• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.149-154
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• 2016

Purpose: The aim of this study is to suggest an intervention method for clinical use in the future by analyzing the effect of breathing exercise on activity of sternocleidomastoid muscle and scalenus anterior muscle, which are respiratory synergist muscles, and pulmonary functions in patients with forward head posture. Methods: Prior to the experiment, 12 patients (experimental group) performed feedback exhalation exercise along with conventional deep neck exercise, and 11 subjects (control group) performed feedback deep neck exercise along with conventional deep neck exercise. The intervention programs were performed for 40 minutes once a day (three times a week for four weeks). Results: Before intervention, %RMS was measured for surface electromyography (sEMG), and FVC, FEV1, and FEV1/FVC were measured using a spirometer. After four weeks, these items were re-measured under the same condition and analyzed. In within-group comparison of the experimental group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05)(p<0.001), and forced vital capacity (FVC) showed a significant increase (p<0.05). In within-group comparison of the control group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05), and in between-group comparison, there were significant differences in activity of sternocleidomastoid muscle and FVC (p<0.05). Conclusion: Long-term forward head posture restrains exercise performance of the neck and leads to exercise avoidance of the neck during daily activities, thus restraint factors might be created even while breathing. To cut off this link, a constant effort is required and diversified research on the correlation between neck functions and breathing should be conducted.

• 대한물리의학회지
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• 제11권2호
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• pp.123-130
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• 2016

PURPOSE: This study was conducted to determine correlations between grip and lower limb muscle strength and pulmonary function and respiratory muscle in children with cerebral palsy. METHODS: Subjects were 17 children with cerebral palsy. Inclusion criteria for participation were having GMFCS from I to III grade and ability to independently blow into a spirometer. Pulmonary function and respiratory muscle were measured with a spirometer. All subjects performed maximal expiratory flow maneuvers using a spirometer in order to determine their forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), peak expiratory flow (PEF) and FEV1/FVC, and maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP). Muscle strength was measured in terms of grip strength and lower limb muscle strength in terms of knee extension strength with a dynamometer and manual digital muscle tester respectively. Data were analyzed using Person product correlation. RESULTS: Grip strength significantly positively correlated with FVC (r=0.95, p<0.01), FEV1 (r=0.95, p<0.01), PEF (r=0.84, p<0.01), MIP (r=0.65, p<0.01) MEP (r=0.71, p<0.01) and lower limb strength with FVC (r=0.72, p<0.01), FEV1 (r=0.69, p<0.01), PEF (r=0.54, p<0.05), and MEP (r=0.69, p<0.01). CONCLUSION: Grip and lower limb muscle strengths of children with cerebral palsy were positively correlated pulmonary function and respiratory muscle.

• 대한물리의학회지
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• 제8권4호
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• pp.489-496
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• 2013

PURPOSE: The aim of this study was to investigate the effect of respiratory muscle strengthening training on pulmonary function and gait ability in patients with subacute stroke. METHODS: Eighteen inpatients with subacute stroke were recruited for this study. The subjects were randomized into two group. All study groups participated in a conventional stroke rehabilitation intervention 30minutes a day 5 times a week for 4 weeks. For subjects from the experimental group, respiratory muscle strengthening training was performed: 30minutes a day 3 times a week for 4 weeks. Outcomes such as the pulmonary function(Forced Vital Capacity, Forced Expiratory Volume in one second, Maximal Voluntary Ventilation) and gait ability(10m walk test, 6 minute walk test) were measured before and after training. RESULT: There were significant differences of pulmonary function(FVC, FEV1 and MVV) and gait ability(10m walk test, 6minute walk test) between pre and post in the experimental group. In comparison of two group, experimental group was significant different pulmonary function(FVC, FEV1, MVV) and gait ability(6minute walk test) than control group. but, There was no significant difference of the gait ability(10m walk test). CONCLUSION: This study showed experimental group can be used to improve pulmonary function and gait ability than control group. These findings suggest that the respiratory muscle strengthening training effect on pulmonary function and gait ability for rehabilitation in patients with subacute stroke.

