• Journal of The Korean Society of Integrative Medicine
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• v.12 no.2
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• pp.55-63
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• 2024

Purpose : The purpose of this study is to determine the effects of scapula and pelvis symmetrical reciprocal pattern exercise of PNF concept on respiratory function and quality of life in elderly subjects. Methods : Nineteen elderly subjects with healthy were recruited. Subjects performed scapula and pelvis symmetrical reciprocal pattern exercise of PNF concept. Exercise was appied 30 minutes three times per week for four weeks. The respiratory function and quality of life (QOL) test three times (before, two weeks, and four weeks). Respiratory function includes forced vital capacity (FVC), forced expiratory volume at one second (FEV₁), Peak Expiratory Flow (PEF) and chest cage expansion test (CCET). The QOL test was measured Korean WHOQOL-BRIEF. The analysis method was analyzed through the one-way ANOVA repeated methods, and the statistical significance is α=.05. It was analyzed through the post test Bonferroni test. Results : After the 4 week scapula and pelvis symmetrical reciprocal pattern exercise of PNF concept showed statistically significant differences in the respiratory function (FVC, FEV₁, PEF, and CCET), and QOL (p<.05). As a result of the post-hoc test, FVC showed a significant increase in the mid test and post test compared to the pre test (p<.05), FEV₁ showed a significant increase in the post test compared to the pre test (p<.05). PEF showed a significant increase in all pre-test, mid-test, and post-test sections (p<.05), CCET showed a significant increase in all pre-test, mid-test, and post-test sections (p<.05). QOL showed a significant increase in all pre-test, mid-test, and post-test sections (p<.05). Conclusion : In this study, the scapula and pelvis symmetrical reciprocal pattern exercise of PNF concept improved respiratory function and QOL. The findings suggest that this intervention could be beneficial in improving respiratory function and QOL in the elderly.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.30 no.1
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• pp.29-42
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• 2024

Background: This study aimed to determine the effects of training on breathing re-education on pain and dysfunction levels, posture, quality of life (QoL), and pulmonary function in patients. Methods: This study included 34 patients with chronic neck pain and upper thoracic breathing pattern were included. The participants were assigned to either the routine physical therapy program (RPTP) (CG; n=17) or RPTP and breathing pattern re-education training (EG; n=17). The CG and EG groups performed RPTP for 40 minutes, and only the EG groups performed breathing re-education training for 10 minutes. Exercises were performed thrice weekly for both groups. Level of pain and dysfunction, posture, QoL and pulmonary function status were assessed before and after the intervention. Results: After four weeks of intervention, numeric pain rating scale (NPRS), Korean version of neck disability index, cranio-vertebral angle, cranial rotation angle, and 12-item short form health survey-physical and mental component summaries had significant differences before and after intervention in both groups (p<.01). However, only NPRS, forced vital capacity, forced expiratory volume in 1s, and maximum voluntary ventilation showed significant interactions between the two groups and measurement time (p<.01). Conclusion: Breathing re-education training and RPTP may be optimal for patients with chronic neck pain and may be more effective in improving neck pain and pulmonary function.

• Physical Therapy Rehabilitation Science
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• v.13 no.1
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• pp.26-35
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• 2024

Objective: The aim of this study is to explore how using inspiratory training affects the respiratory function and balance of stroke patients. We also plan to compare the results with a control group that does not receive the intervention. Design: A Randomized Controlled Trial Methods: In this study, 27 chronic stroke patients were randomly assigned to either a control group (n=14) or an experimental group (n=13). Both groups underwent six weeks of common interventions involving standard physiotherapy and treadmill training. Additionally, the experimental group received inspiratory training. Respiratory function and balance were evaluated using Forced Vital Capacity (FVC), Forced Expiratory Volume in 1 second (FEV1), Maximal Inspiratory Pressure (MIP), Maximal Expiratory Pressure (MEP), Peak Expiratory Flow (PEF), Five times Sit-to-Stand (FTSTS), Seated Center of Pressure (S-COP), and Timed Up and Go (TUG) tests. Results: Respiratory function and balance were compared within each group before and after intervention. The experimental group, which received inspiratory training, showed significant improvements in FVC (0.26±0.18), FEV1 (0.35±0.32), MIP (11.54±12.39), PEF (1.12±1.52), and TUG (-3.39±2.45) compared to pre-intervention values (p<0.05). When comparing changes between groups post-intervention, the experimental group demonstrated significant increases in FVC, FEV1, MIP, PEF, and TUG compared to the control group (p<0.05). However, there were no significant differences in MEP, FTSTS, and S-COP. Conclusions: The results of this study indicate a positive effect of inspiratory training on chronic stroke patients. These findings suggest that with further research involving a larger sample size and enhanced intervention methods, inspiratory training could be employed positively in the rehabilitation of stroke patients.

