• 성인간호학회지
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• 제25권4호
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• pp.473-482
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• 2013

Purpose: The purpose of this study was to investigate the effects of a structured preoperative instruction upon anxiety and postoperative self-care compliance. Methods: A randomized control group pre-post design was used. Sixty subjects undergoing cataract surgery were randomly assigned to one of two groups. The instruction consisted of cataract surgery procedure, sensory information, deep breathing, use of eye drop, and post op self-care regimen and was provided to the experimental group with control group receiving an usual treatment. State anxiety NRS, pulse, BP, and self-care compliance scale developed by Cho & Rho were used. Data were collected at two time periods: on the day of surgery in the clinic and prior to anesthesia in the operating room. The postoperative self-care compliance scores were measured at their second visits to the hospital after surgery. Data were analyzed using Kolmogorov Smirnov test, t-test, and Mann-Whitney U test. Results: There were significant differences between the two groups in the postoperative state anxiety (t=-3.57, p=.001) and the postoperative self-care compliance score (t=3.92, p<.001). There were no significant difference between the two groups in the postoperative blood pressure and pulse rate. Conclusion: The results of this study suggest that the structured preoperative instruction could be a nursing intervention for cataract surgery patients.

• 대한물리의학회지
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• 제11권4호
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• pp.55-64
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• 2016

PURPOSE: The aim of this study was to examine the effect of air stacking exercise on lung capacity, activities of daily living, and walking ability in elderly adults. METHODS: A total of 27 subjects were randomly assigned to an experimental group (EG=13) or a control group (CG=14). Subjects in the experimental group participated in an active pulmonary rehabilitation program. 5 days a week for 4 weeks. The active pulmonary rehabilitation program was composed of an air stacking exercise with an oral nasal mask and manually assisted coughing. Conventional pulmonary rehabilitation exercises, such as, cough exercise, deep breathing, and abdominal muscle strengthening exercises were performed by both groups. Pulmonary function parameters, peak cough flow (PCF), and oxygen saturation were measured and the 6-minute walk test and Korean version of the modified Barthel index (K-MBI) scores were applied. RESULTS: Significant intergroup differences were observed for forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) results after intervention (p<.05), and for 6 minute walk test and PCF results after intervention and at 2-week follow-up visits (p<.05). Post hoc test results showed significant differences in K-MBI, 6-minute walk test, and FEV1 in the experimental group after intervention (p<.05). FVC values were significantly higher after intervention and at 2-week follow-up visits versus pre-intervention (p<.05). PCF values were also significantly higher after intervention and remained significantly higher at 2-week follow-up visits (p<.05). CONCLUSION: Air stacking exercise in elderly adults improves lung capacity and exercise tolerance.

• Annals of Clinical Neurophysiology
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• 제21권2호
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• pp.87-93
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• 2019

Background: The standardized autonomic function test has become widely available. However, there are no reference data for this test for the Korean population. This study explored reference data for sudomotor and cardiovagal function tests for the Korean population. Methods: The sweat volume by quantitative sudomotor axon reflex test, heart-rate response to deep breathing (HRdb), expiration:inspiration (E:I) ratio, and Valsalva ratio (VR) were measured in 297 healthy Korean volunteers aged from 20 to 69 years. Multivariate regression analysis was performed to evaluate the effects of age, sex, and body mass index on these variables. The 2.5th, 5th, 10th, 90th, 95th, and 97.5th percentile values were obtained for each investigation. Results: The sweat volume was higher in males than in females. The HRdb and E:I ratio were negatively correlated with age, and were higher in males than in females. The VR was negatively correlated with age, but it was not correlated with sex. Conclusions: This study has provided data on the reference ranges for sudomotor and cardiovagal function tests in healthy Korean adults.

