• Title/Summary/Keyword: 운동부하검사

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허혈성 심질환의 자기공명 영상 진단

  • 최영희
    • Investigative Magnetic Resonance Imaging
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    • v.6 no.1
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    • pp.5-20
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    • 2002
  • 허혈성 심질환 환자의 평가도구로서 MRI의 역할이 확대된 데에는 소위 "one-stop shop"이라는 통합적 심장검사법의 개발이 계기가 되었다. 즉 한 번의 MRI 검사로서 심실벽운동을 평가하여 심근의 기능과 예비능을 측정하여 만성 심근경색을 평가할 수 있고, 심근의 관류를 평가할 수 있고, 관동맥의 혈류 예비능과 심근의 viability를 평가하고, 관동맥 조영술을 통해, 수술 후의 우회로 평가 및 관동맥의 협착 여부의 진단이 가능한 프로토콜이 MRI장비마다 각각 개발되어 보급되고 있다. 하드웨어와 소프트웨어의 개발과 지속적인 연구를 통해서 MRI는 허혈성 심질환의 진단적 검사로서 기존의 다른 검사들과 비교하여 높은 시간적, 공간적 해상력으로 정확한 구조와 기능의 평가를 제공할 수 있는 가장 유용한 검사가 될 것으로 사료된다 특히, MR 관동맥조영술, 심근관류검사, 심근 표지법, dobutamine 부하검사, viability 평가, plaque characterization, MR spectroscopy 분야에서 현재 활발히 연구가 진행되고 있으며 향후 임상적용이 확대될 것으로 예상된다.

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A preliminary study on women's anginal pain induced by exercise stress test (운동부하검사로 유발된 여성의 협심통증에 대한 예비연구)

  • Choe, Myoung-Ae;An, Kyung-Ae;Choo, Ji-Na;Choi, Yoon-Sik
    • Journal of Korean Biological Nursing Science
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    • v.4 no.2
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    • pp.5-18
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    • 2002
  • Purpose: Women have been often underdiagnosed and undertreated when they have as high mortality as men of ischemic heart disease, such as angina. One of the reasons of women's under treatment is associated with either vague, non-traditional symptoms or longer delay in seeking professional help when they experience ischemic heart disease. This study was conducted to investigate the characteristics of women's anginal pain induced by the treadmill test and to explore the potential relationship(s) between anginal pain and other psycho-physiologic factors. Methods: Of 22 female patients referred to treadmill test, 7 with positive finding participated in this study. Anginal pain in the past was analyzed by Rose questionnaire, whereas anginal pain induced by the treadmill test was identified by McGill pain scale, visual analogue scale and present pain index. Results: Women expressed more heaviness than sharp pain, and complained splitting more often than subjects in previous study that included both men and women. Pain intensity by VAS $3.64{\pm}3.94$, Pain rating index was $5.14{\pm}7.29$, present pain index was $1.57{\pm}1.81$, duration of pain was $5.14{\pm}4.8$ min. Exercise intensity was $6.0{\pm}4.63$ METs, exercise duration was $364.29{\pm}141.39$ sec, ST change was -2.0mm and rate of perceived exertion was $16.29{\pm}2.06$. The relationships between pain intensity and pain duration, ST segment changes were significant. Correlation among pain measures was significant. Conclusion: Generalization of these pilot findings may be inappropriate, and therefore, further larger study is needed.

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Content Analysis of Experiences of Chest Pain in Women Who Underwent the Treadmill Test with an Impression of Angina Pectoris (협심증이 의심되어 운동부하검사를 받은 여성들의 흉통에 관한 내용분석)

  • Choe, Myoung-Ae;Yi, Myung-Sun;An, Kyung-Eh;Im, Eun-Ok
    • Korean Journal of Adult Nursing
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    • v.14 no.3
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    • pp.459-469
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    • 2002
  • Purpose: Experience of chest pain may be different in women from that of men and this discrepancy may cause misdiagnosis of angina contribute to mortality by this disease in women. The purpose of this study was to analyze the characteristics of chest pain and responses to the symptoms in women. Method: A content analysis was conducted with interviewed data obtained from women who underwent the treadmill test Result: Seven major categories were identified from this content analysis: attributes of chest pain; accompanied symptoms; precipitating factors; relief strategies; family support; communication with physicians; and effects of chest pain on their lives. Characteristics of pain were described as heaviness, tightness, heating sensation, tearing, and others. Duration and intensity of pain varied in a wide range. Radiating pain presented in 9 patients, and the locations of radiation were throat, neck, shoulder arm and fingers. Women tended not to respond actively to their chest pain, and didn't get appropriate support either from their family or from their physicians when they reported chest pain. Conclusion: Women express non-typical as well as typical patterns of pain when they experience chest pain. Clinicians have to consider the variability of symptoms when they assess women with suspicions of angina.