• Clinical and Experimental Pediatrics
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• v.51 no.2
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• pp.181-187
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• 2008

Purpose : Asthma is characterized by reversible airway obstruction and bronchial hyperresponsiveness result from airway inflammation. Fraction of nitric oxide in expired air (FeNO) has recently been investigated as a noninvasive measure of airway inflammation. FeNO has been reported to correlate with induced sputum eosinophilia and methacholine challenge test that it is represent severity of asthma. The purpose of this study was to analyze the relationship of FeNO with pulmonary function tests in patients with intermittent asthma. Methods : Eighty children included in this study were diagnosed as asthma from April through August, 2005 in Department of Pediatrics, College of Medicine, Kyunghee University. They aged from 4 to 15 years who were able to conduct spirometry and FeNO monitoring. They did not have upper respiratory tract infection and did not use an asthma controller which contain corticosteroids within 4 weeks. Pulmonary function test was done and FeNO was measured with online tidal breathing method using a chemiluminescence NO analyzer (CLD 88 sp, Eco Medics, Duernten, Switzerland). The correlations between pulmonary function test and FeNO were analyzed using Spearman correlation coefficient method. Results : The mean of FeNO of subject was 16.88 parts per billion (ppb). The mean of forced expiratory volume in 1 second ($FEV_1$) was $0.890{\pm}0.455L$ and forced vital capacity (FVC) was $1.071{\pm}0.630L$. The mean of predicted $FEV_1%$ ($FEV_1%pred$) was $98.39{\pm}34.27%$ and $FEV_1/FVC$ was $88.53{\pm}19.49$. FeNO was significantly correlate with $FEV_1$ (r=0.345, P<0.01) and FVC (r=0.244, P<0.05). FeNO did not correlate with $FEV_1%pred$ or $FEV_1/FVC$. Conclusion : The measurement of FeNO could be a useful marker in the management of childhood asthma and it is evolving to provide a complementary role alongside existing pulmonary function test. We propose that measuring technique and establishment of normal reference range are important area for future research.

• Tuberculosis and Respiratory Diseases
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• v.61 no.3
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• pp.227-232
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• 2006

Background: In the measurement of bronchodilator reversibility, the forced expiratory volume in one second($FEV_{1}$) and the forced vital capacity(FVC) are commonly used parameters and recommended criteria for the reversibility requiring an increase of more than 200ml and 12% above the baseline, respectively. However, aged patients do not often meet the criteria of an increase in volume(>200ml) even though the medical history of that patient is adequate for asthma. This study investigated the role of the forced expiratory volume in six seconds($FEV_{6}$) in the bronchodilator reversibility test in elderly patients. Methods: A total of 236 patients more than 65 years of age with a $FEV_{1}$/FVC ratio<80% were enrolled in this study. The bronchodilator revesibility tests were examined. With the setting $FEV_{1}$ as the baseline, the patients were divided into three groups; Group I : $$FEV_{1}{\geq_-}80%$$ of the predicted value, Group II : 60%<$FEV_{1}$<80% of the predicted value, Group III : $$FEV_{1}{\leq_-}60%$$ of the predicted value. Results: Positive reversibility in the $FEV_{1}$, $FEV_{6}$, and FVC was in 33(14.0%), 49(20.8%) and 55(23.3%). However, Group III presented with reversibility in the $FEV_{1}$, $FEV_{6}$, and FVC in 15(22.4%), 30(44.8%) and 32(47.8%) respectively. Conclusions: The $FEV_{6}$ might be used as a complementary parameter in bronchodilatror reversibility in elderly patients. However, more study will be needed to determine the usefulness of $FEV_{6}$ in bronchodilator reversibility test.