• 한국전문물리치료학회지
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• 제25권1호
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• pp.12-21
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• 2018

Background: Research efforts to improve the pulmonary function of children with cerebral palsy (CP) need to focus on their decreased diaphragmatic ability compared to normal children. Real-time ultrasonography is appropriate for demonstrating diaphragmatic mechanisms. Objects: This study aimed to compare diaphragm movement, pulmonary function, and pulmonary strength between normal children and children with CP by using ultrasonography M-mode. The correlation between general characteristics, diaphragm movement, pulmonary function, and pulmonary strength was also studied. Methods: The subjects of this study were 25 normal and 25 CP children between five and 14 years of age. Diaphragm movement was measured using real-time ultrasonography during quiet and deep breathing. Pulmonary function (such as forced expiratory volume in one second; FEV1 and peak expiratory flow; PEF) and pulmonary strength (such as maximum inspiratory pressure; MIP and maximum expiratory pressure; MEP) were measured. A paired t-test and Spearman's Rho test, with a significance level of .05, were used for statistical analysis. Results: The between-group comparison revealed that normal children had significantly greater diaphragm movement, FEV1, PEF, MIP, and MEP (p<.05) than CP children. The results showed that general characteristics were significantly related to FEV1, PEF, MIP, and MEP (p<.05). Conclusion: In clinical settings, clinicians need to concern decreased diaphragm movement, pulmonary function, and pulmonary strength in CP group compared to normal children.

• 한국전문물리치료학회지
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• 제6권3호
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• pp.72-81
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• 1999

The purpose of this study was to identify the differences in pulmonary functioning after respiratory exercise with IPPB (Intermittent Positive Pressure Breather) in patients with progressive muscular dystrophy (PMD). The subjects were 46 patients with PMD who were admitted to the Rehabilitation Medicine Department of Youngdong Severance Hospital. The subjects were assigned into one of 2 groups. The control group received comprehensive treatments such as ROM exercise, deep breathing exercise, moist hot packs, and ultrasound twice a day while admitted at the Rehabilitation Medicine Department. Unlike the control group, the subjects at the experimental group received respiratory exercise treatment with IPPB. The subjects were admitted for 10~19 days, and the average length of hospital stay was 12.2 days. Pulmonary functioning was evaluated at admission and discharge by SENSOR MEDICS. The data were analyzed by a paired t-test and a independent t-test. The results were as follows: 1) The change of each parameter of pulmonary function tests were significantly improved in all groups after respiratory exercise treatment during admission (p<0.05). 2) By comparing the change of each parameter of pulmonary function tests between the experimental group and control group, the parameters of vital capacity (VC), forced vital capacity, forced vital capacity predicted (FVCP) and forced expiratory volume in 1 second (FEV1) were significantly improved in the experimental group which had received the pulmonary exercise treatment with IPPB (p<0.05). In conclusion, this study suggests that the pulmonary exercise treatments with IPPB facilitated improvement in the pulmonary functioning for the PMD patients during their hospital stay.

• 한국의학물리학회지:의학물리
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• 제33권4호
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• pp.136-141
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• 2022

Purpose: This study aimed to develop a breath control training system for breath-hold technique and respiratory-gated radiation therapy wherein the patients can learn breath-hold techniques in their convenient environment. Methods: The breath control training system comprises a sensor device and software. The sensor device uses a loadcell sensor and an adjustable strap around the chest to acquire respiratory signals. The device connects via Bluetooth to a computer where the software is installed. The software visualizes the respiratory signal in near real-time with a graph. The developed system can signal patients through visual (software), auditory (buzzer), and tactile (vibrator) stimulation when breath-holding starts. A motion phantom was used to test the basic functions of the developed breath control training system. The relative standard deviation of the maxima of the emulated free breathing data was calculated. Moreover, a relative standard deviation of a breath-holding region was calculated for the simulated breath-holding data. Results: The average force of the maxima was 487.71 N, and the relative standard deviation was 4.8%, while the average force of the breath hold region was 398.5 N, and the relative standard deviation was 1.8%. The data acquired through the sensor was consistent with the motion created by the motion phantom. Conclusions: We have developed a breath control training system comprising a sensor device and software that allow patients to learn breath-hold techniques in their convenient environment.

• 핵의학기술
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• 제16권2호
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• pp.18-24
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• 2012

