문화기술의 융합 (The Journal of the Convergence on Culture Technology)

  • 제10권6호
  • /
  • Pages.377-384
  • /
  • 2024
  • /
  • 2384-0358(pISSN)
  • /
  • 2384-0366(eISSN)
국제문화기술진흥원 (The International Promotion Agency of Culture Technology)
권호 표지
DOI QR코드

DOI QR Code

만성기 뇌졸중 환자의 호흡훈련 방법에 따른 폐기능, 가슴우리 확장, 균형에 미치는 영향

The Effects of Different Respiratory Training Methods on Pulmonary Function, Thoracic Expansion, and Balance in Patients with Chronic Stroke

  • 김은자 (경동대학교 물리치료학과)
  • Eun-Ja Kim (Dept. Of Physical Therapy, Kyungdong, University)
  • 투고 : 2024.08.19
  • 심사 : 2024.11.05
  • 발행 : 2024.11.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

만성기 뇌졸중 환자에서 호흡근 약화는 폐기능과 균형 능력 저하가 나타난다. 따라서 본 연구는 기구를 이용한 호흡훈련과 호흡근에 저항을 적용한 훈련 방법이 폐기능, 가슴우리 확장, 균형에 미치는 영향을 알아보고자 하였다. 본 연구의 대상자는 총 20명이었으며, 저항성 흡기 훈련기구를 이용한 호흡훈련군 1(10명)과 가슴팽창 저항 훈련의 호흡훈련군 2(10명)으로 선정하였다. 폐기능, 몸통손상척도(K-TIS), 가슴우리 확장검사(CEM), 기능적 전방 팔 뻗기검사(FRT)를 호흡훈련 전과 후에 평가 하였다. 호흡훈련은 주 5회, 총 6주간 실시하였다. 호흡훈련군 1과 호흡훈련군 2에서 폐기능, 몸통손상척도, 가슴우리 확장검사, 기능적 전방 팔 뻗기 검사에서 유의한 증가를 보였으며, 그룹간의 변화 비교에서 유의한 차이가 나타나지 않았다. 본 연구의 결과 기구를 이용한 호흡훈련과 호흡근에 저항을 이용한 호흡훈련은 폐기능, 가슴우리 확장, 균형에 효과가 있었으며, 호흡근에 직접적 저항을 적용한 호흡훈련은 호흡근 강화와 균형 능력에 향상에 긍정적 영향을 미치며, 만성기 뇌졸중 환자의 일반적 재활치료와 병행하는 것이 기능회복을 위해 중요하다고 판단된다.

In chronic stroke patients, respiratory muscle weakness leads to decreased pulmonary function and balance ability. Therefore, this study was conducted to investigate the effects of respiratory training using a device and training methods that apply resistance to respiratory muscles on pulmonary function, thoracic cage expansion, and balance. A total of 20 participants were included in the study, divided into two groups: Respiratory Training Group 1 (n:10) using a resistive inspiratory device and Respiratory Training Group 2 (n:10) undergoing chest expansion resistance training. Lung function, the Korean Version of the Trunk Impairment Scale (K-TIS), Chest Expansion Measurement (CEM), and the Functional Reach Test (FRT) were assessed before and after the respiratory training. The training was conducted five times a week for a total of six weeks. Both Respiratory Training Group 1 and Group 2 showed significant improvements in lung function, K-TIS, CEM, and FRT scores, with no significant differences between the groups. The results of this study showed that breathing training using a device and breathing training that applied resistance to respiratory muscles were effective for pulmonary function, thoracic cage expansion, and balance, and that breathing training that applied direct resistance to respiratory muscles had a positive effect on strengthening respiratory muscles and improving balance ability, and that it was judged important to perform it in conjunction with general rehabilitation treatment for chronic stroke patients for functional recovery.

