• Tuberculosis and Respiratory Diseases
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• v.87 no.2
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• pp.155-164
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• 2024

Background: Exercise capacity is associated with lung function decline in chronic obstructive pulmonary disease (COPD) patients, but a discrepancy between exercise capacity and airflow limitation exists. This study aimed to explore factors contributing to this discrepancy in COPD patients. Methods: Data for this prospective study were obtained from the Korean COPD Subgroup Study. The exercise capacity and airflow limitation were assessed using the 6-minute walk distance (6-MWD; m) and forced expiratory volume in 1 second (FEV₁). Participants were divided into four groups: FEV₁ >50%+6-MWD >350, FEV₁ >50%+6-MWD ≤350, FEV₁ ≤50%+6-MWD >350, and FEV₁ ≤50%+6-MWD ≤350 and their clinical characteristics were compared. Results: A total of 883 patients (male:female, 822:61; mean age, 68.3±7.97 years) were enrolled. Among 591 patients with FEV₁ >50%, 242 were in the 6-MWD ≤350 group, and among 292 patients with FEV₁ ≤50%, 185 were in the 6-MWD >350 group. The multiple regression analyses revealed that male sex (odds ratio [OR], 8.779; 95% confidence interval [CI], 1.539 to 50.087; p=0.014), current smoking status (OR, 0.355; 95% CI, 0.178 to 0.709; p=0.003), and hemoglobin levels (OR, 1.332; 95% CI, 1.077 to 1.648; p=0.008) were significantly associated with discrepancies in exercise capacity and airflow limitation in patients with FEV₁ >50%. Meanwhile, in patients with FEV₁ ≤50%, diffusion capacity of carbon monoxide (OR, 0.945; 95% CI, 0.912 to 0.979; p=0.002) was significantly associated with discrepancies between exercise capacity and airflow limitation. Conclusion: The exercise capacity of COPD patients may be influenced by factors other than airflow limitation, so these aspects should be considered when assessing and treating patients.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.3
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• pp.2155-2163
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• 2020

Background: Various treatments have been proposed for chronic low back pain (CLBP), but recent guidelines and reviews recommend regular physical exercise. However, some other studies have reported opposite results that sling exercise (SE) and other exercises (OE) did not differ in improving CLBP. Objectives: To systematically review and meta-analyze the effects of SE on CLBP in studies published in Korea. Design: A Systemic Review and Meta-analysis. Methods: Randomized controlled trials comparing SE with OE and modality therapy (MT), published up to June 2020, were identified by electronic searches. Primary outcomes were pain and disability. The weighted mean difference (WMD), stand mean difference (SMD) and 95% confidence interval (CI) were calculated using a random-effects model. Results: Based on the results of the meta-analysis, SE was effective for pain in the comparison of SE and MT [short-term: WMD=-1.64, 95% CI (-3.06, -0.22); long-term: WMD=-0.34, 95% CI (-0.42, -0.26)]. It was effective for pain in the comparison of SE and OE [short-term: WMD=-1.18, 95% CI (-2.15, -0.20); long-term: WMD=-0.66, 95% CI (-0.89, -0.43)]. It was also effective for disability in the comparison of SE and MT [short-term: SMD=-15.82, 95% CI (-23.10, -8.54)]. We found no clinically relevant differences in disability between SE and OE. Heterogeneity was high in the comparison of SE and overall variables. Conclusion: If SE is applied to physical therapy to improve the main symptoms of CLBP patients, it may contribute to their recovery. More high-quality randomized studies on the topic are warranted.

• Journal of the Korean Applied Science and Technology
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• v.41 no.2
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• pp.219-232
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• 2024

The aim of this study was to explore the impact of body mass index (BMI) and drumming exercise on autonomic nervous system function in adult women. Ten adult women (aged 30-50) were divided into two groups based on their BMI: a normal BMI group (Low BMI, LBMI < 23 kg/m²) and an overweight BMI group (High BMI, HBMI > 23 kg/m²). Both groups participated in a drumming exercise program, consisting of 50-minute sessions, three times a week, for a duration of 8 weeks. Body composition and heart rate variability were assessed before and after the 8-week exercise period. Heart rate variability was evaluated using linear analysis in the time domain and frequency domain. Additionally, non-linear analysis was conducted using a Poincaré plot. The autonomic nervous system index was determined by measuring parasympathetic nervous system index and sympathetic nervous system index. Following the 8-week intervention, the HBMI group exhibited a significant decrease in weight (p=0.034), BMI (p=0.044), body fat mass (p=0.032), and waist circumference (p=0.013) compared to the LBMI group. Furthermore, the HBMI group demonstrated significant increases in RMSSD (p=0.018) and TP (p=0.033) in linear analysis, as well as SD1 (p=0.018) in non-linear analysis and PNS Index (p=0.040) compared to the LBMI group. RMSSD, SD1, and PNS Index serve as indicators of parasympathetic nervous system activity in linear and non-linear analyses, respectively. These findings indicate that drumming exercise significantly enhances autonomic nervous system function in overweight women.

