• 제목/요약/키워드: Respiratory therapy

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Update of Sepsis: Recent Evidences about Early Goal Directed Therapy

  • Cho, Woo Hyun
    • Tuberculosis and Respiratory Diseases
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    • 제78권3호
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    • pp.156-160
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    • 2015
  • Severe sepsis and septic shock is a life-threatening disease. It is combined with multi-organ failure. In the past decade, early goal directed therapy has been proposed as an effective treatment strategy for better outcome. Recent epidemiologic studies showed that the outcome of sepsis has been improved with the introduction of early goal directed therapy. However, it is unclear which elements of early goal directed therapy contributed to the better outcome. Recent prospective and randomized trials suggested that some elements of early goal directed therapy did not have any effect on the outcome benefit. In this paper, recent articles about early goal directed therapy will be reviewed and the effectiveness of individual elements of early goal directed therapy will be discussed.

치료적 복합운동이 제한성 폐질환 노인의 호흡기능과 체간자세 개선에 미치는 효과 (Effects of Combined Therapeutic Exercise on Improvement of Respiratory Function and Trunk Posture in Elderly Patients with Restrictive Lung Disease)

  • 왕중산
    • 디지털융복합연구
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    • 제13권9호
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    • pp.333-339
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    • 2015
  • 본 연구의 목적은 호흡기 장애가 있는 제한성 폐질환 노인의 체간에 관절가동술과 스트레칭이 호흡기능, 자세, 신체피로감의 개선효과를 확인하는데 있다. 연구대상자는 총 10명으로 2014년 1월부터 동년 11월까지 8주간 비동시적으로 진행되었고, 주 3회, 1일 30분간 체간에 관절가동술과 스트레칭을 실시하였다. 연구 결과 FVC, FEV1, 체간자세, 체간움직임, 신체피로감이 유의하게 개선되었다(p<.05). 본 연구를 통해 관절가동술과 스트레칭이 호흡기장애 노인의 호흡기능, 체간자세, 체간움직임, 신체피로감을 동시에 개선시킬 수 있는 호흡정형물리치료가 될 수 있음을 확인하였다. 이후 연구들에서는 제한성 폐질환 노인을 대상으로 본 연구에서 적용한 호흡정형물리치료와 운동 분야들과의 치료적 융복합을 통한 지속적인 연구가 필요하겠다.

복부 브레이싱 운동이 20대 성인의 호흡기능에 미치는 영향에 관한 예비연구 (A Preliminary Study on Effects of Abdominal Bracing Exercise on Respiratory Function of Normal Adults)

  • 장혜리;황보각;이도연
    • 한국산학기술학회논문지
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    • 제20권7호
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    • pp.236-241
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    • 2019
  • 요부안정화 운동은 척추 주변 근육과 복부 근육을 강화시켜 최근 임상에서 많이 사용하는 운동 방법이지만 호흡기능에 어떠한 영향을 미치는지에 대한 연구는 부족한 실정이다. 이에 본 연구에서는 대표적인 요부안정화 운동인 복부 브레이싱 운동이 정상 성인의 호흡기능에 효과적인지를 알아보고자 실시하였다. 20대 성인 40명을 대상으로 각각 복부 브레이싱 운동을 25분간 실시하는 실험군과 일상생활을 25분간 하는 대조군으로 무작위 배치하였다. 호흡기능의 변화량을 비교하기 위하여 노력성 폐활량, 1초간 노력성 호기량과 최대호기유속을 통해 폐기능 검사를 하였고, 호흡압력의 변화량을 알아보기 위해 최대 호기압력과 최대 흡기압력을 측정하였다. 본 연구의 실험 결과 실험군에서 폐기능과 호흡압력 모두 유의하게 증가되었고(p<.05), 그룹 간 비교에서는 최대 흡기압력을 제외한 나머지 수치에서 유의한 차이가 있었다(p<.05). 이러한 결과는 복부 브레이싱 운동이 호흡기능을 향상시키기 위한 효과적인 운동으로 제시될 수 있다고 사료된다.

