• The Journal of Korean Physical Therapy
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• v.30 no.2
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• pp.58-62
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• 2018

Purpose: This study evaluated the effects of respiratory muscle training on respiratory function, balance, and activities of daily living (ADL) in patients with stroke. Methods: The study included 21 patients with stroke, divided into the experimental group and control group. Both groups underwent traditional physical therapy once a day for 30 minutes, five times weekly for 6 weeks. The experimental group underwent additional respiratory muscle training once a day, five times a week during the study period. Maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), Berg balance scale (BBS), and Korean-modified Barthel index (K-MBI) were measured before and after the study period. For statistical analysis, paired t-test was used to compare the difference between the pre and post values. Independent t-test was used compare the differences between groups. Results: Both groups had significantly improved MIP, MEP, BBS, and K-MBI scores after the study period. The experimental group had significantly improved MIP, MEP, BBS, and K-MBI scores. Conclusion: These results suggest that respiratory muscle training improves respiratory function, balance, and ADL in patients with stroke.

• Tuberculosis and Respiratory Diseases
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• v.74 no.2
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• pp.63-69
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• 2013

Background: Aiming to improve outcome of lung transplantation (LTx) patients, we reviewed risk factors and treatment practices for the LTx recipients who experienced respiratory infection in the late post-LTx period (>1 month after LTx). Methods: We analyzed the clinical data of 48 recipients and donors from 61 LTx, who experienced late respiratory infections. Late respiratory infections were classified according to the etiology, time of occurrence, and frequency of donor-to-host transmission or colonization of the recipient prior to transplantation. Results: During the period of observation, 42 episodes of respiratory infections occurred. The organisms most frequently involved were gram (-) bacteria: Acinetobacter baumannii (n=13, 31.0%), Pseudomonas aeruginosa (n=7, 16.7%), and Klebsiella pneumoniae (n=4, 10.0%). Among the 42 episodes recorded, 14 occurred in the late post-LTx period. These were bacterial (n=6, 42.9%), fungal (n=2, 14.3%), viral (n=4, 28.5%), and mycobacterial (n=2, 14.3%) infections. Of 6 bacterial infections, 2 were from multidrug-resistant (MDR) A. baumannii and one from each of MDR P. aeruginosa, extended spectrum ${\beta}$-lactamase (+) K. pneumoniae, methicillin-resistant Staphylococcus aureus and Streptococcus pneumoniae. Infection-related death occurred in 6 of the 14 episodes (43%). Conclusion: Although the frequency of respiratory infection decreased sharply in the late post-LTx period, respiratory infection was still a major cause of mortality. Gram (-) MDR bacteria were the agents most commonly identified in these infections.

• Journal of The Korean Society of Integrative Medicine
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• v.11 no.4
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• pp.135-145
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• 2023

Purpose : The purpose of this study was to discover which breathing technique is more effective in improving respiratory function by applying different breathing techniques-the chest expansion respiratory technique and the abdominal expansion respiratory technique-to adults in the same aerobic exercise situation. Methods : In this study, 30 people were randomly assigned to two groups: chest expansion respiratory technique with aerobic exercise (A group) and abdominal expansion respiratory technique with aerobic exercise (B group). Group A was asked to breathe after wrapping their rib cage with an elastic band, and Group B was asked to breathe after wrapping their abdomen with an elastic band. A total of 3 sets of 30 breaths were performed, 3 times a week for 6 weeks. For statistical processing, an independent t-test was used to verify homogeneity between the two groups, and a repeated measure analysis of variance (ANOVA) was used to compare differences according to the period for each group. Results : The changes in FVC and FEV₁ for each group following 6 weeks of intervention are as follows. In comparison according to the intervention period, there was a significant increase in all groups depending on the timing of measurement (p<.05), and as a result of the inter-subject effect test, there was no significant difference between groups (p>.05). In addition, there was no interaction effect between period and group (p>.05). Conclusion : The conclusion of this study is that FVC and FEV₁ values increased according to the intervention period in both groups; therefore, it can be suggested that flexible breathing techniques can be applied depending on the patient's physical situation when applying a breathing program to improve respiratory function.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.3
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• pp.55-64
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• 2021

PURPOSE: The purpose of this study was to apply dynamic neuromuscular stabilization (DNS) to subjects with forward head posture (FHP) and to compare its effects on respiratory function as against the conventional neck stabilization exercise and neck stretching and extensor strengthening exercises. METHODS: The whole-body posture measurement system was used to measure the degree of FHP, and a spirometer and a respiratory gas analyzer were used to measure the respiratory function. After the intervention was completed, the changes over time were analyzed in the DNS group, the neck stabilization exercise group, and the neck stretching and extensor strengthening exercise group. The inter-group difference in the changes was also analyzed. A repeated ANOVA was performed to compare the respiratory function according to the period between the three groups, and the least significant difference (LSD) method was used for the post hoc test. RESULTS: After the 6-week exercise period, respiratory functions, such as forced vital capacity (FVC), forced expiratory volume for 1 second (FEV1), forced expiratory volume for 1 sec/forced vital capacity (FEV1/FVC), maximum oxygen intake (VO₂max), and the volume of expired gas (VE), significantly improved according to the period (p < .05), but no inter-group differences were found. CONCLUSION: DNS is an effective training method, and can be applied along with neck stabilization exercise and neck stretching and extensor strengthening exercises, which are widely used in clinical practice, to people with FHP who cannot directly perform neck exercises to improve their respiratory function.