키워드

과제정보

이 논문은 2023년도 경동대학교 교내연구비로 연구되었음

참고문헌

  1. B. W. Lee., H. K. Kwon and H. J. Lee. "Clinical pictures of stroke patients", Journal of Korean Academy of Rehabilitation Medicine. 24(3), pp.370-374.(2000).
  2. R. S. Howard., A. G. Rudd and C. D. Wolfe., et al. "Pathophysiological and clinical aspects of breathing after stroke", Postgraduate Medical Journal. 77(913), pp.700-702. (2001). https://doi.org/10.1136/pmj.77.913.700
  3. E. M. Khedr., E. l. Shinawy O., and T. Khedr., et al.. "Assessment of corticodiaphragmatic pathway and pulmonary function in acute ischemic stroke patients", European Journal of Neurology. 7(3), pp.323-330. (2000). https://doi.org/10.1046/j.1468-1331.2000.00078.x
  4. C. M. Laroche., N. Carroll and J. Moxham., et al. "Clinical significance of severe isolated diaphragm weakness", American Review of Respiratory Dsease. 138(4), pp. 862-866. (1988). https://doi.org/10.1164/ajrccm/138.4.862
  5. J. M. Annoni., D. Ackermann and J. Kesselring. "Respiratory function in chronic hemiplegia", International Disability Studies. 12(2), pp.78-80. (1990). https://doi.org/10.3109/03790799009166256
  6. R. R. Britto., N. R. Rezende and K. C. Marinho., et al. "Inspiratory muscular training in chronic stroke survivors: a randomized controlled trial", Archives of Physical Medicine and Rehabilitation. 92(2), pp.184-190. (2011). https://doi.org/10.1016/j.apmr.2010.09.029
  7. T. Troosters., R. Gosselink and M. Decramer. "Respiratory muscle assessment", European Respiratory Monograph. 31,57. (2005).
  8. J. H. Lee. "Effects of general and preferred exercise programs on balance ability and fall efficacy in elderly people", The Journal of the Convergence on Culture Technology, 10(3), pp.533-539. (2024). https://doi.org/10.17703/JCCT.2024.10.3.533
  9. E. Battaglia., A. Fulgenzi and M. E. Ferrero. "Rationale of the combined use of inspiratory and expiratory devices in improving maximal inspiratory pressure and maximal expiratory pressure of patients with chronic obstructive pulmonary disease", Archives of Physical Medicine and Rehabilitation. 90(6), pp.913-918. (2009). https://doi.org/10.1016/j.apmr.2008.12.019.
  10. T. Padkao and O. Boonla. "Relationships between respiratory muscle strength, chest wall expansion, and functional capacity in healthy nonsmokers", Journal of exercise rehabilitation, 16(2),pp. 189-196. (2020). doi: 10.12965/jer.2040080.040
  11. S. Aydogan Arslan., K. Ugurlu and E. Sakizli Erdal., et al. "Effects of inspiratory muscle training on respiratory muscle strength, trunk control, balance and functional capacity in stroke patients: a single-blinded randomized controlled study", Topics in Stroke Rehabilitation, 29(1), pp. 40-48. (2022). https://doi.org/10.1080/10749357.2020.1871282
  12. G. B. Song and E. C. Park. "Effects of chest resistance exercise and chest expansion exercise on stroke patients' respiratory function and trunk control ability", Journal of physical therapy science, 27(6), pp.1655-1658. (2015). https://doi.org/10.1589/jpts.27.1655
  13. H. Kubo., M. Nozoe and M. Yamamoto., et al. "Recovery process of respiratory muscle strength in patients following stroke: A Pilot Study", Physical Therapy Research. 23(2), pp123-131, https://doi.org/10.1298/ptr.E10006
  14. R. D. Pollock and G. F. Rafferty , Moxham J. "Respiratory muscle strength and training in stroke and neurology: a systematic review", International Journal of Stroke. 8(2), pp.124-130. (2013). https://doi.org/10.1111/j.1747-4949.2012.00811.x
  15. T. H. Shaffer., M. R. Wolfson and V. K. Bhutani. "Respiratory muscle function, assessment, and training", Physical Therapy. 61(12), pp.1711-1723. (1981). https://doi.org/10.1093/ptj/61.12.1711
  16. J. H. Jung and N. S. Kim. "Effects of inspiratory muscle training on diaphragm thickness, pulmonary function, and chest expansion in chronic stroke patients", Journal of The Korean Society of Physical Medicine. 8(1), pp.59-69. (2013). https://doi.org/10.13066/kspm.2013.8.1.059.
  17. N. J. Jung., S. S. Na., S. K. Kim and G. Hwangbo. "The effect of the inspiratory muscle training on functional ability in stroke patients", Journal of Physical Therapy Science, 29(11), pp.1954-1956. (2017). https://doi.org/10.1589/jpts.29.1954.
  18. A. Klusiewicz, L. Borkowski and R. Zdanowicz., et al. "The inspiratory muscle training in elite rowers", Journal of Sports Medicine and Physical Fitness. 48(3), pp.279-284.(2008).
  19. C. B. Kim., J. M. Yang and J. D. Choi. "The effects of chest expansion resistance exercise on chest expansion and maximal respiratory pressure in elderly with inspiratory muscle weakness", The Journal of Physical Therapy Science, 27(4), pp.1121-1124. (2015). https://doi.org/10.1589/jpts.271121.
  20. S. P. Nair., S. S. Gardas and R. Mithaiwala. "Efficacy of chest expansion resistance exercise on respiratory function, trunk control and dynamic balance in patients with chronic stroke: A Comparative study", Bulletin of Faculty of Physical Therapy. 26(23), pp.1-8. (2021). https://doi.org/10.1186/s43161-021-00041-z.
  21. S. W. Saunders., D. Rath anf P. W.. Hodges. "Postural and respiratory activation of the trunk muscles changes with mode and speed of locomotion", Gait & Posture 20(3), pp.280-290. (2004). https://doi.org/10.1016/j.gaitpost.2003.10.003.
  22. P. W. Hodges., I. Heijnen and S. C. Gandevia. "Postural activity of the diaphragm is reduced in humans when respiratory demand increases", The Journal of Physiology. 537(3), pp.999-1008. (2001). https://doi.org/10.1111/j.1469-7793.2001.00999.x.
  23. M. S. Lee., Y. K. Seo and K. T. Kim., et al. "Factors associated with Anxiety and Depression among University Students during the COVID-19 Pandemic in Korea", International Journal of Advanced Culture Technology, 11(1), pp. 1-11. (2023).https://doi.org :10.17703/IJACT.2023.11.1..1.