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Breathing Reserve Index at Anaerobic Threshold of Cardiopulmonary Exercise Test in Chronic Obstructive Pulmonary Disease (만성폐쇄성 폐질환의 운동부하 심폐기능검사에서 무산소역치 예비호흡지수의 의의)

  • Lee, Byoung-Hoon;Kang, Soon-Bock;Park, Sung-Jin;Jee, Hyun-Suk;Choi, Jae-Chol;Park, Yong-Bum;Ahn, Chang-Hyuk;Kim, Jae-Yeol;Park, In-Won;Choi, Byung-Whui;Hue, Sung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.46 no.6
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    • pp.795-802
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    • 1999
  • Objective : Cardiopulmonary exercise test is a useful tool to evaluate the operative risk and to plan exercise treatment for the patients with chronic obstructive pulmonary disease(COPD). In cardiopulmonary exercise test, most of the measured parameters are recorded at the time of peak exercise, which are hard to attain in COPD patients. So we evaluated the usefulness of the parameter, breathing reserve index(BRI=minute ventilation [$V_E$]/maximal voluntary ventilation[MVV]) at the time of anaerobic threshold($BRI_{AT}$) for the differentiation of COPD patients with normal controls. Methods : Thirty-six COPD patients and forty-two healthy subjects underwent progressive, incremental exercise test with bicycle ergometer upto possible maximal exercise. All the parameters was measured by breath by breath method. Results : The maximal oxygen uptake in COPD patients (mean$\pm$SE) was $1061.2{\pm}65.6ml/min$ which was significantly lower than $2137.6{\pm}91.4ml/min$ of normal subjects(p<0.01). Percent predicted maximal oxygen uptake was 54.3% in COPD patients and 86.0% in normal subjects(p<0.01). Maximal exercise(respiratory quotient; $VCO_2/VO_2{\geq}1.09$) was accomplished in 7 of 36 COPD patients(19.4%) and in 18 of 42 normal subjects(42.9%). The $BRI_{AT}$ of COPD patients was higher($0.50{\pm}0.03$) than that of control subject($028{\pm}0.02$, p<0.01), reflecting early hyperventilation in COPD patient during exercise. The correlation between $BRI_{AT}$ and BRI at maximal exercise in COPD patients was good(r=0.9687, p<0.01). Conclusion : The $BRI_{AT}$ could be a useful parameter for the differentiation of COPD patients with normal controls in the submaximal cardiopulmonary exercise test.

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Effect of Rope-skipping Exercise on the Enhancement of Cardiopulmonary Function (줄넘기 운동 훈련이 심폐기능 항진에 미치는 효과)

  • Hwang, Sang-Ik
    • The Korean Journal of Physiology
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    • v.20 no.1
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    • pp.79-88
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    • 1986
  • In an attempt to observe the effects obtained by the regular physical training, nine soldiers performed regularly the rope-skipping for nine weeks. All subjects were healthy and did not experience any special military training Programs. During the course of the training, their cardiopulmonary functions were measured in the resting and the Post-exercise recovery periods, and the values were compared with ones of the pre-trained. The test exercises loaded to the subjects were rope-skipping and step-rising & falling. The results obtained were as follows: 1) By the training, heart rates decreased very significantly in the resting and post-exercise recovery periods. And the effects began to bring out at the early stage, about the 7th day. 2) As the duration of the training increased, the systolic blood pressures decreased meaningfully in the resting and recovery periods. 3) Only in the early recovery phase after the exercise of the rope·skipping, the respiration rates decreased significantly by the training. 4) The lighter the intensity of the test exercise loaded was, the more prominent the effect of the physical training on the cardiopulmonary functions was. The above results suggest that the 9 week training of the rope-skipping would bring about the enhancement of the cardiopulmonary functions.