• The Journal of Korean Society for Radiation Therapy
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• v.23 no.2
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• pp.83-90
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• 2011

Purpose: This study statistically analyzed the difference of the stability of maintaining a respiratory period shown according to position and use of a device to search the tendency and usefulness of a device. Materials and Methods: The study obtained respiratory signals which maintained a respiratory period for 20 minutes each supine and prone position for 11 subjects. The study obtained respiratory signals in a state of using a belly board for 7 patients in a bad condition of a respiratory period in a prone position to analyze a change in respiration and the stability before and after the use of a device. Results: The supine part showed 54.5%, better than the prone part of 36.4% in a case that the stability for maintaining a respiratory period was in a good condition as a fixed respiratory period was well maintained according to the position. 6 patients (85%) showed a maintenance pattern of a respiratory period significantly different before the use and 4 patients showed a significantly good change in the stability for maintaining a respiratory period as a result that belly boards were used for 7 patients that the maintenance of a respiratory period was not in a good condition on a prone position. Conclusion: It seemed that this study could contribute to the maintenance of respiratory period and of respiratory stability as the optimal position for maintenance of respiration and the use of a device such as a belly board were decided through statistic analysis of respiratory signals and its application even if patient position and use of device were decided by the beam arrangement a treatment part of a patient, location of a target, and an expected plan.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.123-135
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• 2012

Purpose: It is essential to minimize the movement of tumor due to respiratory movement at the time of respiration controlled radiotherapy of non-small cell lung cancer patient. Accordingly, this Study aims to evaluate the usefulness of restricted respiratory period by comparing and analyzing the treatment plans that apply free and restricted respiration period respectively. Materials and Methods: After having conducted training on 9 non-small cell lung cancer patients (tumor n=10) from April to December 2011 by using 'signal monitored-breathing (guided- breathing)' method for the 'free respiratory period' measured on the basis of the regular respiratory period of the patents and 'restricted respiratory period' that was intentionally reduced, total of 10 CT images for each of the respiration phases were acquired by carrying out 4D CT for treatment planning purpose by using RPM and 4-dimensional computed tomography simulator. Visual gross tumor volume (GTV) and internal target volume (ITV) that each of the observer 1 and observer 2 has set were measured and compared on the CT image of each respiratory interval. Moreover, the amplitude of movement of tumor was measured by measuring the center of mass (COM) at the phase of 0% which is the end-inspiration (EI) and at the phase of 50% which is the end-exhalation (EE). In addition, both observers established treatment plan that applied the 2 respiratory periods, and mean dose to normal lung (MDTNL) was compared and analyzed through dose-volume histogram (DVH). Moreover, normal tissue complication probability (NTCP) of the normal lung volume was compared by using dose-volume histogram analysis program (DVH analyzer v.1) and statistical analysis was performed in order to carry out quantitative evaluation of the measured data. Results: As the result of the analysis of the treatment plan that applied the 'restricted respiratory period' of the observer 1 and observer 2, there was reduction rate of 38.75% in the 3-dimensional direction movement of the tumor in comparison to the 'free respiratory period' in the case of the observer 1, while there reduction rate was 41.10% in the case of the observer 2. The results of measurement and comparison of the volumes, GTV and ITV, there was reduction rate of $14.96{\pm}9.44%$ for observer 1 and $19.86{\pm}10.62%$ for observer 2 in the case of GTV, while there was reduction rate of $8.91{\pm}5.91%$ for observer 1 and $15.52{\pm}9.01%$ for observer 2 in the case of ITV. The results of analysis and comparison of MDTNL and NTCP illustrated the reduction rate of MDTNL $3.98{\pm}5.62%$ for observer 1 and $7.62{\pm}10.29%$ for observer 2 in the case of MDTNL, while there was reduction rate of $21.70{\pm}28.27%$ for observer 1 and $37.83{\pm}49.93%$ for observer 2 in the case of NTCP. In addition, the results of analysis of correlation between the resultant values of the 2 observers, while there was significant difference between the observers for the 'free respiratory period', there was no significantly different reduction rates between the observers for 'restricted respiratory period. Conclusion: It was possible to verify the usefulness and appropriateness of 'restricted respiratory period' at the time of respiration controlled radiotherapy on non-small cell lung cancer patient as the treatment plan that applied 'restricted respiratory period' illustrated relative reduction in the evaluation factors in comparison to the 'free respiratory period.

