Purpose: This study examined the effects of sagittal spinopelvic alignment on the clinical parameters, motor symptoms, and respiratory function in patients with mild to moderate Parkinson's disease (PD). Methods: This study was a prospective assessment of treated patients (n=28, Hoehn and Yahr (H&Y) stage 2-3) in a PD center. Twenty-eight subjects ($68.5{\pm}5.7yrs$) participated in this study. The clinical and demographic parameters, including age, sex, symptoms duration, treatment duration, and H&Y stage, were collected. Kinematic analysis was conducted in the upright standing posture with a motion capture system. A pulmonary function test (PFT) was performed in the sitting position using a spirometer. The motor symptoms were assessed on part III of the movement disorder society sponsored version of the unified Parkinson's disease rating scale (MDS-UPDRS). SPSS 18.0 was used to analyze the collected data. Results: The exceeding 12 degrees group of the lower trunk showed significantly higher on the clinical parameters than the below 12 degrees group. In addition, the exceeding 12 degrees group of the lower trunk showed a significantly lower forced expiratory volume at one second (FEV1) / forced vital capacity (FVC) (%) and 25-75% forced mid-expiratory flow (FEF) (L/s) than in the below group. On the other hand, there was no difference in the upper trunk and the cervical pelvis between the groups. Conclusion: These findings suggest that the sagittal balance in the lower trunk is related to the clinical parameters and respiratory function, but not the motor symptoms in patients with mild to moderate PD.
Purpose: This study investigated the effects of proprioceptive neuromuscular facilitation (PNF) respiratory muscle strengthening exercise on the pulmonary function, back pain, and disability level of patients with chronic low back pain (CLBP). Methods: There were 24 CLBP patients randomly divided into the experimental group (n = 12) who took part in PNF respiratory muscle strengthening exercise and the control group (n = 12) who performed a mock treatment. Both groups performed their respective interventions for 15 min five times per week for four weeks. The pulmonary function was measured using a portable spirometer. The back pain of the participants was assessed using a visual analogue scale. The Oswestry disability index was conducted to measure disability level. A paired t-test was performed to compare within-group changes before and after the PNF respiratory muscle strengthening exercise. Differences between the experimental and the control groups were analyzed using an independent t-test. For all tests, the level of statistical significance was α = 0.05. Results: The within-group change in pulmonary function was significantly different in the experimental group (p < 0.05), and the levels of back pain and disability were significantly different between the groups (p < 0.05). There was also a significant between-group difference in pulmonary function, back pain, and disability level after intervention (p < 0.05). Conclusion: These results suggest that PNF respiratory muscle strengthening exercise enhances pulmonary function and reduces levels of back pain and disability in patients with CLBP.
Purpose : The purpose of this study was to investigate a comparative study on the effects of maximum voluntary ventilation (MVV) and thickness of the abdominal muscles through two Kegel exercise postures. Methods : Twenty eight (male= 7, female= 21) subjects participated in this experiment. They performed Kegel exercise in sitting and hooklying. The order of exercise was conducted in the order chosen by the subjects to exclude the learning effect. The MVV was measured using a spirometer. The thickness of the abdominal muscles were measured by ultrasound. The MVV and thickness of the abdominal muscles were measured according to the manual in a sitting and hooklying position before the experiment. After each exercise, the MVV and thickness of the abdominal muscles were also measured in the same way. A one way repeated measures analysis of variance (ANOVA) was used to compare the MVV and thickness of the abdominal muscles according to two postures and post hoc analysis, Bonferroni was used. Results : As a result of this study, significant differences in the MVV were observed after exercise than before exercise (p<.05). However, as a result of post hoc analysis, there was no difference in the MVV according to the postures (p>.05). Significant differences in thickness of the abdominal muscles were observed after exercise than before exercise (p<.05). However, as a result of post hoc analysis, there was no difference in thickness of the abdominal muscles according to the postures (p>.05). Conclusion : Based on the results of this study, the MVV and the thickness of the abdominal muscles were confirmed in the sitting and hooklying posture after Kegel exercise. However, further studies on vital capacity and abdominal muscles according to Kegel exercise postures should be conducted.