간암 호흡동조 방사선치료 환자의 호흡신호분석 (Respiratory signal analysis of liver cancer patients with respiratory-gated radiation therapy)

  • 강동임;정상훈;김철종;박희철;최병기
    • 대한방사선치료학회지
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    • 제27권1호
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    • pp.23-30
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    • 2015
  • 목 적 : 외부표지자 호흡움직임 측정 장치(RPM; Real-time Position Management, Varian Medical System, USA)를 이용한 간암 호흡동조 방사선치료 시 호흡신호와 방사선 조사 시간 및 실제 조사된 호흡위상을 분석하여 호흡움직임 측정 장치를 이용한 호흡동조 방사선 치료의 정확도를 평가하였다. 대상 및 방법 : 2014년 5월부터 9월까지 Novalis Tx.(Varian Medical System, USA)와 RPM을 이용하여 간암 호흡동조 방사선치료(Duty Cycle 20%, Gating window 40% ~ 60%)를 시행한 환자 총 16명의 치료 시 기록된 호흡움직임을 분석하였다. RPM에 기록된 외부표지자의 호흡움직임을 후행적 분석을 통해 호흡위상으로 재구성하였으며, 재구성된 호흡위상을 이용하여 기록된 Beam-on Time과 Duty Cycle에 대해 RPM을 사용한 호흡동조 방사선치료의 예측 정확도를 분석하고, 호흡움직임의 재현성에 따른 Duty Cycle과 예측 정확도의 상관관계를 분석하였다. 결 과 : 대상 환자 16명의 치료계획 시와 실제 치료 시 호흡주기 차이는 평균 -0.03초(범위 -0.50초 ~ 0.09초)로 분석되었으며 두 호흡간의 통계적 차이는 확인할 수 없었다(p=0.472). 치료 시 평균 호흡주기는 4.02 sec (${\pm}0.71sec$), 치료 중 호흡주기 표준편차의 평균값은 7.43%(범위 2.57% ~ 19.20%)로 분석되었다. 실제 Duty Cycle은 평균 16.05%(범위 13.78% ~ 17.41%)로 나타났고 이 중 후행적 분석을 통해 평균 56.05%(범위 39.23% ~ 75.10%)가 계획된 호흡위상(40% ~ 60%)에서 조사되었음을 확인하였다. 호흡주기의 표준편차와 Duty Cycle과 계획된 호흡위상에서 조사된 비율의 상관관계는 각각 -0.156 (p=0.282)와 -0.385 (p=0.070)으로 분석되었다. 결 론 : 본 연구는 실제 치료 중 기록된 외부표지자의 호흡움직임을 후행적으로 분석하여 치료 중 호흡움직임의 재현성 및 Duty Cycle, 계획된 호흡동조창에서의 실제 치료 비율 등을 확인하였다. 4DCT를 이용한 치료계획과의 오차를 최소화하고 효율적인 치료를 위해 호흡훈련 및 호흡신호 모니터링의 강화가 필요 할 것으로 판단된다.

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노력성 호흡운동을 통한 편마비환자의 기능적 보행지수 개선 (The improve of hemiplegic patients functional ambulation profile by forceful respiratory exercise)