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Walking test for assessing lung function and exercise performance in patients with cardiopulmonary disease (심폐질환 환자에서 걷기검사를 이용한 폐기능 및 운동기능의 평가)

  • Jung, Hye Kyung;Chang, Jung Hyun;Cheon, Seon Hee
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.6
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    • pp.976-986
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    • 1996
  • BACKGROUND : Dyspnea is common among patients with cardiopulmonary disease, and "daily disability" is defined as a functional impairment resulting from exercise intolerance. The maximal oxygen uptake(VO2max) during exhausting work is not only the best single physical indicator of the capacity of a man for sustaining hard muscular work, but also the most objective method by which one can determine the physical fitness of an individual as reflected by his cardiovascular system. However, the expense, time and personnel requirements make this procedure prohibitive for testing large group. The walking test is well-known type of exercise and it cost nothing to perform and have good reproducibility. Thus we performed the walking test and investigated correlations with spirometry, ABG and exercise test. METHOD: We observed the walking test and exercise test by cycle ergometer in 37 patients who visited our hospital because of dyspnea. Arterial blood gas analysis and spiromety, dyspnea index were performed, too. RESULT : (1) The VO2max was significantly lower in patients with COPD and cardiovascular disease than asthma and dyspnea on exertion group(p<0.05). The walking test distance was also lower in former. (2) The 12 minute walking test was significantly correlated with VO2max, PaCO2, FVC(%), FEV1(%) in all patients(p<0.05), and the walking test was only conelated with VO2max in patients with COPD(p<0.05). (3) In COPD patients, the VO2max was best correlated with FEV1(%) and FVC(%) and significantly correlated with walking test. But there was no correlation between walking test and FEV1(%) & FVC(%). (4) The 6 minute walking test was well correlated with 12 minute walking test(r=0.92. p<0.01). CONCLUSION : The walking test is the simple method for assessing exercise performance in patient with cardiopulmonary disease and a reliable indicator for VO2max. And the walking test is practical method for assessing on everyday disability rather than maximal exercise capacity. The 6 minute walking test is highly correlated with 12 minute walking test and a less exhausting for the patients and a time-saving for the investigator.

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Immediate Full Weight Bearing in Extension Brace Following Arthroscopic Primary Repair or Reconstruction of ACL (관절경하 전방십자인대 일차수복술 및 재건술후 신전보조기를 착용한 조기 완전체중부하)

  • Kim Jung Man;Chang Cheong Ho;Cho Woo-Shin
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.128-131
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    • 1997
  • 전방십자인대의 일차수복술이나 재건술후에 장기간의 비체중부하가 필요한지를 결정하기 위해서 일차수복술을 시행한 96례와 재건술을 시행한 82례등 총 178례를 대상으로 술후 체중부하시기에따라 두군으로 나누어 비교분석 하였다. 모든 례에서 술후 보조기를 착용하였고 120례에서는 술후 첫6주간 점차적으로 관절운동범위를 증가를 시키고 다음 6주간은 완전운동범위 회복상태에서 유지후 술후 12주에 체중부하를 허용하였으며 나머지 58례에서 술후 완전신전상태에서 즉시 체중부하를 시켜서 정기적으로 Lachman검사, KT 2000을 이용하여 불안정성여부를 관찰하였다. 평균 추시기간은 4.2년(2년$\~$6년)이었고 불안정성에 대한 평가는 AMA 분류에 따랐다. 최종추시상 모든환자에서 1+이상의 불안정성은 발견되지 않았으며 술후 12주에 체중부하를 한군에서 1a+가 104례$(86.7\%)$, 1b+군이 16례$(13.3\%)$로 관찰되고 즉시 체중부하를 한 군에서 1a+가 51례$(87.9\%)$, 1b+가 7례$(12.1\%)$에서 보였으나 통계적으로 의미있는 차이는 없었다(P>0.05). 본연구의 결과로 전방십자인대 일차수복술이나 재건술후 신전보조기를 착용시키고 즉시 보행을 시키는 것이 술후 슬관절의 불안정성에 영향을 주지 않으며 안전한 재활방법으로 생각된다.

