• 대한의용생체공학회:의공학회지
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• 제13권3호
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• pp.209-216
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• 1992

A new experimental technique is proposed to localize the flow limiting segment(FLS) during forced expiration. The present technique is based on the pressure drip across FLS and a consequent change in airway resistance, which can provide an accurate and objective location of FLS. During forced expiratory maneuver artificially induced by a strong negative pressure (-100mmHg) applied at the trachea in an anesthetized open chest dog, airway resistance( R) was calculated from air flow and airway pres- sure signals at various airway locations and lung volumes, At the lung volumes above 10 % VC, FLS located in the trachea 6cm lower from the larynx. With the lung volume decreased below 8% VC, FLS jumped upstream to End-3rd generation of the airway. These results were similar with the previous reports from excised dog lungs, which demonstrated the validity of the present technique. Since the present technique provides a more objective measure of FLS location, it would be useful in future studies of expiratory flow limitation.

• 한국전문물리치료학회지
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• 제16권1호
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• pp.10-17
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• 2009

The aim of this study was to investigate the effect of abdominal drawing-in maneuver (ADIM) on peak exploratory flow (PEF), forced exploratory volume in 1 second ($FEV_1$), and low back pain during forced expiration. Twenty-two subjects (14 subjects in experimental group, 8 subjects in control group) participated in this study. The stabilizer was used for ADIM training for five consecutive days. Vitalograph PEF/$FEV_1$ DIARY and visual analogue scale (VAS) were used to determine forced expiratory pulmonary function and low back pain, respectively. Independent t-test and analysis of covariance were used for statistical analysis with a significance level of .05. The findings of this study were as follows: 1) There were no significant differences of ADIM effect on PEF and $FEV_1$ between experimental group and control group. 2) There was a significant pain reduction in experimental group with ADIM. 3) PEF and $FEV_1$ increased significantly in the fifth day compared with the first day pre-exercise baseline. Therefore, it is concluded that ADIM was effective in improving PEF and $FEV_1$, and reducing VAS during forced expiration in patients with chronic low back pain.

• 대한통합의학회지
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• 제9권1호
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• pp.23-31
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• 2021

Purpose : To compare the immediate effects of air stacking maneuver using resuscitator bags and balloons. Methods : Twenty healthy young adults participated in this study. Forced vital capacity (FVC) and peak cough flow (PCF) tests were performed at pre-intervention, and then, the maximum insufflation capacity (MIC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow (PEF), and peak cough flow (PCF) were measured using the air stacking maneuver via resuscitator bags and balloons. Interventions were randomly performed, and a 40-min break was provided between interventions. The evaluation process in this study was conducted in accordance with the guidelines of the American Thoracic Society (ATS) 2019. To compare the three outcomes measured at pre-and post-interventions, repeated measures analysis of variance was performed. Results : A significant difference was found in the MIC, FEV1, PEF, and PCF after the air stacking maneuver using resuscitator bags and balloons, whereas no significant difference was observed between resuscitator bags and balloons. Conclusion : No significant difference was found in the immediate effect of the air stacking maneuver using resuscitator bags and balloons in this study. Air stacking maneuver using balloons can increase the success rate of the techniques by providing visual feedback on the amount of air insufflation when performed with balloon blowing exercise. Balloons are cheaper and easier to buy compared to manual resuscitator bags; therefore, education on the air stacking maneuver using balloons will have a positive effect on pulmonary rehabilitation.

• 대한물리의학회지
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• 제8권4호
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• pp.513-523
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• 2013

PURPOSE: The purpose of this study was to investigate characteristics of the forced pulmonary function test effect and abdominal muscles activation by combined complex exercise with abdominal drawing-in maneuver training of chronic stroke patients. METHODS: 14 post stroke patients(10 males and 4 females) involved voluntary this study and we divided two groups into CEG(complex exercise group) and CEAG (complex exercise and abdominal drawing-in maneuver group).(n=7, per goup). Each groups implicated the 2 times, 30minute exercises for 6 weeks a day. The CEAG performed the complex exercise 15 minutes and 15 minutes of abdominal drawing-in maneuver. For data analysis, the mean and standard deviation were estimated; non-parametric independent t-test was carried out. RESULTS: According to the study, in the combined complex exercise with abdominal drawing-in maneuver group, FVC and activation of transversus abdominis/internal oblique were statistically significant difference compared to the complex exercise group. CONCLUSION: These results indicate that the combined complex with abdominal drawing-in maneuver was efficient in enhancing abdominal muscles activation and pulmonary function of chronic stroke patients.