Lung SPECT는 planar scan 보다 깊이 위치한 병변을 명확히 보여주며 보다 예민한 것으로 보고되고 있다. 그러나 ventilation SPECT는 정맥주사를 통해 방사성의약품을 주입하는 perfusion SPECT와 다르게 환자의 호흡을 통해 흡입시키므로, 원활한 호흡이 불가능한 환자의 경우 목적 장기에 방사성의약품의 섭취율이 저하되고 검사에 유효한 적정count/rate가 낮아지므로 필연적으로 검사시간이 길어지게 되어 이에 수반되는 여러 문제로 인하여 실제 임상에 적용하기 어려운 실정이다. 따라서 본 연구는 고감도(high sensitivity) 특성을 지닌 AP (All Purpose) 혹은 GP (General Purpose) collimator를 사용하여 low count/rate 환자의 검사시간을 단축시킴으로써 lung ventilation SPECT 임상적용 가능성과 유용성을 평가하였다. 정상 성인 남녀 4명($24.3{\pm}0.95$세)을 실험대상으로 Technegas 370 MBq을 흡입시키고, E.cam SPECT를 사용하여 count/rate를 측정한 후, LEUHR, LEHR, LEAP collimator를 장착하여 300counts acquisition 조건으로 ANT, POST, LPO, RPO, both-LAT 총 6 view의 lung ventilation planar scan 하였다. 동일 실험 대상자를 본원에서 사용하던 기존 프로토콜을 적용하여 70 kcounts/view acquisition 조건으로 high counting mode SPECT를 시행하고, 같은 방법으로 7kcounts/view acquisition하여 비교 실험인 low counting mode SPECT를 시행한 후 모든 실험의 결과를 lung segmentation ratio와 검사 소요시간을 통해 비교하여 분석하였다. 각 실험군 사이의 상관관계를 분석하기 위해 paired t-test를 시행하였고, p값이 0.05를 초과할 때 실험의 통계적 의미가 있는 것으로 판단하였다. 모든 자료의 통계처리는 SPSS ver. 20을 사용하였으며, 각 실험 결과는 산술 및 기하 평균(mean)을 구하고${\pm}$표준편차(SD)를 산출하였다. 실험 결과 lung planar scan은 300 kcounts/6 iew를 acquisition하여 총 1,800 kcounts를 획득하였다. 반면 7 kcounts/view로 acquisition한 low counting mode SPECT의 경우 collimator 종류에 따라서 최소 773 kcounts에서 최대 1,106 kcounts를 획득하였고, 70 kcounts/view로 acquisition한 high counting mode SPECT의 경우 collimator 종류에 따라서 최소 7,984 kcounts에서 최대 10,222kcounts를 획득하였다. 모든 실험 자료를 통해 실험대상 4명의 lung segmentation ratio를 산출하고, 평균값과 표준편차를 계산한 결과, LT:RT lung ratio는 순서대로 각각 45.5:54.5 (${\pm}0.26$), 45.4:54.6 (${\pm}0.40$), 50.1:49.9 (${\pm}0.28$), 49.4:50.6 (${\pm}0.57$)이었다. 따라서 정량분석한 결과 planar scan과 low, high counting mode SPECT사이 collimator 종류에 의한 lung segmentation ratio는 오차 범위내에 모두 존재하였다. 보다 자세한 분석을 위해 기존의 LEHR collimator를 장착한 planar scan과 비교 실험인 LEAP collimator를 장착한 low counts mode SPECT를 통계처리한 결과 p-value가 0.10이상으로 두 실험의 결과는 통계적으로 유의하였다. 실험에 소요된 시간을 분석한 결과 planar scan은 LEUHR, LEHR, LEAP collimator 순서로 각각 $1803{\pm}268$ sec, $915{\pm}162$ sec, $501{\pm}134$ sec이었고, 비교실험인 low counting mode SPECT는 $1125.5{\pm}103.6$ sec, $900{\pm}64$ sec, $740{\pm}0$ sec 이었으며, 본원에서 사용하던 기존 프로토콜인 high counting mode SPECT는 $5794.5{\pm}946.5$ sec, $3620{\pm}397.9$ sec, $2020{\pm}104.5$ sec이었다. 관심실험인 LEAP collimator를 장착한low counting mode SPECT의 검사 소요시간 740 sec에 비하여, 기존 본원의 프로토콜인 LEHR collimator를 장착한 high counting mode SPECT의 검사 소요시간 평균은 3620sec이므로, 약 5배 정도 시간 단축이 가능한 것으로 조사되었으며, 모든 실험의 정량분석 결과도 임상적으로 유의한 것으로 분석되었다. 결국 high sensitivity LEAP collimator를 장착하여 lung SPECT를 시행하면, 임상적으로 유의한 정량분석 결과를 얻을 수 있으며, 동시에 검사시간을 효과적으로 단축시킬 수 있음을 의미한다.