Background: This study was to determine whether the diaphragmatic breathing exercise using a DiP Belt(Diaphragmatic Pressure Belt) is effective in increasing the diaphragmatic motion and forced vital capacity. Design: Pretest-Posttest design. Methods: A total of 44 subjects(15 male, 29 female) participated in this study. All subjects were measured the diaphragmatic motion with a sonography and the Forced Vital Capacity(FVC) was measured with a digital spirometer. After 4 weeks, the subjects were intervened the diaphragmatic breathing exercise using a DiP belt and were remeasured for diaphragm motion and FVC. Results: After exercise intervention, quiet breathing significantly increased with the change in diaphragmatic motion and showed a moderate effect size (p<.01, Cohen's d = -0.53). In addition, it was significantly increased in deep breathing and showed a high effect size (p<.001, Cohen's d = -1.32). The mean diaphragmatic contraction pressure increased, but there was no significant difference and the peak diaphragmatic contraction pressure increased significantly (p<.05). Both diaphragmatic contraction pressure showed small effect sizes (respectively Cohen's d = -0.28, -0.33). In spirometry, FVC, Forced Expiratory Volume in 1 second (FEV1), and FEV1/FVC% all increased, but there was no significant difference. Only peak expiratory flow increased significantly and showed a small effect size (p<.05, Cohen's d = -0.41). Conclusion: The DiP belt diaphragmatic breathing exercise that the principle of visual feedback can correct diaphragm breathing in a short time, so it is a useful breathing exercise device that can help the diaphragm breathing exercise in the right way in clinical practice.
Purpose : The purpose of this study was to investigate the effect of stair exercise and Kegel combined exercise on the maximum voluntary ventilation (MVV) and limits of stability (LOS). Methods : 23 female students participated in this experiment. MVV was measured with a spirometer. The LOS was measured with a Biorescue. Subjects were randomly assigned to two groups. 12 subjects were assigned to the experimental group and 11 subjects were assigned to the control group. The experimental group performed 5 minutes of stair exercise and 5 minutes of Kegel exercise. The control group performed 10 minutes of stair exercise. After 5 minutes of exercise, 1 minute of rest was provided. Both groups exercised for 5 minutes according to the metronome beat 130 during the stair exercise. After 5 minutes of rest after exercise, MVV and LOS were measured again in the same way. The measurement sequence was also randomly alternated. Results : Significant differences were found within and between groups in the experimental group in MVV (p<.05). In LOS, significant differences were confirmed in left, right, forward, backward, and total LOS in the experimental group (p<.05). In the control group, there were significant differences in left, forward, and total LOS (p<.05). However, there was no significant difference between groups (p>.05). Conclusion : Based on the results of this study, it was confirmed that the stairs and Kegel combined exercise had a positive effect on MVV and LOS. However, in the short term, it was found that the stair and Kegel combined exercise was insufficient in time and the threshold of exercise to show the difference between groups in LOS. Therefore, additional research should be conducted by modifying the limitations of this study.
Purpose : Kegel exercises reported that it is effective in managing stress-related or complex urinary incontinence through contraction and relaxation of the pelvic floor muscles. In many previous studies, it was confirmed that Kegel exercise is involved in respiration as well as urinary system diseases. However, there is a lack of research on the effect of pelvic setting when performing Kegel exercises. Therefore, this study was conducted to investigate the effect on maximum voluntary ventilation (MVV) and abdominal muscle thickness through Kegel exercise after lumbar-pelvic motor control using pressure biofeedback unit (PBU). Methods : The subjects of this study were 10 healthy female students in their 20s. Subjects measured MVV with a spirometer. In hooklying, external oblique, internal oblique, and transverse abdominis of the dominant hand were measured using ultrasound. The measured value was an average of three times. After one week of intervention, measurements were made in the same manner. Before Kegel exercise, pelvic setting training was performed using PBU. In hooklying, PBU was placed in the waist and set to 40 mmHg, and it was adjusted to 60 mmHg through pelvic muscle contraction. For Kegel exercise, the pelvis was first set using PBU, and then the pelvic floor muscles were contracted for 8 seconds and relaxed for 8 seconds, 10 times, 1 set, and 3 sets. Results : In MVV, a significant difference was confirmed after exercise than before exercise (p<.05). There was also a significant difference in abdominal muscle thickness before and after exercise (p<.05). Conclusion : Based on the results of this study, Kegel exercise using PBU had an effect on MVV and abdominal muscle thickness. However, since this study was conducted without a control group as a preliminary study, additional research should be conducted to supplement this.
Purpose: Pneumoconiosis is a chronic lung disease in which the lungs become hardened due to the accumulation of fine mineral dust that has been breathed in at industrial sites. The lungs are unable to function properly, resulting in complications of several respiratory diseases. Methods: The subjects were 36 elderly adults (pneumoconiosis patients 18, healthy elderly 18) over the age of 65 years. The respiratory function was assessed using a spirometer to measure forced vital capacity (FVC), first second of forced expiration (FEV1), FEV1/FVC, and peak expiratory flow n(PEF). The static balance function test was determined by the center of mass (COM), ankle angle range, hip angle range, sway parameters, and reciprocal compensatory index (RCI). Cognitive function was measured by applying MoCA-k. Results: Comparison of respiration functions between the two groups showed statistically significant differences in FVC, FEV1, FEV1/FVC, and PEFs (p<0.05). Cognitive abilities showed statistically significant differences due to higher cognitive skills in the control group as compared to the patient group (p<0.05). Most results of the static balance capability measurements showed statistically significant differences between the groups (p<0.05). However, no statistically significant differences were obtained for COM AP Range, Angle AP Range, RCI ML Range, and AP Range (p>0.05). Conclusion: The results of the current study indicate that patients suffering from pneumoconiosis have less cognitive ability and balance function as compared to healthy elderly people. Therefore, we expect an improvement in the balance ability and cognitive function through systematic management and strengthening lung function training to improve the quality of life of pneumoconiosis patients.