• 국제물리치료학회지
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• 제9권2호
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• pp.1494-1497
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• 2018

This study aimed to determine the effect of McKenzie lumbar support on pulmonary function in Stroke patients. Twenty subjects (n=20) were divided into two groups: a McKenzie lumbar support group (MLS group=10), a control group (n=10). Pulmonary function was performed to assess its effectiveness. A spirometer was used to measure the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF). The intervention was conducted for four weeks. In the MLS group, FEV1, FVC, and PEF were increased after McKenzie lumbar support. (p<0.05), while no significant differences in the variables were found in the control group (p>0.05). There were no significant differences in variables between the MLS group and the control group (p>0.05). Our findings suggest that applying Mckenzie lumbar support may be an alternative maneuver to improve pulmonary function in stroke patients.

• The Journal of Korean Physical Therapy
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• 제27권3호
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• pp.147-153
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• 2015

Purpose: The purpose was to determine whether the application of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) to stroke patients would affects their trunk stability, balance, pulmonary function, and grip strength. Methods: The subjects were 36 stroke patients who were randomly and equally assigned to an ADIM group (n=12), an AEM group (n=12), and a control group (n=12). The intervention was applied to each group three times per week, 30 minutes each time, for four weeks. Outcome measures were grip strength, modified functional reach test (mFRT) and pulmonary function. Pulmonary function were measured force expiratory volume at one second (FEV1), forced vital capacity (FVC), FEV1/FVC and peak expiratory flow (PEF) values. Results: The results of the three groups showed statistically significant improvements in grip strength. The AEM group showed significantly greater differences in grip strength than either the ADIM group or the control group. In the anterior mFRT, the ADIM group showed significantly improvements than the control group. The ADIM and AEM groups were showed statistically significant greater improvements in PEF between the baseline and post-intervention and the post-analysis revealed that the AEM group showed significantly greater improvements than the control group. Conclusion: The results of this study indicate that the ADIM and AEM were effective in improving the PEF of pulmonary function. The ADIM was more effective than AEM in trunk stabilization.

• 전기학회논문지
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• 제58권4호
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• pp.867-872
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• 2009

Peak expiratory flow rate(PEF) is one of the most important diagnostic parameters in spirometry. PEF occurs in a very short duration during the forced expiratory maneuver, which could lead to measurement error due to non-ideal dynamic characteristic of the transducer. In such case the initial slope of the flow rate signal determines the accuracy of the measured PEF. The present study considered this initial slope as a parameter to compensate PEF. The 26 standard flow rate signals recommended by the American Thoracic Society(ATS) were flown through the air flow transducer followed by simultaneous measurements of PEF and maximum transducer output$(N_{PEF})$. $N_{PEF}$-PEF satisfied a quadratic equation in general, however, two signals (ATS #2 and #26) having large initial slopes deviated from the fitting equation to a significant degree. The relative error was found to be in a linear relationship with the initial slope, thus, $N_{PEF}$ was appropriately compensated to provide accurate PEF with mean relative error less than only 1%. The 99% confidence interval of the mean relative error was less than a half of the error limit of 5% recommended by ATS. Therefore, PEF can be very accurately determined by compensating the transducer output based on the initial slope, which should be a useful technique for air flow transducer calibration.

