• Title/Summary/Keyword: Walking capacity

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Effect of pulmonary rehabilitation on patients with acute COVID-19: a single-center case series

  • Son Mi Lee;Min Woo Kim;Donghyun Shin;Songi Han;Ju Sun Oh
    • Journal of Yeungnam Medical Science
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    • v.40 no.3
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    • pp.297-301
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    • 2023
  • The coronavirus disease 2019 (COVID-19) pandemic has been ongoing for more than 2 years. Many patients who recover from severe acute respiratory syndrome coronavirus 2 infection continue to have aftereffects such as dyspnea and fatigue, which may lead to functional decline. Therefore, the need for managing these symptoms using methods such as pulmonary rehabilitation (PR) has emerged. The purpose of this study was to report the effectiveness of PR in five patients with acute COVID-19. PR was performed in patients with persistent dyspnea and oxygen demand after COVID-19. All five patients were able to maintain an independent functional status before COVID-19. However, after acute COVID-19, they were unable to walk independently and needed assistance for activities of daily living due to dyspnea and fatigue. Therefore, they were referred to rehabilitation units, and PR was performed. The modified Medical Research Council dyspnea scale, maximal expiratory pressure (MEP), 6-minute walking test, forced vital capacity, and grip strength were assessed before and after PR, and the results were compared. After PR, the parameters improved, except for the MEP in one patient (patient 3) and the grip strength in another patient (patient 4). After PR, two out of five patients returned to work and the other three returned home. Therefore, we conclude that PR is necessary for patients with acute COVID-19 with activity limitations.

Development of Firefighting Performance Test Drills while Wearing Personal Protective Equipment (소방방화복을 착용했을 때의 소방진압 업무 적합도 평가 프로토콜의 개발)

  • Kim, Siyeon;Lee, Joo-Young
    • Fire Science and Engineering
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    • v.30 no.1
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    • pp.138-148
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    • 2016
  • A firefighting simulation was developed in order to assess the physical work capacity of firefighters. The simulation consisted of eight common firefighting tasks, including walking with radiant heat for 3 min while wearing full personal protective equipment (PPE). Nine professional firefighters performed the test a total of three times with a 5 min rest interval between each session. The entire series of tests took approximately 30 min to complete ($381{\pm}30s$). Rectal temperatures were found to increase from $37.4{\pm}0.3^{\circ}C$ to $38.5{\pm}0.4^{\circ}C$, while heart rates were found to increase from $92{\pm}18bpm$ to $185{\pm}13bpm$ during testing. Time to completion of the test drills and non-modified physical fitness values showed a significantly negative correlation (r = -0.728, p < 0.05). Firefighters who had longer periods of firefighting service had longer duration time and also recorded higher scores using an integrated scoring system of time to completion (TTC) and physiological strain index (PhSI). The results indicated that the determination of TTC alone can be a misrepresentation of capability, as it neglects to account for accumulated heat strain. The simulated firefighting test provided a useful insight into physical fitness level, but also the comprehensive work capacity of the firefighters when assessed based on TTC and PhSI.

Clinical Features according to the Frequency of Acute Exacerbation in COPD

  • Lee, Seung-Jun;Lee, Seung-Hun;Kim, Yu-Eun;Cho, Yu-Ji;Jeong, Yi-Yeong;Kim, Ho-Cheol;Kim, Jin-Hyun;You, Jin-Jong;Yoon, Chul-Ho;Lee, Jong-Deog;Hwang, Young-Sil
    • 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.