• The Korean Journal of Physiology
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• v.1 no.1
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• pp.103-120
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• 1967

As pointed out by many previous investigators, the cardio-pulmonary system of well trained athletes is so adapted that they can perform a given physical exercise more efficiently as compared to non-trained persons. However, the time course of the development of these cardio-pulmonary adaptations has not been extensively studied in the past. Although the development of these training effects is undoubtedly related to the magnitude of an exercise load which is repeatedly given, it would be practical if one could maintain a good physical fitness with a minimal daily exercise. Hence, the present investigation was undertaken to study the time course of the development of cardio-pulmonary adaptations while a group of non-athletes was subjected to a daily 6 to 10 minutes running exercise for a period of 4 weeks. Six healthy male medical students (22 to 24 years old) were randomly selected as experimental subjects, and were equally divided into two groups (A and B). Both groups were subjected to the same daily running exercise (approximately 1,000 kg-m). 6 days a week for 4 weeks, but the rate of exercise was such that the group A ran on treadmill with 8.6% grade for 10 min daily at a speed of 127 m/min while the group B ran for 6 min at a speed of 200 m/min. In order to assess the effects of these physical trainings on the cardio-pulmonary system, the minute volume, the $O_2$ consumption, the $CO_2$ output and the heart rate were determined weekly while the subject was engaged in a given running exercise on treadmill (8.6% grade and 127 m/min) for a period of 5 min. In addition, the arterial blood pressure, the cardiac output, the acid-base state of arterial blood and the gas composition of arterial blood were also determined every other week in 4 subjects (2 from each group) while they were engaged in exercise on a bicycle ergometer at a rate of approximately 900 kg m/min until exhaustion. The maximal work capacity was also determined by asking the subject to engage in exercise on treadmill and ergometer until exhaustion. For the measurement of minute volume, the expired gas was collected in a Douglas bag. The $O_2$ consumption and the $CO_2$ output were subsequently computed by analysing the expired gas with a Scholander micro gas analyzer. The heart rate was calculated from the R-R interval of ECG tracings recorded by an Offner RS Dynograph. A 19 gauge Cournand needle was inserted into a brachial artery, through which arterial blood samples were taken. A Statham $P_{23}AA$ pressure transducer and a PR-7 Research Recorder were used for recording instantaneous arterial pressure. The cardiac output was measured by indicator (Cardiogreen) dilution method. The results may be summarized as follows: (1) The maximal running time on treadmill increased linearly during the 4 week training period at the end of which it increased by 2.8 to 4.6 times. In general, an increase in the maximal running time was greater when the speed was fixed at a level at which the subject was trained. The mammal exercise time on bicycle ergometer also increased linearly during the training period. (2) In carrying out a given running exercise on treadmill (8.6%grade, 127 m/min), the following changes in cardio·pulmonary functions were observed during the training period: (a) The minute volume as well as the $O_2$ consumption during steady state exercise tended to decrease progressively and showed significant reductions after 3 weeks of training. (b) The $CO_2$ production during steady state exercise showed a significant reduction within 1 week of training. (c) The heart rate during steady state exercise tended to decrease progressively and showed a significant reduction after 2 weeks of training. The reduction of heart rate following a given exercise tended to become faster by training and showed a significant change after 3 weeks. Although the resting heart rate also tended to decrease by training, no significant change was observed. (3) In rallying out a given exercise (900 kg-m/min) on a bicycle ergometer, the following change in cardio-vascular functions were observed during the training period: (3) The systolic blood pressure during steady state exercise was not affected while the diastolic blood Pressure was significantly lowered after 4 weeks of training. The resting diastolic pressure was also significantly lowered by the end of 4 weeks. (b) The cardiac output and the stroke volume during steady state exercise increased maximally within 2 weeks of training. However, the resting cardiac output was not altered while the resting stroke volume tended to increase somewhat by training. (c) The total peripheral resistance during steady state exercise was greatly lowered within 2 weeks of training. The mean circulation time during exorcise was also considerably shortened while the left heart work output during exercise increased significantly within 2 weeks. However, these functions_at rest were not altered by training. (d) Although both pH, $P_{co2}\;and\;(HCO_3-)$ of arterial plasma decreased during exercise, the magnitude of reductions became less by training. On the other hand, the $O_2$ content of arterial blood decreased during exercise before training while it tended to increase slightly after training. There was no significant alteration in these values at rest. These results indicate that cardio-pulmonary adaptations to physical training can be acquired by subjecting non-athletes to brief daily exercise routine for certain period of time. Although the time of appearance of various adaptive phenomena is not identical, it may be stated that one has to engage in daily exercise routine for at least 2 weeks for the development of significant adaptive changes.