• Tuberculosis and Respiratory Diseases
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• v.60 no.2
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• pp.215-220
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• 2006

Background : A spirometric reference equation was recently developed for the general population in Korea. The applicability of the new Korean equation to clinical practice was examined by comparing it with the Morris equation, which is one of the most popular reference equations used for interpreting the spirometric patterns and for grading the disease severity in Korea. Methods : Spirometry was performed on 926 men and 694 women, aged 20 years or older, in November 2004 at the Asan Medical Center, Seoul, Korea. The subjects' age, gender, height, weight, and spirometric values ($FEV_1$ [forced expiratory volume in one second], FVC [forced vital capacity], and $FEV_1/FVC$) were obtained. The spirometric patterns and disease severity were evaluated using both equations, and the results of the Korean equation were compared with the Morris equation. The spirometric patterns were defined as normal, restrictive, obstructive, and undetermined according to the level of $FEV_1/FVC$ and FVC. The disease severity was defined according to the level of $FEV_1$ level for subjects with an airflow limitation, and according to the FVC level for those subjects without an airflow limitation. Results : Spirometric patterns were differently interpreted in 22.5% (208/926) of the men and 24.8% (172/694) of the women after the application of the Korean equation compared with the Morris equation. Of the subjects with airflow limitation, disease severity was differently graded in 30.2% (114/378) of the men and 39.4% (37/94) of the women after the application of the Korean equation. Of the subjects without airflow limitation, disease severity was differently graded in 27.9% (153/548) of the men and 30.2% (181/600) of the women after the application of the Korean equation. Conclusion : Achange in the reference equation for spirometry could have an effect on the interpretation of spirometric patterns and on the grading of disease severity.

• Tuberculosis and Respiratory Diseases
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• v.49 no.1
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• pp.30-36
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• 2000

Background : The purpose of decortication is to eliminate the infection focus and to improve the decreased lung function due to chronic empyema. However, lung function is not improved in all cases. It would be clinically useful if we could predict prepoperatively whether lung function would improve after decortication. The purpose of this study is to find useful indices for predicting the possible improvement of lung function after decortication. Method : The medical records of 37 tuberculous empyema patients who underwent pleural decortication were analyzed retrospectively from 1990 to 1996. The measurements of preoperative and postoperative foræd vital capacity(FVC) were used for evaluating the effects of decortication. Results : The sex ratio was 29:8 (male to female), and the median age was 34 years. The time interval between the formation of empyema and operation was 1 month to 30 years. Postoperative pulmonary function test was performed 5.4$\pm$2.6 months later. FVC(forced vital capacity) was significantly increased from 2.77$\pm$0.67(L) to 2.95$\pm$0.81(L). Interestingly, postoperative pulmonary function was significantly improved in patients who were less than 40 years old, within 4 months after diagnosis of tuberculous empyema, in the group with FVC of less than 60% of the predicted value and in the absence of calcification. Conclusion : The improvement of lung function after decortication was expected in patients younger than 40 years old, within 4 months after diagnosis of tuberculous empyema, in the group having less than 60% of the predicted FVC, without calcification.

• Korean journal of health promotion
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• v.19 no.2
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• pp.91-95
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• 2019

Background: Obesity and deterioration of pulmonary function are known to increase all-cause mortality and morbidity associated with chronic diseases. Obesity is a known risk factor for decreasing pulmonary function; however, studies on the effect of changes in body weight or body mass index (BMI) on pulmonary function are rare. This study aimed to investigate the relationship between the change in body weight or BMI and the pulmonary function test (PFT) in Koreans who underwent consecutive screening at a health promotion center. Methods: We enrolled 5,032 patients who underwent consecutive screening health check-ups at a health promotion center in 2015 and 2017. The BMI was calculated as the body weight (kg) divided by the square of the height (m²) in 2015 and 2017. We analyzed the association between the change in body weight or BMI and PFT. Results: In males, PFT and changes in body weight were associated with forced expiratory volume in 1 second (FEV₁) but not with changes in BMI. In females, FEV₁/forced vital capacity and forced expiratory flow between 25-75% of vital capacity (FEF_25-75%) were significantly associated with the changes in body weight and BMI. A correlation analysis between body weight and BMI showed a negative correlation with FEF_25-75% in males. In females, FEV₁/FVC and FEF_25-75% were negatively correlated. Conclusions: We observed that the increase in body weight and BMI was significantly associated with pulmonary function. This finding suggests that careful monitoring of body weight and BMI may aid in maintaining proper pulmonary function, thereby, reducing mortality and morbidity.