The Effects of Simultaneous Pulmonary Rehabilitation during Thoracic Radiotherapy in the Treatment of Malignant Diseases

  • Choi, Myeong Geun;Lee, Hyang Yi;Song, Si Yeol;Kim, Su Ssan;Lee, Seung Hak;Kim, Won;Choi, Chang-Min;Lee, Sei Won
    • Tuberculosis and Respiratory Diseases
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    • v.84 no.2
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    • pp.148-158
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    • 2021
  • Background: Radiotherapy is a common treatment option for lung or esophageal cancer, particularly when surgery is not feasible for patients with poor lung function. However, radiotherapy can affect pulmonary function and thereby induce pneumonitis or pneumonia, which can be fatal in patients with respiratory impairment. The purpose of this study is to evaluate if reductions in pulmonary function after radiotherapy can be minimized through simultaneous pulmonary rehabilitation (PR). Methods: In this matched case control study, we retrospectively analyzed patients who had undergone radiotherapy for thoracic malignant disease between January 2018 and June 2019. We analyzed results from pulmonary function tests and 6-minute walking tests (6MWT) conducted within the six months before and after radiotherapy treatment. Results: In total, results from 144 patients were analyzed, with 11 of the patients receiving PR and radiotherapy simultaneously. Of the 133 patients in the control group, 33 were matched with 11 patients in the PR group. Changes in forced expiratory volume in one second (FEV1) and FEV1/forced vital capacity were significantly different between the PR group and the matched control group (240 mL vs. -10 mL, p=0.017 and 5.5% vs. 1.0%, p=0.038, respectively). The median distance of 6MWT in the PR group also increased significantly, from 407.5 m to 493.0 m after radiotherapy (p=0.017). Conclusion: Simultaneous PR improved pulmonary function, particularly in measures of FEV1, and exercise capacity for patients with lung or esophageal cancer even after radiotherapy treatment. These findings may provide an important base of knowledge for further large population studies with long-term follow-up analysis in the identification of the PR's effects during thoracic radiotherapy.

The Effect of Pulmonary Rehabilitation in Patients with Chronic Lung Disease (만성 폐질환 환자에서의 호흡재활치료의 효과)

  • Choe, Kang Hyeon;Park, Young Joo;Cho, Won Kyung;Lim, Chae Man;Lee, Sang Do;Koh, Youn Suck;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.736-745
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    • 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.

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Risk Factors of Primary Nocturnal Enuresis (일차성 야뇨증의 위험 요인)

  • Lee, Soo-Jin;Yang, Jung-An;Yoo, Eun-Sun;Seo, Jang-Wan;Lee, Seung-Joo
    • Childhood Kidney Diseases
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    • v.4 no.1
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    • pp.69-76
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    • 2000
  • Purpose: The Pathogenesis of primary noctllrnal enuresis(PNE) is still controversial. Genetic factor and maturational delay of micturition reflex including arousal disorder, lack of nocturnal Arginine Vasopressin(AVP) release and functional bladder capacity have been suggested. We analyzed the risk factors of PNE. Methods: Fifty five children with PNE (20 enuretics diagnosed at school physical examination of the first grade students at Mok-Dong Elementary School and 35 enuretics (Age 6-7 year) diagnosed at Ewha Womans University Mok Dong Hospital) and 221 control students without PNE at school physical examination were included. Genetic, stress and developmental factors, arousability, water intake, urine volume, maximun voiding volume and daytime voiding dysfunction were compared. Results: 1) There was no significant difference between PNE and control group in sex ratio, birth order, percentage of working mothers, parental and child personality, age to start walking, school record and duration of sleep. 2) Family history in the PNE group was significantly higher than control group ($20.0\%\;vs\;2.7\%$)(P<0.05). 3) The difficulty in arousal in the PNE group was significantly more common than the control group ($70.9\%\;vs\;54.3\%$)(P<0.05). 4) Nocturnal water intake in the PNE group was significantly greater than the control group ($330{\pm}158.2\;mL\;vs\;235{\pm}129.5\;mL$). Nocturnal urine volume in the PNE group was significantly greater than the control group ( $390{\pm}61.5\;mL\;vs\;140{\pm}43.2\;mL$)(P<0.05). Daily water intake and daily urine volume did not significantly differ between the two groups. 5) Maximum urine volume per void in the PNE group was significantly lower than the control group ($107{\pm}35.9\;mL\;vs\;236{\pm}41.3\;mL$). Daytime voiding dysfunction in the PNE group was significantly more common than the control group ($80.0\%\;vs\;57.9\%$). The voiding frequency in the PNE group was significantly greater than the control group ($7.0{\pm}3.6\;vs\;5.4{\pm}1.6$)(P<0.05). Conclusion: In addition to genetic factors and maturational delay of micturition reflex (difficulty in arousal, nocturnal polyuria and decreased functional bladder capacity) nocturnal polydypsia was found to be the important risk factors fur PNE. So nocturnal fluid restriction should be encouraged as the first-line management of PNE.