• 한국전문물리치료학회지
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• 제17권1호
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• pp.9-16
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• 2010

This study aimed to compare 2 protocols recommended to patients with chronic cervical cord injury: each protocol included breathing exercises (inhalation-oriented or exhalation-oriented) and facilitation maneuver for the accessory respiratory muscles. Seventeen patients with chronic cervical cord injury volunteered to participate in this study, and we randomized these patients into 2 groups: the inhalation-oriented breathing exercise group (IOBEG) and exhalation-oriented breathing exercise group (EOBEG), consisting of 8 and 9 patients, respectively. Patients in the IOBEG performed inspiratory exercises using intermittent positive pressure breathing devices, while those in the EOBEG performed expiratory exercises using incentive spirometry. All exercises were performed by the subjects twice a day for 4 weeks, with each session lasting an average of 20 min. The outcomes were assessed on the basis of the pre- and post-treatment values of vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC. In the IOBEG, no significant differences were observed between the pre- and post-treatment values of any of the measured variables (p>.05); however, in the EOBEG, significant improvement was noted in the VC, FVC, FEV1 measured (p<.05) after the treatment. In addition, the rates of change in the values of VC, FVC, and FEV1 differed significantly between the 2 groups (p<.05). These findings suggest that the EOBEs can enhance respiratory function and are clinically feasible in patients with chronic cervical cord injury. Further studies will be undertaken to evaluate the clinical application of these findings.

• Clinical and Experimental Pediatrics
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• 제52권11호
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• pp.1267-1272
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• 2009

목 적:국내 학동 전기 소아를 대상으로 폐활량 측정법을 시행하여 기존에 제시된 여러 지표를 기준으로 검사 결과의 적정성을 평가함으로써 이 연령대에서의 폐기능 검사의 성공률을 알아보고자 하였다. 방 법:만성 기침이나 천식이 의심되어 내원한 2세 이상 6세 이하의 176명을 대상으로 폐활량 측정법을 시도하여 총 155 명에서 측정 결과를 얻을 수 있었다. ATS/ERS 에서 제시한 기준에 따라 후외삽용적(Vbe)이 80 mL 미만이고 FVC의 12.5% 미만일 때를 시작 기준에 적합하다고 정의하였다. 검사의 반복성을 확인하기 위해 선별한 두개의 유량-용적 곡선에서 FVC, FEV1의 차이를 구하여 FVC와 $FEV_1$의 절대적 차이값이 100 mL 또는 10% 미만인 경우를 적합하다고 정하였다. 검사의 종료에 대한 기준은 학동 전기 연령에서 수치적으로 정의되어 있지 않지만 유량-용적 곡선이 초기에 급격하게 증가해서 후기에 완만하게 감소하는 것을 합당하다고 보았다. 또한 유량-용적 곡선이 적절하게 나온 대상자(107명)를 선별하여 다른 문헌에 발표된 여러 정도 관리 기준에 맞추어 각 항목별로 성공률을 비교하였다. 결 과:전체 폐기능 검사의 성공률은 59% 이었고 연령이 증가할수록 폐활량 측정법의 성공률이 증가하였으며, 특히 3세부터 급격하게 성공률이 증가하였다(2세 14.3%, 3세 53.7%, 4세 65.1%, 5세 69.7%, 6세 70.8%). 폐활량 측정법의 실패 원인으로는 시작 기준에 맞지 않는 경우가 전체의 6.5%, 반복성 기준에 맞지 않는 경우가 12.3% 또 최대 호기량의 부족, 조기 종료 등으로 인해 검사 종료 기준에 맞지 않는 경우가 전체의 31% 로 가장 높았다. 폐활량 측정법 성공군와 실패군을 비교하였을 때 나이에서만 유의한 차이가 있었다(P<0.01). 정도 관리에 대한 몇몇 연구결과에 따라 각 항목별로 성공률을 보았을 때 연령이 증가할수록 성공률도 증가하였다. 결 론:학동 전기 소아에서도 약 60% 정도 폐활량 측정법을 성공적으로 수행하였다. 성공률은 연령에 따라 급격히 변화하므로 각 연령에 적합한 정도 관리 기준을 개발하여 이용한다면 검사의 성공률을 높일 수 있을 것으로 사료된다.