• Journal of Dental Anesthesia and Pain Medicine
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• v.18 no.2
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• pp.97-103
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• 2018

Background: Respiration monitoring is necessary during sedation for dental treatment. Recently, acoustic respiration rate ($RRa^{TM}$), an acoustics-based respiration monitoring method, has been used in addition to auscultation or capnography. The accuracy of this method may be compromised in an environment with excessive noise. This study evaluated whether noise from the ultrasonic scaler affects the performance of RRa in respiratory rate measurement. Methods: We analyzed data from 49 volunteers who underwent scaling under intravenous sedation. Clinical tests were divided into preparation, sedation, and scaling periods; respiratory rate was measured at 2-s intervals for 3 min in each period. Missing values ratios of the RRa during each period were measuerd; correlation analysis and Bland-Altman analysis were performed on respiratory rates measured by RRa and capnogram. Results: Respective missing values ratio from RRa were 5.62%, 8.03%, and 23.95% in the preparation, sedation, and scaling periods, indicating an increased missing values ratio in the scaling period (P < 0.001). Correlation coefficients of the respiratory rate, measured with two different methods, were 0.692, 0.677, and 0.562 in each respective period. Mean capnography-RRa biases in Bland-Altman analyses were -0.03, -0.27, and -0.61 in each respective period (P < 0.001); limits of agreement were -4.84-4.45, -4.89-4.15, and -6.18-4.95 (P < 0.001). Conclusions: The probability of missing respiratory rate values was higher during scaling when RRa was used for measurement. Therefore, the use of RRa alone for respiration monitoring during ultrasonic scaling may not be safe.

• The Journal of Korean Physical Therapy
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• v.24 no.5
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• pp.340-347
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• 2012

Purpose: This study was conducted in order to investigate the effect on respiratory function, trunk control, and functional activities of daily living (ADL) through respiratory muscle strength training in patients with chronic stroke. Methods: Eighteen subjects who were six months post stroke participated in this study. The subjects were randomly allocated to two groups: experimental (n=10) and control (n=8). Both groups received physical therapy for five sessions, 30 minutes per week, during a period of six weeks. Subjects in the experimental group participated in an additional respiratory muscle strength training program, in which the threshold PEP device was used for 30 minutes per day, three days per week, during a period of six weeks. Results from pretest-posttest control were evaluated by pulmonary function forced vital capacity (FVC), forced expiratory volume at one second (FEV1), FEV1/FVC, peak expiratory flow (PEF), capacity of cough, trunk control, and functional ADL. Results: Significant improvement in the FEV1, PEF of pulmonary function (p<0.05), cough function (p<0.05), and trunk control (p<0.05) was observed among the groups. Conclusion: Respiratory muscle strength training improves pulmonary function, capacity of cough, and trunk control. These results suggest that respiratory muscle strength training is feasible and suitable for individuals with chronic stroke.

• The Korean Journal of Emergency Medical Services
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• v.24 no.3
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• pp.161-169
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• 2020

Purpose: This study aims to identify changes in patients' transport time and chief complaints visiting the emergency room via emergency medical services from the "pre-COVID-19 period" compared to the "COVID-19 early-stage period". Methods: This retrospective observational study analyzed the emergency medical services reports at two time periods defined by the COVID-19 virus outbreak in Korea. The study was conducted in Busan, the Republic of Korea, from January 19 through May 6, 2019. Results: The transfer time of patients transported during the "COVID-19 early-stage period" was significantly delayed compared to the "pre-COVID-19 period" (p<.05). We found a significant increase in transport time for patients complaining of respiratory infections compared to patients without symptoms (p<.05). During the "COVID-19 early-stage period", there was a significant increase in the number of patients with respiratory infections and patients complaining of general symptoms compared to the "COVID-19early-stage period" (p<.05). Conclusion: The spread of the COVID-19 virus infection delayed patient transport and increased the number of patients reporting respiratory infection symptoms. Emergency medical services will need administrative and economic support to transport the increased number of patients requiring services.

• Progress in Medical Physics
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• v.23 no.1
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• pp.1-7
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• 2012

The purpose of this study was to develop the respiratory training system using individual characteristic guiding waveform to reduce the impact of respiratory motion that causes artifact in radiotherapy. In order to evaluate the improvement of respiratory regularity, 5 volunteers were included and their respiratory signals were acquired using the in-house developed belt-type sensor. Respiratory training system needs 10 free breathing cycles of each volunteer to make individual characteristic guiding waveform based on Fourier series and it guides patient's next breathing. For each volunteer, free breathing and guided breathing which uses individual characteristic guiding waveform were performed to acquire the respiratory cycles for 3 min. The root mean square error (RMSE) was computed to analyze improvement of respiratory regularity in period and displacement. It was found that respiratory regularity was improved by using respiratory training system. RMSE of guided breathing decreased up to 40% in displacement and 76% in period compared with free breathing. In conclusion, since the guiding waveform was easy to follow for the volunteers, the respiratory regularity was significantly improved by using in-house developed respiratory training system. So it would be helpful to improve accuracy and efficiency during 4D-RT, 4D-CT.