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A Study on Strategy for developing LBS Entertainment content based on local tourist information (지역 관광 정보를 활용한 LBS 엔터테인먼트 컨텐츠 개발 방안에 관한 연구)

  • Kim, Hyun-Jeong
    • Archives of design research
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    • v.20 no.3 s.71
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    • pp.151-162
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    • 2007
  • How can new media devices and networks provide an effective response to the world's growing sector of cultural and historically-minded travelers? This study emerged from the question of how mobile handsets can change the nature of cultural and historical tourism in ubiquitous city environments. As wireless network and mobile IT have rapidly developed, it becomes possible to deliver cultural and historical information on the site through mobile handset as a tour guidance system. The paper describes the development of a new type of mobile tourism platform for site-specific cultural and historical information. The central objective of the project was to organize this cultural and historical walking tour around the mobile handset and its unique advantages (i.e. portability, multi-media capacity, access to wireless internet, and location-awareness potential) and then integrate the tour with a historical story and role-playing game that would deepen the mobile user's interest in the sites being visited, and enhance his or her overall experience of the area. The project was based on twelve locations that were culturally and historically significant to Korean War era in Busan. After the mobile tour game prototype was developed for this route, it was evaluated at the 10th PIFF (Pusan International Film Festival). After use test, some new strategies for developing mobile "edutainment content" to deliver cultural historical contents of the location were discussed. Combining 'edutainment' with a cultural and historical mobile walking tour brings a new dimension to existing approaches of the tourism and mobile content industry.

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Activation plan of social safety network of the aged living alone - Focused on the aged using wireless paging system in Gwangyang-si - (독거노인의 사회안전망에 대한 활성화 방안 - 광양시 무선페이징시스템 대상자 중심으로 -)

  • Lee, Jae-Min
    • The Korean Journal of Emergency Medical Services
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    • v.13 no.3
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    • pp.41-58
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    • 2009
  • Objective : The purpose of this study is to identify actual operations and issues of wireless paging system operation for the aged living alone as the end users of wireless paging system primarily in Gwangyang city, and thereby to explore possible advanced and integrated ways to promote social safety network for the aged. Methods : The survey tool used in this study was a structured questionnaire form consisting of question items. The researcher hereof conducted this survey by means of direct visit and interview during two seasons, i.e. from February to August, 2008 and from December 2008 to March 2009, respectively. Results : 1) For general demographic characteristics, it was found that 90.9% of all respondents were women and 61.2% of all respondents were at age 75 to 84. for health conditions, it was found that more than 90% of all respondents often took medicines due to their unhealthy body, and most of respondents suffered from musculoskeletal diseases 79.3% and circulatory diseases 61.6%. for walking capacity, it was found that 45.5% of all respondents used walking aids, and disable respondents (11.5% of all respondents) were represented primarily by those with physical disability (52.6% of disable respondents). for actual use of medical institutions, it was found 47.3% of all respondents relied on local clinics, since they preferred neighborhood hospitals or clinics they can trust for medical care. for social activities and supports, it was found that 43.6% respondents had 'needs for assistance at times' and 33.9% respondents have 'no need for assistance'. And it was found that the major difficulties in living alone at old age were represented primarily by health problems 37.8% and economic difficulties 33.5%. 2) For characteristics related to wireless paging system, it was found that 90.3% respondents used wireless paging system recommended by firemen, and 28.5% respondents used this system. and it was found that 59.6% respondents used this system once, and 85.2% respondents used it because of acute or chronic diseases. more than 90% respondents thought that they knew about wireless paging system and considered themselves safe, but 83.6% respondents didn't attach a remote control on their upper clothes, and even 49.1% respondents turned off the power of wireless paging system due to their concern about electricity bill and noise. 3) It was found that 83.6% respondents felt it necessary to use wireless paging system, and wireless paging users felt more satisfied with using the system than non-users, and 50.7% showed high satisfaction at certain psychological benefits like 'confidence in coping with critical situations' and 'a sense of relief'. In addition, it was found that some respondents who answered that 'they didn't turn off the paging system as they knew how it works' and those who answered that they knew 'how to use it' showed relatively high satisfaction. And some respondents who kept it well and felt it necessary also showed high satisfaction. 4) It was found that the level of satisfaction our respondents felt with using wireless paging system varied significantly availability($x^{2}$ = 12.759, p = .002), psychological advantages($x^{2}$ = 12.174, p = .002), knowledge about how to use system($x^{2}$ = 7.021, p = .016), power on/off($x^{2}$ = 13.221, p = .001), level of knowledge about system($x^{2}$ = 21.002, p = .000), maintenance($x^{2}$ = 9.871, p = .007) and level of necessity($x^{2}$ = 34.939, p = .000) on the statistical basis.

