletal muscle metabolism after the rehabilitation could be a possible mechanism. The metabolc changes in skeletal muscle in patients with COPD are characterized by impaired oxidative phosphorylation which causes early activation of anaerobic glycolysis and excess lactate production with exercise. In order to evaluate the change in the skeletal muscle metabolism as a possible cause of the improvement in the exercise tolerance after the rehabilitation, noninvasive $^{31}P$ magnetic resonance spectroscopy(MRS) of the forearm flexor muscle was performed before and after the exercise training in nine patients with chronic lung disease who have undertaken intensive pulmonary rehabilitation for 6 weeks. 31p MRS was studied during the sustained isometric contraction of the dominant forearm flexor muscles up to the exhaustion state and the recovery period. Maximal voluntary contraction(MVC) force of the muscle was measured before the isometric exercise, and then 30% of MVC force was constantly loaded to each patient during the isometric exercise. After the exercise training, exercise endurance of upper and lower extremities and 6 minute walking distance were significantly increased(p<0.05). There were no differences of baseline intracellular pH (pHi) and inorganic phosphate/phosphocreatine(Pi/PCr). After rehabilitation pHi at the exercise and the exhaustion state showed a significant increase($6.91{\pm}0.1$ to $6.99{\pm}0.1$ and $6.76{\pm}0.2$ to $6.84{\pm}0.2$ respectively, p<0.05). Pi/PCr at the exercise and the recovery rate of pHi and Pi/PCr did not show significant differences. These results suggest that the delayed intracellular acidosis of skeletal muscle may contribute to the improvement of exercise endurance after pulmonary rehabilitation.

• Journal of the Korean Society of Physical Medicine
• /
• v.15 no.4
• /
• pp.55-65
• /
• 2020

PURPOSE: This study examined the effects of breathing exercises via joint mobilization on the lung function and spinal alignment of 30 straight-necked women in their 20 s and 30 s. METHODS: The participants were divided into two groups: an experimental group who performed breathing exercises via joint mobilization, and a control group who performed general stretching exercises. The differences between the two groups were measured and compared at three points in time: during the pre-examination, after four weeks of intervention, and after a four-week maintenance period. The changes in each group were measured before and after the intervention and after a one-month maintenance period and compared. For data analysis, the SPSS 22 was used to obtain the mean and standard deviation with a significance level of α = .05. RESULTS: Eight weeks of breathing exercises via joint mobilization and general stretching exercises positively impacted the lung function and spinal alignment in straight-necked patients. In particular, the experimental group showed more significant differences in spinal alignment after four weeks period of intervention and four weeks of maintenance. CONCLUSION: Breathing exercises via joint mobilization can be considered an effective intervention that can improve the respiratory volume and spinal alignment for patients with straight necks.

• PNF and Movement
• /
• v.18 no.2
• /
• pp.297-303
• /
• 2020

Purpose: The purpose of this study was to examine the effects of inhalation and exhalation exercise combined with upper extremity proprioceptive neuromuscular facilitation pattern on two spirometry values: forced volume vital (FVC) and peak expiratory flow (PEF). Methods: Thirty-two healthy adults were divided into two groups: 1) a combined group, which performed upper extremity D2 flexion pattern (shoulder flexed/abducted/external rotated, forearm supinated, wrist radial deviated, and finger extended) during exhalation and D2 extension pattern (shoulder extended/adducted/internal rotated, forearm pronated, wrist ulnar deviated, and finger flexed) during inhalation; and 2) reverse combined group, which performed the D2 flexion pattern during inhalation and the D2 extension pattern during exhalation. The inverse application of upper extremity movements during inhalation and exhalation induced selective resistance or assistance on respiration. FVC and PEF were measured at two time points, before and after four weeks. Results: In both groups, the pre-post intervention comparison showed significant increases in FVC and PEF (p < .05). In the between-groups comparison, the reverse combined group showed a significantly higher PEF than the combined group at four weeks post intervention (p < 0.05). Conclusion: The combined respiration exercise with reverse PNF upper extremity patterns using selective resistance showed an effective increase in PEF in healthy adults. Clinicians and researchers might consider using selective resistance as a widely applicable and cost-effective option for respiratory rehabilitation planning.

• Tuberculosis and Respiratory Diseases
• /
• v.85 no.2
• /
• pp.122-136
• /
• 2022

Although chronic obstructive pulmonary disease (COPD) and interstitial lung disease (ILD) have distinct clinical features, both diseases may coexist in a patient because they share similar risk factors such as smoking, male sex, and old age. Patients with both emphysema in upper lung fields and diffuse ILD are diagnosed with combined pulmonary fibrosis and emphysema (CPFE), which causes substantial clinical deterioration. Patients with CPFE have higher mortality compared with patients who have COPD alone, but results have been inconclusive compared with patients who have idiopathic pulmonary fibrosis (IPF). Poor prognostic factors for CPFE include exacerbation, lung cancer, and pulmonary hypertension. The presence of interstitial lung abnormalities, which may be an early or mild form of ILD, is notable among patients with COPD, and is associated with poor prognosis. Various theories have been proposed regarding the pathophysiology of CPFE. Biomarker analyses have implied that this pathophysiology may be more closely associated with IPF development, rather than COPD or emphysema. Patients with CPFE should be advised to quit smoking and undergo routine lung function tests, and pulmonary rehabilitation may be helpful. Various pharmacologic agents and surgical approaches may be beneficial in patients with CPFE, but further studies are needed.