• Journal of Chest Surgery
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• 제20권1호
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• pp.1-12
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• 1987

Respiratory care with oxygen inhalation is often a necessity to maintain life, and it is one of the important therapeutic adjuncts in respiratory disease and in intensive care after surgery. However, it has been reported that oxygen toxicity occurs after prolonged exposure to 100% 0, [Smith, 1899; Kistler et al. 1967; Schaffner et al. 1967; Rowland and Newman, 1969. Subjective symptoms of oxygen toxicity include tracheal irritation, frequent cough, some burning sensation in the trachea, tachypnea, severe dyspnea, etc. [Welch, 1963; Fisher et al, 1968; Milier et al, 1970; Clark and Lambertsen, 1971; Sackner, 1975]. Pathologic findings are atelectasis, injuries to the pulmonary capillaries and hemorrhage in the alveoli in gross specimens. There can be inflammation, proliferation of fibrin, thickening of alveolar membranes, degeneration of collagen fibers and interstitial edema in the microscopic findings. [Penrod, 1956; Cedergren, 1959; Bean, 1965; Schaffner, 1967]. Dubois and colleagues [1961] found that the amount of pulmonary surfactant was decreased in oxygen toxicity and atelectasis followed by the decreased pulmonary surfactant. Many authors reported that vital capacity, inspiratory force, pulmonary compliance, pulmonary capillary blood flow and pulmonary elasticity were deceased and arteriovenous shunting increased. [Comroe et al, 1945; Fuson et al, 1965; Kistler et al, 1966; Knowles and Blenner-hassett, 1967; Barber et al, 1978]. Many human volunteers were examined after prolonged exposure in a high oxygenated chamber and there were a few reports on animals with oxygen toxicity, subjects including rabbits. Gas partial pressures of alveoli and arteries were measured in rabbits exposed to 100% $O_2$ and the alveolar-arterial gas gradients were analyzed, which is the basis for the study of oxygen toxicity. These rabbits were divided into two groups; rabbits under natural respiration, and second group under artificial respiration with a respirator. The alveolar $PO_2$ [$P]AO_2$] and $PCO_2$ [$PACO_2$], and the arterial $PO_2$ [$PaO_2$] were measured under varying $O_2$ pressures; 15% $O_2$, 21% $O_2$ and 100% $O_2$.

• 한국보건간호학회지
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• 제28권1호
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• pp.22-31
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• 2014

Purpose: The purpose of this study was to examine the impact of body mass index (BMI) and waist circumference (WC) for pulmonary function in normal-weight and obese women. Methods: Data from women aged ${\geq}40$ years were obtained from the 2011 Korean National Health and Nutrition Examination Survey. Obesity was measured by BMI and WC and pulmonary function was measured by forced vital capacity (FVC), forced expiratory volume in 1 second ($FEV_1$), and a ratio between forced expiratory volume in 1 second ($FEV_1$/FVC). Multiple linear regression analysis was performed for assessment of the association between FVC, $FEV_1$, $FEV_1$/FVC and obesity variables. Results: BMI showed positive association with FVC, $FEV_1$, $FEV_1$/FVC, and WC showed positive association with $FEV_1$ and $FEV_1$/FVC in normal-weight women. BMI and WC showed negative association with FVC, $FEV_1$ in obese women. A 1 unit increase in BMI showed an association with a 25-mL reduction in FVC and a 19-mL reduction in $FEV_1$. A 1-cm increase in WC showed an association with a 6-mL reduction in FVC and a 4-mL reduction in $FEV_1$. Conclusions: BMI and WC showed negative association with pulmonary function in obese adult women. Therefore, obese women with reduced pulmonary function should be encouraged to lose weight for improvement of their pulmonary function.