  • 김병조;배성수;황보각
    • The Journal of Korean Physical Therapy
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    • 제16권1호
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    • pp.32-48
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    • 2004
  • The purpose of this study was to evaluate the change of functional ambulation profile(FAP) and temporal-spatial gait parameters in hemiplegic patient by forceful respiratory exercise. 28 Hemiplegic patients due to stroke was randomized in 3 groups, forceful expiratory training(FET), forceful inspiratory training(FIT) and control group. In the experimental groups, ordinary physical therapy with forceful expiratory training and forceful inspiratory training for 20 minutes duration 3 times per week for 6 weeks were respectively performed. In the control group, only ordinary physical therapy was done. FAP and temporal-spatial gait parameters was measured at before and after experiments. The results of this experimental study were as follows : 1. In comparison of FAP before and after experiment, the FAP was significantly increased in the FET and FIT group (p<.01). In comparison of difference of FAP among 3 groups, there was the significant difference between the FIT group and the control group (p<.05). 2. The results of temporal-spatial gait parameters are as follows : 1) In comparison of gait velocity before and after experiment, the gait velocity was significantly increased in the FET and FIT group (p<.05). In comparison of difference of the gait velocity among 3 groups, there was the significantly difference between the FIT group and the control group (p<.05). 2) In comparison of gait cadence before and after experiment, the gait cadence was significantly increased in FIT group (p<.05). In comparison of the difference of the gait cadence among 3 groups, there was no significant difference between the FIT group and the control group (p>.05). Based on these results, it is concluded that the forced respiratory exercise program for 6 weeks can be improve the FAP and temporal-spatial gait parameters in hemiplegic patients. Therefore, the forced respiratory exercise is useful to improve the walking ability in hemiplegic patients.

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Effects of Respiratory Muscle Activity in Stroke Patients after Feedback Breathing Exercise

  • Han, Jong Man;Kim, Hyeon Ae;Koo, Ja Pung;Seo, Kyo Chul
    • 국제물리치료학회지
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    • 제4권2호
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    • pp.552-556
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    • 2013
  • The purpose of this study is to examine the effects of feedback breathing exercise on respiratory muscle activity. Thirty stroke patients were randomly and equally assigned to an experimental group and a control group. The experimental group received rehabilitation exercise treatment for 30 minutes and feedback respiratory exercise for 30 minutes and the control group received rehabilitation exercise treatment for 30 minutes and conducted motomed exercise for 30 minutes. All of them conducted exercises five times per week for four weeks. Respiratory muscles including the upper trapezius(UT), longissimus dorsi(LD), rectus abdominis(RA), external abdominal oblique(EAO) and, internal abdominal oblique(IAO) were measured using MP 150WSW prior to and after the experiment. Regarding pulmonary functions prior to and after the experiment, the experimental group showed significant differences in all sections but the control group did not show significant differences in any sections. As for in-between group differences after the experiment, there were significant differences in the UT, LD, RA, and IAO but no significant differences in the EAO. In conclusion, respiratory muscle activity was more effective for the experimental group than the control group. It is considered that feedback respiratory exercise may induce improvement in respiratory muscles in stroke patients through feedback breathing exercise.

호흡 주기와 자세에 따른 자율신경계의 변화 (Autonomic Nervous System Changes Associated with Respiratory Cycle and Posture)

  • 송성인;구봉오
    • 대한통합의학회지
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    • 제6권2호
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    • pp.17-23
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    • 2018
  • Purpose : The purpose of this study was to investigate whether the respiratory cycle and posture can modulate the autonomic nervous system. Methods : Thirty-two healthy men and women, aged 20-30 years, were enrolled in this study. We conducted 2-second and 6-second respiratory cycle with the subjects in standing, sitting, and supine positions, respectively. Their heart rate variability was measured in each position for both cycle lengths. Results : The low frequency/high frequency (LF/HF) ratio is derived from heart rate variability. In the 2-second respiratory cycles, the LF/HF ratios were highest in standing, sitting, and supine position in descending order. There was a significant difference in heart rate between standing and sitting positions (P<.005). In addition, there was a significant difference in heart rate between standing and supine position (P<.000). In the 6-second respiratory cycles, the LF/HF ratios were again highest in a standing, sitting, and supine position in descending order. However, posture was not found to make a significant difference in this case. Conclusion : Respiratory cycle and posture effectively modulated the autonomic nervous system. Further studies of the clinical application of these results should be conducted.

