• 제목/요약/키워드: pulmonary rehabilitation

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코비드-19와 물리치료적 접근 (Physiotherapy Management for COVID-19)

  • 한윤아;노효련
    • 대한물리의학회지
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    • 제15권3호
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    • pp.135-147
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    • 2020
  • PURPOSE: The purpose of this paper is to provide a review of physiotherapy intervention for patients with COVID-19 during their hospital admission and post-discharge. METHODS: The recommendations and guidelines of physiotherapy management, medical management, and general information of the WHO, Australian Physiotherapist, European Respiratory Society, British Thoracic Society, and American Thoracic Society were reviewed. RESULTS: This paper contains general information on COVID-19, including medical management, and the importance of physiotherapy approaches including an assessment of the patients' function, such as the 6-minute walking test, five sit to stand or sit to stand for one minute to measure their function as their recovery journey. The patients' quality of life, anxiety, and depression should be considered. Physiotherapy management should be based on an assessment of the patient's presenting impairments, including inclusion and exclusion of physiotherapy intervention. The paper also approaches step by step with the disease progress, from an intensive care unit, the general ward in the acute phase, through to the rehabilitation ward if needed, and post-discharge as an outpatient.. CONCLUSION: The paper has a limitation due to the unknown factor of the natural history of COVID-19. Depending on the patients' recovery journey and the rehabilitation needed, any physiotherapy interventions should focus on what the patients' need on their journey to recovery, e.g., pulmonary, cardiac, neurological, and general rehabilitation. In addition, applying personal protection equipment for treating physiotherapists is a mandatory requirement because this protects from the transmission of COVID-19.

만성폐쇄성폐질환 환자의 영양관리 (Nutritional Management in Patients with Chronic Obstructive Pulmonary Disease)

  • 이관호
    • Journal of Yeungnam Medical Science
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    • 제21권2호
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    • pp.133-142
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    • 2004
  • Chronic obstructive pulmonary disease(COPD) is characterized by a not entirely reversible limitation in the airflow. An airflow limitation is progressive and associated with an abnormal inflammatory response of the lung to gases and harmful particles. In COPD, the weight loss is commonly observed and there is a negative impact on the respiratory as well as skeletal muscle function. The pathophysiological mechanisms that result in weight loss in COPD are not fully understood. However, the mechanisms of weight loss in COPD may be the result of an increased energy expenditure unbalanced by an adequate dietary intake. The commonly occurring weight loss and muscle wasting in COPD patients adversely affect the respiratory and peripheral muscle function, the exercise capacity, the health status, and even the survival rates. Therefore, it is very valuable to include management strategies that the increase energy balance in order to increase the weight and fat free mass. A Better understanding of the molecular and cellular pathological mechanisms of COPD can improve the many new directions for both the basic and clinical investigations. The Nutritional supply is an important components of a multidisciplinary pulmonary rehabilitation program. Future studies combining an exercise program, the role of anabolic steroids, nutritional individualization, a more targeted nutritional therapy, and the development of new drugs including anti-cytokines is needed for the effective management of COPD.

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간헐적 양압호흡기를 이용한 호흡운동치료 후 근 이영양증 환자의 폐기능 변화 (Changes in Pulmonary Functioning After Respiratory Excercise Treatment in Patients With Progressive Muscular Dystrophy)

  • 김기송;이규완;오덕원
    • 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.

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순환식 유산소운동이 만성 뇌졸중 환자의 폐 기능 및 보행 지구력에 미치는 영향 (Effects of Circuit Aerobic Exercise on Gait Endurance and Pulmonary Function in Patients after Chronic Stroke)

  • 박종준;최윤희;차용준
    • 대한물리의학회지
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    • 제11권4호
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    • pp.33-39
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    • 2016
  • PURPOSE: The purpose of this study was to investigate whether a circuit aerobic exercise program positively affects pulmonary function and gait endurance in chronic stroke patients. METHODS: Twenty-four chronic stroke patients were allocated equally and randomly to an experimental group (n=12) or a control group (n=12). All participants received 60 minutes of comprehensive rehabilitation treatment, the experimental group additionally performed a circuit aerobic exercise for 30 minutes, while the control group additionally performed a general aerobic exercise, i.e., gait training on the treadmill for 30 minutes. These 30-minute exercise sessions were held three times per week for six weeks. Pulmonary function was assessed using forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximal voluntary ventilation (MVV), and gait endurance was assessed using the 6-minute walk test (6MWT). RESULTS: In the both groups, FVC, FEV1, MVV, and 6MWT were significantly increased after training. Members of the experimental group showed significant improvements in FVC, FEV1, and MVV, and significantly greater improvements than controls (p<.05). However, 6MWT improvements were not significantly different in the two groups (p>.05). CONCLUSION: The devised circuit aerobic exercise program offers an effective rehabilitation aerobic exercise for improving pulmonary function and gait endurance in patients after chronic stroke.