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The Effect of Duration Protocols on VO2max and Presence of Plateau (운동검사시간이 최대산소섭취량과 정체현상에 미치는 영향)

  • Kim, Do-Yeon;Yoon, Byung-Kon
    • Journal of Life Science
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    • v.19 no.12
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    • pp.1712-1717
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    • 2009
  • The purpose of this study was to compare $VO_2$max, maximal power output, and presence of $VO_2$ plateau across 4 protocol durations (5, 8, 12, and 16 min) during incremental cycling exercise to $VO_2$max. Twenty moderately to highly trained subjects ($24.9{\pm}6.6$) participated in the study. The mean $VO_2$max in the 5-min ($3.55{\pm}0.80\;l/min$) and 8-min ($3.66{\pm}0.88\;l/min$) duration protocols had higher and significantly higher mean value in the 8-min duration protocol compared to the 12-min ($3.49{\pm}0.76\;l/min$) and 16-min ($3.45{\pm}0.73\;l/min$) duration protocols. The AMPO across four protocols showed a significant difference. The AMPO for the 5-min protocol was 12%, 24%, and 35% higher than AMPO for the 8-min, 12-min and 16-min protocols. The presence of plateau was 12.5% for the 5 min protocol, 56.25% for the 8 min protocol, 37.5% for the 12 min protocol, and 56.25% for the 16 min protocol. This study indicates that the short duration protocol (<8 min) is a more valid measurement for $VO_2$ max than optimal duration protocol (8-12 min) in moderate to highly trained individuals on the cycle ergometer.

Sling Exercise Therapy (S-E-T) : A total concept for exercise and active treatment of musculoskeletal disorders (슬링운동치료(Sling Exercise Therapy) : 근골격계 질환에 대한 능동적 운동과 치료의 총체적 개념)

  • Kirkesola, Gitle
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.7 no.1
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    • pp.87-106
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    • 2001
  • 슬링 운동 치료(Sling Exercise Therapy)는 근골격계 질환 환자의 영구적인 치유를 목적으로 슬링을 이용한 능동적인 치료와 운동법을 체계화한 접근법이다. 이 개념은 10 여년 전부터 노르웨이의 물리치료사들을 중심으로 발전되어 왔으며, 현재 뇌졸중 환자와 신경학적 질환자 그리고 소아 환자와 건강 증진 프로그램에서도 이용되는 방법들이 개발되어지고 있다. 현재 정형물리치료 분야에 대한 세계적인 흐름은 전기치료 기구나 물리치료사의 손에 의해 수동적으로 이루어지는 치료 접근에서 점차 환자가 스스로 물리치료사에 의해 특별히 고안된 운동방법에 따라 능동적인 치료적 운동을 통해 손상 치료와 건강 관리를 하는 방향으로 발전되어지고 있으면 많은 치료 분야에서 이러한 접근법을 채택하고 있다. 슬링운동치료 개념은 이러한 능동적인 운동법을 주된 목적으로 이용하고 있다. 이 논문은 근골격계 질환의 치료를 중심으로 쓰여졌다. SET 개념에는 체계적인 진단과 치료의 요소들이 포함되어져 있다. 진단 체계에는 열린 사슬과 닫힌 사슬을 이용하여 단계적으로 부하를 가해 줌으로서 근육의 상태를 검사하는 방식을 가지고 있다. 치료적 체계를 구성하는 요소에는 근육의 안정화, 감각운동 훈련, 열린 사슬과 닫힌 사슬을 이용한 훈련법, 가동성있는 연부 조직의 역동적 훈련, 심폐 강화 훈련, 단체 훈련, 가정에서의 개별적 훈련과 추후 관리 그리고 운동 프로그램을 제공하기 위한 컴퓨터 소프트웨어가 포함되어 있다.

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Functional analysis of isolated posterior cruciate ligament deficient subjects (후방 십자 인대 단독 손상 환자의 기능적 분석)

  • Kim Jin Goo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.3 no.1
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    • pp.66-72
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    • 2004
  • Purpose: To evaluate the compensatory mechanism in vivo and develop the treatment guide by performing the comprehensive functional tests of the posterior cruciate ligament (PCL) deficient subjects. Material and Methods: 10 PCL deficient subjects and 10 healthy control group were evaluated. Performed functional tests were range of motion, posterior drawer test, Telos, 30$^{\circ}$ flexion wt-bearing view, KT-1000 arthrometer, gait analysis, EMG test and isokinetic tests. Results: Physical, KT-1000, Telos posterior tests showed significant differences, but 300 full weight bearing lateral view, muscle strength test revealed no difference between two groups. Less knee flexion at initial contact and reduced maximum valgus moment were observed in PCL deficient group. In vertical drop landing, PCL group had increased plantar flexion angle at initial contact. Conclusion: Compensatory mechanisms such as reduced unstable components and absorbing the maximal load of the joint were occurred after PCL insufficiency, which result in good clinical and functional outcomes. Further investigations would be needed to understand the functional adaptations of PCL deficient subjects.

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