수중과 지상에서 대각선 패턴 운동이 만성 뇌졸중 환자의 균형 자신감과 호흡 기능에 미치는 효과 비교 (Comparing the Effects of Underwater and Ground-Based Diagonal Pattern Exercises on the Balance Confidence and Respiratory Functions of Chronic Stroke Patients)

  • 박재철;이동규
    • PNF and Movement
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    • 제19권2호
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    • pp.173-182
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    • 2021
  • Purpose: The purpose of this study was to compare the effects of underwater and ground-based diagonal pattern exercises on the balance confidence and respiratory functions of chronic stroke patients. Methods: Thirty chronic stroke patients were assigned randomly to an experimental (n = 15) or control (n = 15) group. The experimental group performed an underwater diagonal pattern exercise. The control group performed a ground-based diagonal pattern exercise. Training was conducted once a day for 30 minutes, five days per week for six weeks. Balance confidence was measured using the Activities-Specific Balance Confidence Scale-Korea version. Respiratory function was measured using a spirometer. Results: In a comparison within groups, the experimental and control groups showed significant differences in balance confidence after the experiment (p < 0.05). In a comparison between the two groups, the experimental group showed a more significant difference in balance confidence than the control group (p < 0.05). In a comparison within groups, the experimental group showed a significant difference in respiratory functions after the experiment (p < 0.05). In a comparison between the two groups, the experimental group showed a more significant difference in respiratory functions than the control group (p < 0.05). Conclusion: Based on these results, underwater diagonal pattern exercises effectively improved the balance confidence and respiratory functions of chronic stroke patients.

간섭파가 노인의 교감신경계에 미치는 영향 (The Effects of Interferential Current Therapy on Sympathetic Nerve System in Senile patients)

  • 박래준;이문환;김동현
    • The Journal of Korean Physical Therapy
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    • 제15권2호
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    • pp.111-122
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    • 2003
  • The purpose of this study was to investigate the influence on sympathetic nerve system of interferential current therapy(ICT). The subjects were consisted of 20 senile patients, 10 males and 10 females with an average age of 71 years old. And systolic and diastolic blood pressure, temperature, heart rate, and respiratory were tested. The results were as follows: 1) Systolic and diastolic blood pressure were observed a statistical significance between before and during stimulation(p < .05). 2) Temperature was observed a statistical significance between before and during, and before and after 10 minutes stimulation(p < .05). 3) Heart rate and respiratory were not statistical significance(p > .05). These results are imply that electrical stimulation is directly or indirectly influence on sympathetic nerve system.

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인공호흡기 치료를 받은 흉부외상 환자의 임상적 고찰 (Clinical experience of ventilator therapy in chest trauma)

  • 서강석
    • Journal of Chest Surgery
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    • 제26권1호
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    • pp.59-63
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    • 1993
  • A clinical evaluation was performed with a population of 49 patients of chest trauma, who were diagnosed to undergo ventilator therapy, and had gone through ventilator therapy at the Department of Thoracic and Cardiovascular Surgery, Kyungpook University Hospital. One of most common causes of chest trauma was vehicle accidents [77.5%] with the prevalent age group being their forties. The common findings were multiple rib fractures [89.8%], hemopneumothrax [81.6%], lung contusion [61.2%] and flail chest [44.9%]. Their common combined injuries were the orthopedics and neurosugical injuries [86.7%]. Complications caused by chest trauma were pneumonia, respiratory failure, atelectasis, barotrauma and empyema. Pulmonary infections were commonly associated with mechanical ventilation in the long term group and were best prevented by using bronchial hygiene therapy.The mortality rate was 5.8% of the total patients and that was 38.8% of the patients, who needed ventilator therapy. The causes of death were pneumonia, respiratory failure, acute renal failure and hypovolemic shock. Mechanical ventilation has an important place in the treatment of patients with severe chest trauma.

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