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Development of Simulation Technology Based on 3D Indoor Map for Analyzing Pedestrian Convenience (보행 편의성 분석을 위한 3차원 실내지도 기반의 시뮬레이션 기술 개발)

  • KIM, Byung-Ju;KANG, Byoung-Ju;YOU, So-Young;KWON, Jay-Hyoun
    • Journal of the Korean Association of Geographic Information Studies
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    • v.20 no.3
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    • pp.67-79
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    • 2017
  • Increasing transportation dependence on the metro system has lead to the convenience of passengers becoming as important as the transportation capacity. In this study, a pedestrian simulator has been developed that can quantitatively assess the pedestrian environment in terms of attributes such as speed and distance. The simulator consists of modules designed for 3D indoor map authoring and algorithmic pedestrian modeling. Module functions for 3D indoor map authoring include 3D spatial modeling, network generation, and evaluation of obtained results. The pedestrian modeling algorithm executes functions such as conducting a path search, allocation of users, and evaluation of level of service (LOS). The primary objective behind developing the said functions is to apply and analyze various scenarios repeatedly, such as before and after the improvement of the pedestrian environment, and to integrate the spatial information database with the dynamic information database. Furthermore, to demonstrate the practical applicability of the proposed simulator in the future, a test-bed was constructed for a currently operational metro station and the quantitative index of the proposed improvement effect was calculated by analyzing the walking speed of pedestrians before and after the improvement of the passage. The possibility of database extension for further analysis has also been discussed in this study.

Improvement on Street Greenery for the Landscape Specialization and Increase of Green Volume on the Streets of Seoul (서울시 가로경관 특성화 및 녹량증진을 위한 가로녹지 개선 방안)

  • Byon, Hye-Ok;Han, Bong-Ho;Ki, Kyong-Seok;Jung, Jin-Mi
    • Journal of the Korean Institute of Landscape Architecture
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    • v.40 no.6
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    • pp.35-46
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    • 2012
  • This study attempts to specifically analyze green volume and scenery characteristics by classifying the streets in Seoul and suggest improvements accordingly. The subject streets for research were limited to those that have high occupancy ratio and are wide enough to have a big potential in improving green volume. In terms of green volume and scenery according to the types of streets, Platanus occidentalis and Ginkgo biloba were most common regardless of the street type, and the green ratio was 51.6% in residential areas, 50.4% in commercial areas, and 43.7% in business areas. Apart from the residential area, there was almost no green areas, and the ratio of green coverage was 71.0% in business areas, 64.0% in green areas, 37.3% in residential areas, and 36.2% in commercial areas, while the green volume coefficient was $1.9m^3/m^2$ on average. Based on the study results, it was set as a goal to provide the residential areas with a green community space and flowering trees throughout the year for scenery, and commercial areas with flowering trees and maples to emphasize the stores' image while not interfering with service and walking. For business areas, the goals were to improve green ratio and create streets that suit the urban image, and to set up spaces to provide habitat for wild animals with multi-layer planting and link to surrounding forests.