• Proceedings of the KOSOMBE Conference
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• v.1990 no.05
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• pp.7-8
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• 1990

In this study, a new ensemble average technique was developed to measure cardiac output during treadmill exercise. Each dZ/dt peak (C point) was used as a starting point for ensemble averaging, instead of conventionally used R wave of ECG in order to prevent the peak dZ/dt waveform from blurring. In ease of using R wave as a reference, time interval from R wave to the peak of dZ/dt varies for each heart beat. Stroke volume, heart rate, and cardiac output of five male were successfully measured with Balke protocol using the new ensemble average technique.

• The Korean Journal of Rehabilitation Nursing
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• v.16 no.2
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• pp.100-111
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• 2013

Purpose: The purpose of this study was to identify the effectiveness of back pain prevention intervention program on reducing back pain of patients undergoing percutaneous coronary intervention (PCI). Methods: The patients were divided into two groups as the experimental group and control group. In the experimental group, the participants took bedrest for 4 hours after PCI and then received back pain prevention intervention program (BPPIP). Total of 5 times BPPIP with 1 hour interval for 5-10 minutes per each intervention was administered to the patients taking bedrest for 4 hours after PCI. In the control group, total of 5 times routine nursing care with 1 hour interval was administered to the patients taking bedrest for 4 hours after PCI. The data were collected on admission in the ICU and after the 5 exercise sessions. The collected data were analyzed using SPSS/WIN program. Results: No significant differences in the occurrence of hemorrhage after the BPPIP were observed between the experimental group and the control group. After the BPPIP, back pain outcomes were significantly low in the experimental group. However, urination disorder and cortisol level did not show a statistically significant differences between two groups. Conclusion: It is clear that BPPIP is a useful nursing intervention for reducing back pain of patients undergoing PCI.

• Physical Therapy Rehabilitation Science
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• v.12 no.2
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• pp.115-122
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• 2023

Objective: A previous study reported that cardiovascular training (CT) decreased interleukin-6 (IL-6), a pro-inflammatory cytokine with bidirectional effects. However, because of conflicting results of increasing and decreasing IL-6 levels in stroke patients, it is essential to clarify the effects of CT on IL-6 levels in this population. Therefore, this review aimed to investigate the effects of CT on IL-6 levels in stroke patients through a meta-analysis of randomized controlled trials (RCTs), synthesizing and analyzing the effects qualitatively and quantitatively. Design: A systematic review and meta-analysis of randomized controlled trials. Methods: In this review, conducted in April 2023, electronic databases (Web of Science, CINAHL, Embase, MEDLINE, Google Scholar) were searched to ascertain the effects of CT on IL-6 levels in stroke patients. For qualitative evaluation, ReVMan, provided by the Cochrane Group, was used, and for quantitative evaluation, a random-effects model and SMD (Standardized Mean Difference) were used. Results: Three RCTs measured IL-6 in 117 patients with stroke. The experimental group to which CT was applied showed no significant change compared to the control group.The result of analysis using the random effect model is SMD=-0.23; 95% confidence interval, -0.66 to 0.20. Conclusions: CT does not affect IL-6 levels in stroke patients. These results suggest that CT can be applied regardless of its positive or negative effect on IL-6 levels in stroke patients.

• The Korean Journal of Nuclear Medicine
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• v.26 no.1
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• pp.72-81
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• 1992