• The Journal of Korean Physical Therapy
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• 제29권1호
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• pp.1-6
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• 2017

Purpose: This study aimed to demonstrate reduction in stroke symptoms by analyzing the changes in respiratory function and activities of daily living (ADL) after respiratory muscle strengthening exercise in patients who had a stroke and thereby, propose an efficient exercise method. Methods: Twenty patients with hemiplegic stroke were divided into two groups, with 10 patients in each. The control group (CG) received the traditional exercise therapy, and the experimental group (EG) received the traditional exercise therapy combined with expiratory muscle strengthening training. The training continued for 6 weeks, 5 days a week. Forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1) were measured with a spirometer, $SpO_2$ was measured with a pulse oximeter, and ADL were assessed by using the modified Barthel index (MBI). A paired t test was applied to compare the differences before and after the intervention, and an independent t test was used to compare the differences between the groups. The level of statistical significance was set as ${\alpha}=0.05$. Results: The changes in the FVC and FEV1 values within the group showed significant differences only in the EG (p<0.01). The between-group difference was statistically significant only for FVC and FEV1 in the EG (p<0.01). The changes in $SpO_2$ and MBI within the group showed significant differences only in the EG and CG (p<0.01). Between-group differences were statistically significant only for $SpO_2$ and MBI in the EG (p<0.05). Conclusion: The interventions with active patient involvement and combined breathing exercises had a positive impact on all the functions investigated in this study.

• 대한물리의학회지
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• 제12권4호
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• pp.29-37
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• 2017

PURPOSE: This study investigated the immediate effect of inspiratory muscle training with whole-body vibration on the pulmonary function of subacute stroke patients. METHODS: All participants (n=30) were allocated to the following groups: (1) the inspiratory muscle training group with whole-body vibration (n=10), wherein the patients received inspiratory muscle training with whole-body vibration comprising 3minutes of vibration per session and respiratory training of 30 times and 2 sessions for one day. (2) the inspiratory muscle training group with visual feedback (n=10), wherein the patients received inspiratory muscle training with visual feedback. (3) the inspiratory muscle training group (n=10), wherein the patients received inspiratory muscle training. RESULTS: After the experiment, the inspiratory muscle training group with whole-body vibration exhibited significantly higher forced vital capacity, forced expiratory volume at 1 second, peak inspiratory flow rate, maximal inspiratory pressure, and chest expansion (p<.05), compared to the other groups. Inspiratory muscle training group with whole-body vibration had significantly higher peak expiratory flow rate and maximal voluntary ventilation than the other groups (p<.05). CONCLUSION: These results show that pulmonary function, maximal inspiratory pressure, and chest expansion were significantly better in the inspiratory muscle training group with whole-body vibration than in the other groups. Thus, this treatment will help recovery of pulmonary function in stroke patients.

• 한국펄프종이공학회:학술대회논문집
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• 한국펄프종이공학회 2007년도 제32회 펄프종이기술 국제세미나
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• pp.83-125
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• 2007

Increasing energy costs have caused profitability problems for paper suppliers. Therefore unprofitable lines are being closed down. The actions aiming for improved profits are focused either on cost savings or on increasing the capacity of the remaining machines. The runnability of a paper machine and its total efficiency have a significant effect on energy consumption. Producing one ton of waste paper consumes at least as much energy as producing the same amount of sellable end product. New automation solutions enable significant cost-effective improvements to the total efficiency of a line without large investment projects. The measures focus on minimizing changes, interruptions, interruption recovery times and grade change times. Newest actuators, online quality measurements and wet end analysators create an improvement potential, which can be optimally implemented with the latest machine direction control solutions, based on model predictive control concepts. Equally, drying management is significant to the energy consumption. The newest control strategies optimize the use of various drying actuators for different situations; either by responding to changes as efficiently as possible or by using only the cheapest energy sources in stable situations. An even steam supply, which is vital for paper machines, is achieved with control for the power plant steam network. This makes possible to avoid the delays upon starting the paper machine and assure an even steam supply for the drying section and the actuators. This document describes means which have brought significant energy and raw material savings for paper machines. Metso Automation has provided efficiency improvement packages, which are usually based on optimized control of dry weight and drying in all running conditions. The solutions are based on performance analysis, on which the estimations for improvement potential and the necessary actions are based on. Typically benefits on an annual level have been from hundreds of thousands of euros to over one million euro. For example, variations in dry weight have been decreased more than 50%. The results are presented with a few examples. Additionally, the analysis models, adjustment solutions and the changes in running methods with which the results were achieved, are presented.