• Tuberculosis and Respiratory Diseases
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• v.81 no.4
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• pp.281-288
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• 2018

Background: There are limited number of studies that investigate clinical variables instead of chronic obstructive lung disease (COPD) management according to Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017 classification. The aim of the study was to investigate whether there was a difference between GOLD 2017 classification and spirometric stage in clinical variables in patients with COPD. The data of 427 male patients with stable COPD were investigated retrospectively. Methods: Patients were allocated into combined assessment of GOLD 2017 and spirometric stage. Age, amount of smoking, pulmonary function, modified Medical Research Council (mMRC), incremental shuttle walk test (ISWT), Hospital Anxiety-Depression Scale (HADS), St. George's Respiratory Questionnaire (SGRQ), body mass index (BMI), and fat free mass index (FFMI) were recorded. Results: Seventy-three (17%) patients were in group A, 103 (24%) constituted group B, 38 (9%) were included in group C, and 213 (50%) comprised group D according to the combined assessment of GOLD 2017. Twenty-three patients (5%) were in stage 1, 95 (22%) were in stage 2, 149 (35%) were in stage 3, and 160 (38%) were in stage 4 according to spirometric stage. According to GOLD 2017, age, amount of smoking, mMRC, BMI, FFMI, SGRQ, HADS, forced vital capacity, forced expiratory volume in 1 second ($FEV_1$), and ISWT were significantly different between groups. Ages, amount of smoking, FFMI, BMI, HADS of group A were different from B and D. Smiliar values of $FEV_1$ were found in A-C and B-D. A and C had smiliar ISWT. According to spirometric stage, BMI, FFMI of stage 4 were statistically different. mMRC, ISWT, and SGRQ of stages 3 and 4 were different from other stages, amongst themselves. $FEV_1$ was correlated with mMRC, SGRQ, anxiety scores, BMI, FFMI, and ISWT. Conclusion: This study showed that the GOLD ABCD classification might not represent the severity of COPD sufficiently well in terms of lung function or exercise capacity. The combination of both spirometric stage and combined assessment of GOLD 2017 is important, especially for estimating clinical variables.

• Tuberculosis and Respiratory Diseases
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• v.72 no.4
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• pp.367-373
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• 2012

Background: Chronic obstructive pulmonary disease (COPD) is now regarded as a heterogenous disease, with variable phenotypes. Acute exacerbation of COPD is a major event that alters the natural course of disease. The frequency of COPD exacerbation is variable among patients. We analyzed clinical features, according to the frequency of acute exacerbation in COPD. Methods: Sixty patients, who visited Gyeongsang National University Hospital from March 2010 to October 2010, were enrolled. Patients were divided into two groups, according to their frequency of acute exacerbation. Frequent exacerbator is defined as the patient who has two or more exacerbation per one year. We reviewed patients' medical records and investigated modified Medical Research Council (MMRC) dyspnea scale, smoking history and frequency of acute exacerbation. We also conducted pulmonary function test and 6-minute walking test, calculated body mass index, degree of airway obstruction and dyspnea and exercise capacity (BODE) index and measured CD146 cells in the peripheral blood. Results: The number of frequent exacerbators and infrequent exacerbators was 20 and 40, respectively. The frequent exacerbator group had more severe airway obstruction (forced expiratory volume in one second [$FEV_1$], 45% vs. 65.3%, p=0.001; $FEV_1$/forced vital capacity, 44.3% vs. 50.5%, p=0.046). MMRC dyspnea scale and BODE index were significantly higher in the frequent exacerbator group (1.8 vs. 1.1, p=0.016; 3.9 vs. 2.1, p=0.014, respectively). The fraction of CD146 cells significantly increased in the frequent exacerbator group (2.0 vs. 1.0, p<0.001). Conclusion: Frequent exacerbator had more severe airway obstruction and higher symptom score and BODE index. However, circulating endothelial cells measured by CD146 needed to be confirmed in the future.