Pharmacologic coronary vasodilation in conjunction with myocardial scintigraphy has become an accepted alternative to dynamic exercise testing for the diagnosis of coronary artery disease. Although dipyridamole has traditionally been used for this purpose, it causes frequent side effect, which at times can be life-threatening. Moreover, dipyridamole dose not elicit maximal coronary vasodilation in a substantial number of patients receiving the usual i.v. dose. Adenosine is an endogenously produced compound that has significant effects as a coronary vasodilator and rapid onset action and extremely short half-life (< 10 seconds). The diagnostic accuracy and safety profile of adenosine $^{99m}Tc-MIBI$ myocardial scintigraphy were evaluated and comparison with exercise $^{99m}Tc-MIBI$ was performed. Twenty-eight subjects underwent $^{99m}Tc-MIBI$ imaging after adenosine infusion and exercise $^{99m}Tc-MIBI$ imaging. Adenosine was infused intravenously at a dose of 0.14mg/kg/body weight per minute for 6 min and MIBI was injected at 3 minute. Adenosine caused an incerease in heart rate ($64{\pm}12$ at baseline versus $74{\pm}16$ beats/min at peak effect, p<0.001), a mild decrease in systolic and diastolic blood pressure and a slightly increase in PR interval(p; NS). Side effects were reported in 92% of patients and were mostly mild in nature and promptly resolved within 1 or 2 minutes of termination of adenosine infusion. Facial flushing (53%), chest pain (36%), mild dyspnea (39%), headache (21%), throat discomfort (21%) were frequent symptoms. ST segment depression (> 1 mm) and second degree AV block in electrocardiography occured in 11% of the patients, respectively. The overall sensitivity and specificity for individual coronary stenoses in 16 patients underwent coronary angiography were 88% and 95%, respectively. The agreement ratio of segmental perfusion between adenosine and exercise images was 92% (Kappa index=0.82). In conclusion, $^{99m}Tc-MIBI$ myocardial perfusion scintigraphy with intravenous adenosine is a feasible, safe and highly accurate noninvasive technique for the detection of coronary artery disease and results are at least comparable with those of exercise $^{99m}Tc-MIBI$ scintigraphy.

• Physical Therapy Korea
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• v.17 no.2
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• pp.1-9
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• 2010

To develop effective training methods for strengthening a weakened quadriceps femoris muscle in hemiplegic patients, we examined the effects of maximal isometric contraction of the nonparalyzed knee joint on the electromyographic activities of the paralytic muscle. An electromyogram (EMG) was used to record the electromyographic activities of the paralytic quadriceps femoris muscle in 27 hemiplegic patients. The maximal isometric contraction was measured for each subject to normalize the electromyographic activities. The maximal isometric extension and flexion exercises were randomly conducted when the knee joint angles of the nonparalyzed knees were $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$. The patients were encouraged to maintain maximal isometric contractions in both knee joints during each measurement, and three measurements were taken. A one-minute rest interval was given between each measurement to minimize the effects of muscle fatigue. An average from the three values was taken as being the root mean square of the EMG and was recorded as being the maximal isometric contraction. The electromyographic activity obtained for each measurement was expressed as a percentage of the reference voluntary contraction, which was determined using the values obtained during the maximal isometric contraction. The results of this study are summarized as follows: First, when the knee joint angle of the nonparalyzed knee was $0^{\circ}$, the electromyographic activities of the paralytic medial aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). Second, when the knee joint angle of the nonparalyzed knee was $90^{\circ}$, the electromyographic activities of the paralytic lateral aspect of rectus femoris were related to measurement by a maximal isometric flexion exercise than by an extension exercise (p<.05). The results show that myoelectrical activities of paralytic quardriceps were not related to measurement angles and exercise directions of the nonparalized knee joint. Studies on various indirect intervention to improve muscular strength of patients with nervous system disorders of the weakened muscle should be constantly conducted.

• 한국체육학회지인문사회과학편
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• v.57 no.5
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• pp.269-279
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• 2018

The purpose of this study is to examine the association between resistance exercise frequency, muscular strength, and health-related quality of life in Korean cancer patients. We performed complex sample general linear model and logistic regression analysis using data from a total of 647 cancer patients in the 2014~2016 Korean National Health and Nutrition Examination Survey (KNHANES). Participants who were participating in resistance exercise 0~1 day per week had lower EQ-5D index (0.852±0.016 vs. 0.890±0.020; p=0.006) and a significantly higher risk of having problems in mobility (Odd ratio[OR]=4.07; 95% confidence interval [CI]=1.31-12.63) compared to those who were participating in resistance exercise ≥ 5 days per week. Participants with low hand-grip strength had lower EQ-5D index (0.850±0.018 vs. 0.911±0.016; p<0.001) and a significantly higher risk of having problems in mobility (OR=4.94, 95% CI=2.14-11.41), usual activities (OR=5.18, 95% CI=1.56-17.14), and pain/discomfort (OR=2.46, 95% CI=1.33-4.55) compared to those with high hand-grip strength. This study showed that resistance exercise frequency and muscular strength were associated with health-related quality of life in Korean cancer patients.