• Journal of Chest Surgery
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• 제17권3호
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• pp.409-417
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• 1984

In the early days of open heart surgery, acute respiratory failure following extracorporeal circulation was a significant deterrent to an uncomplicated recovery. Although a marked improvement in prevention and treatment of postoperative respiratory failure has been achieved, the problem has not been completely eliminated and continues to be a causative factor in morbidity and mortality Fates following open heart surgery. We have attempted to evaluate postoperative respiratory failure in patients undergoing cardiac operation with the aid of extracorporeal circulation. Our series comprised 92 patients who underwent elective open heart surgery at the Department of Thoracic and Cariodvascular Surgery, School of Medicine, Kyungpook National University, from January, 1980 to December, 1982. In our study, the overall incidence of acute respiratory failure following open heart surgery was 18.8 percent. The duration of extracorporeal circulation in a series of 18 patients who developed postoperative respiratory failure [Group B] was longer in the mean value [120.3 minutes] than the uncomplicated 74 patients [Group A] [85.8 minutes]. The duration of artificial ventilation after open heart surgery in Group A averaged 13.4 hours as contrasted with 76.5 hours in Group B. In Group B, the inspired oxygen concentration [FiO2] in artificial ventilation was continued in the higher level than Group A until 18 hours after operation. Upon pulmonary function test performed pre-and postoperatively, residual volume[RV], RV/TLC and FEV 1.0/FVC were remained essentially unchanged following extracorporeal circulation, whereas forced vital capacity [FVC], FEV 1.0 and FEF 25-75% were significantly decreased in the early postoperative days. The incidence of acute respiratory failure was significantly higher in a series of patients who developed postoperative complications, such as re- exploration due to massive bleeding, low cardiac output, acute renal failure and arrhythmias. A total of 9 patients died, giving an overall mortality was 33.3 percent whereas the mortality was only 1.1 percent for patients without respiratory failure.

• Journal of Chest Surgery
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• 제49권6호
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• pp.456-460
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• 2016

Background: Surgical correction needs to be considered when diaphragm eventration leads to impaired ventilation and respiratory muscle fatigue. Plication to sufficiently tense the diaphragm by VATS is not as easy to achieve as plication by open surgery. We used pneumatic compression with carbon dioxide ($CO_2$) gas in thoracoscopic diaphragmatic plication and evaluated feasibility and efficacy. Methods: Eleven patients underwent thoracoscopic diaphragmatic plication between January 2008 and December 2013 in Pusan National University Hospital. Medical records were retrospectively reviewed, and compared between the group using $CO_2$ gas and group without using $CO_2$ gas, for operative time, plication technique, duration of hospital stay, postoperative chest tube drainage, pulmonary spirometry, dyspnea score pre- and postoperation, and postoperative recurrence. Results: The improvement of forced expiratory volume at 1 second in the group using $CO_2$ gas and the group not using $CO_2$ gas was $22.46{\pm}11.27$ and $21.08{\pm}5.39$ (p=0.84). The improvement of forced vital capacity 3 months after surgery was $16.74{\pm}10.18$ (with $CO_2$) and $15.6{\pm}0.89$ (without $CO_2$) (p=0.03). During follow-up ($17{\pm}17$ months), there was no dehiscence in plication site and relapse. No complications or hospital mortalities occurred. Conclusion: Thoracoscopic plication under single lung ventilation using $CO_2$ insufflation could be an effective, safe option to flatten the diaphragm.