• Tuberculosis and Respiratory Diseases
• /
• v.43 no.5
• /
• pp.736-745
• /
• 1996

Background : It is known that pulmonary rehabilitation improves dyspnea and exercise tolerance in patient with chronic lung disease, although it does not improve pulmonary function. But there is a controversy whether this improvement after pulmonary rehabilitation is due to increased aerobic exercise capacity. We performed this study to evaluate the effect of pulmonary rehabilitation for 6 weeks on the pulmonary function, gas exchange, exercise tolerance and aerobic exercise capacity in patients with chronic lung disease. Methods : Pulmonary rehabilitations including education, muscle strengthening exercise and symptom-Umited aerobic exercise for six weeks, were performed in fourteen patients with chronic lung disease (COPD 11, bronchiectasis 1, IPF 1, sarcoidosis 1 ; mean age $57{\pm}4$ years; male 12, female 2). Pre- and post-rehabilitaion pulmonary function and exercise capacity were compared. Results: 1) Before the rehabilitation, FVC, $FEV_1$ and $FEF_{25-75%}$ of the patients were $71.5{\pm}6.4%$. $40.6{\pm}3.4%$ and $19.3{\pm}3.8%$ of predicted value respectively. TLC, FRC and RV were $130.3{\pm}9.3%$, $157.3{\pm}13.2%$ and $211.1{\pm}23.9%$ predicted respectively. Diffusing capacity and MVV were $59.1{\pm}1.1%$ and $48.6{\pm}6.2%$. These pulmonary functions did not change after pulmonary rehabilitation. 2) In the incremental exercise test using bicycle ergometer, maximum work rale ($57.7{\pm}4.9$) watts vs. $64.8{\pm}6.0$ watts, P=0.036), maximum oxygen consumption ($0.81{\pm}0.07$ L/min vs. $0.96{\mu}0.08$ L/min, P=0.009) and anaerobic threshold ($0.60{\pm}0.06$ L/min vs. $0.76{\mu}0.06$ L/min, P=0.009) were significantly increased after pulmonary rehabilitation. There was no improvement in gas exchange after rehabilitation. 3) Exercise endurances of upper ($4.5{\pm}0.7$ joule vs. $14.8{\pm}2.4$ joule, P<0.001) and lower extremity ($25.4{\pm}5.7$ joule vs. $42.6{\pm}7.7$ joule, P<0.001), and 6 minute walking distance ($392{\pm}35$ meter vs. $459{\pm}33$ meter, P<0.001) were significantly increased after rehabilitation. Maximum inspiratory pressure was also increased after rehabilitation ($68.5{\pm}5.4$ $CmH_2O$ VS. $80.4{\pm}6.4$ $CmH_2O$, P<0.001). Conclusion: The pulmonary rehabilitation for 6 weeks can improve exercise performance in patients with chronic lung disease.

• Clinical and Experimental Pediatrics
• /
• v.52 no.4
• /
• pp.471-475
• /
• 2009

Purpose : Mitochondrial disorders are a clinical entity characterized by diverse symptoms and signs of involvement of various systems. Furthermore, the disorders are known to show ophthalmologic manifestations as well as neurological findings. Visually evoked potential is a sensitive measure to check the integrity of the visual pathway. In this study, we have investigated the value of visually evoked potential in mitochondrial disorders with respiratory chain defects. Methods : Nineteen patients diagnosed with mitochondrial respiratory chain complex I defect as confirmed by spectrophotometric enzyme assay in muscle samples were enrolled for this study. The patients underwent a visually evoked potential study. We classified the results into four groups and compared these with clinical ophthalmologic findings. Results : Among the 19 patients, 14 showed abnormal visually evoked potential findings. Seven patients showed abnormal clinical ophthalmologic findings. All patients with abnormal ophthalmologic findings showed abnormal visually evoked potential findings. Among the 12 patients with normal ophthalmologic findings, seven showed abnormal results in visually evoked potential. Conclusion : Visually evoked potential study could be used as an effective screening tool for mitochondrial disorders to detect ophthalmologic and neurological abnormalities.

• The Journal of Korean Physical Therapy
• /
• v.24 no.5
• /
• pp.355-361
• /
• 2012

Purpose: The purpose of this study was to evaluate the effectiveness of pulmonary rehabilitation on lung function and fatigue in persons with chronic obstructive pulmonary disease (COPD). Methods: Thirty one persons with COPD participated in this study. Four groups were allocated as follows: experimental group 1 (under 10 years of the post-disease period), control group 1 (under 10 years of the post-disease period), experimental group 2 (over 10 years of the post-disease period), and control group 2 (over 10 years of the post-disease period). Results: Forced expired volume in one second (FEV1) % pred and lactic acid showed improvement in experimental group 1 and experimental group 2 after training. Control group 1 and control group 2 did not show improvement of FEV1% pred and lactic acid after training. However, FEV1% pred and lactic acid in experimental group 1 were not significantly different, compared with the experimental group. Conclusion: Results of our study suggest that implementation of a pulmonary rehabilitation program resulted in improvement of lung function and fatigue in persons with COPD not related to the post-disease period.