만성 폐쇄성 폐질환 환자를 위한 호흡재활 중재가 운동 능력 및 내구성, 일반적 건강상태에 미치는 효과에 대한 메타분석 (Meta-analysis on the Effectiveness of Pulmonary Rehabilitation Program on Exercise Capacity/Tolerance and General Health Status)

  • 오현수
    • 대한간호학회지
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    • 제33권6호
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    • pp.743-752
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    • 2003
  • Purpose: This study was conducted to combine the effects of pulmonary rehabilitation program (PRP) on exercise capacity/tolerance and general health status of COPD patients based on the primary research results examined the effects of PRP, Method: Seventeen studies were selected by the sampling criteria established to include the studies that reported enough statistics necessary to conduct meta-analysis. Result: According to the study results, the most effective indicators for exercise capacity/tolerance were exercise time (such as cycling time or treadmill walking time) and ground walking distance within given time (6 minutes or 12 minutes), whereas effects on such indicators as VE and VO$_2$ were not statistically significant. PRP induced significant effect on patients' general health status, frequently measured by physical, psycho-emotional, and holistic indicators, the enhancement on psycho-emotional dimension resulted from PRP was more prominent than those of the other dimensions. From the results, it was noted that the place where PRP was given and the contents of PRP exercised their influence on the outcome variables. Which body part was trained was also one of the important factors that influence on the patients' perception of dyspnea during exercise as well as on exercise capacity/tolerance. Conclusion: PRP including exercise training significantly improved the exercise capacity and general health status of COPD patients.

호흡근 강화 훈련이 아급성 뇌졸중 환자의 폐기능과 보행 능력에 미치는 영향 (The Effects of Respiratory Muscle Strengthening Training on Pulmonary Function and Gait Ability in Subacute Stroke Patients)

  • 김진석;신원섭
    • 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.

주요대동맥-폐동맥 측부혈관이 동반된 기능적 단심실 환자에서의 폰탄수술 (Fontan Procedure for Functional Single Ventricle with Major Aortopulmonary Collateral Arteries)

  • 홍순창;박한기;조범구;박영환
    • Journal of Chest Surgery
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    • 제37권6호
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    • pp.539-542
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    • 2004
  • 폐동맥 형태가 비정상적이거나 폐동맥 저항이 높은 경우뿐 아니라 주요 대동맥-폐동맥 측부혈관은 폰탄 수술의 위험을 높이는 인자로 알려져 있다. 저자들은 기능적 단심실과 더불어 양측 폐동맥의 발달이 매우 미약하고 양측 폐의 대부분을 주요 체-폐동맥 부행혈관에 의해 혈류가 공급되는 고위험 폰탄수술 환자에서, 단일초점화수술과 체폐동맥 단락술로 폐동맥 재건과 단계적 수술을 거쳐 성공적으로 폰탄수술에 이르렀기에 이를 보고하는 바이다.

Effect of High-Intensity Complex Exercise Program Using Whole-Body Vibration and Respiratory Resistance for Low Back Pain Patients with High Obesity