Purpose : This study was conducted to determine the effect of intervention using a smartphone application on abdominal muscle thickness and maximum voluntary ventilation when conducting pelvic floor muscle exercise (PFME). Methods : This study was performed on 14 subjects. They were divided into two groups; PFME using smartphone application (n=7), common PFME (n=7). Both of group executed the exercise 5 times a week for 1 weeks. Abdominal muscle thickness was measured using ultrasound. Maximum voluntary ventilation was measured using a spirometer. The smartphone application used the paid version of Kegel trainer. This material was analyzed by the paired t-test to compare differences on each group and the independent t-test to compare between the two groups. Results : The PFME group using the smartphone application showed a significant increase in the transverse abdominis and internal oblique muscles (p<.05). The common PFME group showed a significant increase in the internal oblique muscle (p<.05). There was no significant difference in variation of the muscle thickness between the two groups (p>.05). The PFME group using the smartphone application showed a significant increase in the maximal voluntary ventilation (p<.05). There was no significant difference in variation of the maximal voluntary ventilation between the two groups (p>.05). Conclusion : As a results of this study, PFME using a smartphone application seems to induce voluntary participation of subjects and maintain continuity against time constraints. As a result, it is thought that using a smartphone application when performing PFME is efficient and convenient in terms of research method. However, this study is difficult to generalize due to the small number of subjects and short intervention period. Therefore, additional research should be conducted by modifying and supplementing these limitations.
Background: Obstructive sleep apnea (OSA) is a prevalent sleep disorder associated with various health issues. Although some studies have suggested an association between reduced lung function and OSA, this association remains unclear. Our study aimed to explore this relationship using data from a nationally representative population-based survey. Methods: We performed an analysis of data from the 2019 Korea National Health and Nutrition Examination Survey. Our study encompassed 3,675 participants aged 40 years and older. Risk of OSA was assessed using the STOP-Bang (Snoring, Tiredness during daytime, Observed apnea, and high blood Pressure-Body mass index, Age, Neck circumference, Gender) questionnaire and lung function tests were performed using a portable spirometer. Logistic regression analysis was applied to identify the risk factors associated with a high-risk of OSA, defined as a STOP-Bang score of ≥3. Results: Of 3,675 participants, 600 (16.3%) were classified into high-risk OSA group. Participants in the high-risk OSA group were older, had a higher body mass index, and a higher proportion of males and ever-smokers. They also reported lower lung function and quality of life index in various domains along with increased respiratory symptoms. Univariate logistic regression analysis indicated a significant association between impaired lung function and a high-risk of OSA. However, in the multivariable analysis, only chronic cough (odds ratio [OR], 2.413; 95% confidence interval [CI], 1.383 to 4.213) and sputum production (OR, 1.868; 95% CI, 1.166 to 2.992) remained significantly associated with a high OSA risk. Conclusion: Our study suggested that, rather than baseline lung function, chronic cough, and sputum production are more significantly associated with OSA risk.
Spirometry is a physiological test for assessing the functional aspect of the lungs using an objective indicator to measure the maximum amount of air that a patient can inhale and exhale. Acceptable spirometry testing needs to be conducted three times by an acceptable and reproducible method for determining forced vital capacity (FVC). Until the results of three tests meet the criteria of reproducibility, the test should be repeated up to eight times. Interpretation of spirometry should be clear, concise, and informative. Additionally, spirometry should guarantee optimal quality prior to the interpreting spirometry results. Our guideline adopts a fixed normal predictive value instead of the lower limit of normal as the reference value because fixed value is more convenient and also accepts FVC instead of vital capacity (VC) because measurement of VC using a spirometer is impossible. The bronchodilator test is a method for measuring the changes in lung capacity after inhaling a short-acting ${\beta}-agonist$ that dilates the airway. When an obstructive ventilatory defect is observed, this test helps to diagnose and evaluate asthma and chronic obstructive pulmonary disease by measuring reversibility with the use of an inhaled bronchodilator. A positive response to a bronchodilator is generally defined as an increase of ${\geq}12%$ and ${\geq}200mL$ as an absolute value compared with a baseline in either forced expiratory volume at 1 second or FVC.
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