  • Park, Sam-Ho;Lee, Myung-Mo
    • Physical Therapy Rehabilitation Science
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    • 제11권1호
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    • pp.78-87
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    • 2022
  • Objective: The purpose of this study was to investigate the effect of high-intensity complex exercise program using whole-body vibration (WBV) and respiratory resistance on pain and dysfunction, psychosocial level, balance ability, and pulmonary function in low back pain (LBP) patients with high obesity. Design: A randomized controlled trial Methods: A total of 44 LBP patients withhigh obesity (body mass index, BMI≥30kg/m2) were randomly assigned to an experimental group (n=22) and a control group (n=22). Both groups underwent a lumbar stabilization exercise program. In addition, the experimental group implemented the high-intensity complex exercise program combined with WBV and respiratory resistance. In order to compare the effects depending on the intervention methods, numeric pain rating scale (NRPS), Roland-Morris disability questionnaire (RMDQ), fear-avoidance beliefs questionnaire (FABQ), balance ability, and pulmonary function were used for measurement. Results: Both groups showed significant differences in NRPS, RMDQ, FABQ, balance ability before and after intervention (p<0.05). In addition, the experimental groupshowed significant difference in the amount of change in RMDQ, balance ability and pulmonary function values than the control group (p<0.05). Conclusions: High-intensity complex exercise program using WBV and respiratory resistance has been proven to be an effective and clinically useful method to decrease dysfunction, increase balance ablilty, and pulmonary function for LBP patients with high obesity.

척수손상 환자의 자세 변화 후 시간경과와 복대사용이 폐기능에 미치는 영향 (A Study on the Effect of Time Lapse After Position Change and Abdominal Band on Pulmonary Function in the Cervical Cord Injuries)

  • 이재호;박창일;전중선
    • 한국전문물리치료학회지
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    • 제4권3호
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    • pp.17-33
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    • 1997
  • The objective of this study was to identify pulmonary functional variations in relation to postural changes, lapse after changing position, and the use of abdominal band in the cervical cord injured. The subjects of this study were 19 quadriplegic patients who had been admitted to the department of the Rehabilitation Hospital, College of Medicine, Yousei University, from April, 1997 through May 3, 1997. A spiroanalyzer was used to measure pulmonary function in supine, standing, time after changing position, and recording to the position, application method, and tightness of the abdominal band. The data were analyzed by the repeated measure one-way ANOVA, and Wilcoxon signed rank test. The findings were as follows: 1. All phase of the patients' pulmonary function improved significantly in supine posture in contrast to standing (vital capacity by $0.46{\ell}$ and expiratory reserve volume by $0.09{\ell}$). 2. The longer the time lapsed from supine posture to standing, the patient's expiratory reserve volume, maximum ventilation volume, vital capacity, and forced expiratory volume increased. 3. When the patient lay in supine position, the maximum ventilation volume, vital capacity, and the forced vital capacity increased then the center line of the abdominal band was placed along iliac crest; on the other hand, when the patient was standing, placing the bottom line of the abdominal band along iliac crest increased the maximum ventilation volume, vital capacity, and forced expiratory volume. 4. In placing the abdominal band in the patients, leaving space between the top and bottom lines of the band helped increased in maximum ventilation volume, vital capacity, and forced vital capacity for patient in supine as well as in standing. 5. When placing the abdominal band to patients in supine posture, reducing the length of the band by 2.5% along the patient's waist line increased the patients' vital capacity, while reducing the length by 10% to patients in standing increased the maximum ventilation volume. The abdominal band should be placed in such a way that the bottom part of the band should be more tightly fastened while leaving enough room for a hand to be placed in between the body and the band for the top part of the hand. It should also be noted that in a supine position, the bottom line of the band should be placed along the iliac crest, while in standing, the center line should be placed along the iliac crest. The length of the band should also be reduced by 2.5% of the waist line in supine position, and in standing, the length should be reduced by 10%. It should also be noted that the pulmonary function of the patients should be measured at least 10 minutes after one position change.

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Rehabilitation of spinal muscular atrophy: current consensus and future direction

  • Yi, You Gyoung;Shin, Hyung-Ik;Jang, Dae-Hyun
    • Journal of Genetic Medicine
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    • 제17권2호
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    • pp.55-61
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    • 2020
  • Spinal muscular atrophy (SMA) is a neuromuscular disease that requires multidisciplinary medical care, including rehabilitation management. The emergence of a genetic therapy-based approach for SMA has markedly changed the disease course. Nonetheless, currently, updated physical therapy and rehabilitation are warranted for individuals with SMA in the era of gene therapy. In this review, we discuss the physical therapy and rehabilitation strategies currently performed for people with SMA, such as positioning and bracing, supported standing, management of musculoskeletal deformities, stretching, physical exercise training like aerobics and strengthening exercises, assistive devices, pulmonary rehabilitation, and dysphagia treatment.