• Tuberculosis and Respiratory Diseases
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• v.72 no.3
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• pp.310-317
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• 2012

Background: Airway obstruction and the extent of emphysema are reported to be responsible for reduced bone mineral density (BMD). Corresponding to different phenotypes of a pulmonary disease, different severity in extra pulmonary features may exist. We compared BMDs of subjects with or without airway obstruction and/or emphysema and investigated the relationships among BMD, the severity of airway obstruction, and the extent of emphysema. Methods: Using a university hospital database, we reviewed patients over 40 years old who performed spirometry, computed tomography of chest, and measurement of BMD of the lumbar (L) spine. According to the presence or absence of airway obstruction and/or emphysema, four groups were classified. Results: Among a total of 59 subjects, 33 (56%) had osteoporosis. The prevalence of osteoporosis in subjects with no airway obstruction and no emphysema, those with only emphysema, those with only airway obstruction, and those with both airway obstruction and emphysema were 42%, 57%, 64%, and 73%, respectively (p=0.047 by linear-by-linear association). The mean T-scores of BMD of L1 (p=0.032) and L1-4 spines were different among the four groups (p=0.034). Although the T-score of L1 BMD negatively correlated with the extent of emphysema (r=-0.275, p=0.035) and positively with each of body mass index (BMI) (r=0.520, p<0.001), forced expiratory volume in one second ($FEV_1$) (r=0.330, p=0.011), $FEV_1$/forced vital capacity (r=0.409, p=0.001), and forced expiratory flow at 25~75% of FVC ($FEF_{25-75%}$) (r=0.438, p=0.0001), respectively, multiple linear regression analysis indicated that BMI (p<0.001) and $FEF_{25-75%}$ were predictive of BMD (p=0.012). Conclusion: Low BMI and airway obstruction were strongly associated with reduced bone density rather than the extent of emphysema.

• Tuberculosis and Respiratory Diseases
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• v.71 no.3
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• pp.188-194
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• 2011

Background: When patients with chronic respiratory symptoms have a normal spirometry result, it is not always easy to consider bronchial asthma as the preferential diagnosis. Forced expiratory flow between 25% and 75% of vital capacity ($FEF_{25{\sim}75%}$) is known as a useful diagnostic value of small airway diseases. However, it is not commonly used, because of its high individual variability. We evaluated the pattern of bronchodilator responsiveness (BDR) and the correlation between $FEF_{25{\sim}75%}$ and BDR in patients with suspicious asthma and normal spirometry. Methods: Among patients with suspicious bronchial asthma, 440 adult patients with a normal spirometry result (forced expiratory volume in one second [$FEV_1$]/forced vital capacity [FVC] ${\geq}70%$ & $FEV_1%$ predicted ${\geq}80%$) were enrolled. We divided this group into a positive BDR group (n=43) and negative BDR group (n=397), based on the result of BDR. A comparison was carried out of spirometric parameters with % change of $FEV_1$ after bronchodilator (${\Delta}FEV_1%$). Results: Among the 440 patients with normal spirometry, $FEF_{25{\sim}75%}%$ predicted were negatively correlated with ${\Delta}FEV_1%$ (r=-0.22, p<0.01), and BDR was positive in 43 patients (9.78%). The means of $FEF_{25{\sim}75%}%$ predicted were $64.0{\pm}14.5%$ in the BDR (+) group and $72.9{\pm}20.8%$ in the BDR (-) group (p<0.01). The negative correlation between $FEF_{25{\sim}75%}%$ predicted and ${\Delta}FEV_1%$ was stronger in the BDR (+) group (r=-0.38, p=0.01) than in the BDR (-) group (r=-0.17, p<0.01). In the ROC curve analysis, $FEF_{25{\sim}75%}$ at 75% of predicted value had 88.3% sensitivity and 40.3% specificity for detecting a positive BDR. Conclusion: BDR (+) was not rare in patients with suspicious asthma and normal spirometry. In these patients, $FEF_{25{\sim}75%}%$ predicted was well correlated with BDR.

• Physical Therapy Korea
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• v.6 no.3
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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.

• Tuberculosis and Respiratory Diseases
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• v.72 no.1
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• pp.24-29
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• 2012

Background: Measurement of peak expiratory flow rate (PEFR) in a follow-up examination for a chronic airway disease is useful because it has the advantages of being a simple measurement and can be repeated during examination. The aim of this study was to examine the annual decrease of PEFR in asthma and chronic obstructive pulmonary disease (COPD) patients and to confirm the factors which influence this decrease. Methods: From May, 2003 to September, 2010, the annual decrease of PEFR was obtained from asthma and COPD patients attending an outpatient pulmonary clinic. PEFR was measured using a Mini-Wright peak flow meter (Clement Clarke International Ltd. UK), and we conducted an analysis of factors that influence the change of PEFR and its average values. Results: The results showed an annual decrease of $1.70{\pm}12.86$ L/min the asthmatic patients and an annual decrease of $10.3{\pm}7.32$ L/min in the COPD patients. Age and $FEV_1$ were the predictive factors influencing change in asthma, and $FEV_1$ and smoking were the predictive factors influencing change in COPD. Conclusion: We confirmed the annual decreasing PEFR in patients with chronic airway disease and identified factors that work in conjunction with $FEV_1$ to influence the change.

• The Journal of Korean Physical Therapy
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• v.27 no.3
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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.

• Tuberculosis and Respiratory Diseases
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• v.85 no.2
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• pp.137-146
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• 2022

Background: Farinelli breathing (FB) exercise is a typical breathing exercise used by singers. This study aimed to compare effects of FB exercise and diaphragmatic breathing (DB) exercise on respiratory function and symptoms in patients with chronic obstructive pulmonary disease (COPD). Methods: Sixteen patients aged 51-80 years with mild or moderate COPD were recruited for this study. They were divided into two groups: DB group (n=8) and FB group (n=8). Both groups received complete breathing exercise training five times per week for 8 weeks. Their respiratory functions, COPD symptoms, cytokine levels, and oxidative stress variables were analyzed during pre- and post-tests. Dependent variables were compared between pre- and post-tests using paired t-tests. An independent t-test was used to compare variables between the groups. Differences were considered significant at p<0.05. Results: The maximal expiratory pressure (MEP), maximum oxygen consumption (VO₂max), and COPD Assessment Test (CAT) scores changed significantly in the DB group after the 8-week intervention compared to those at pre-test, whereas force vital capacity, forced expiratory volume in the first second, maximum voluntary ventilation, maximal inspiratory pressure (MIP), MEP, VO₂max, CAT score, tumor necrosis factor-α, and malondialdehyde level changed significantly in the FB group at post-test compared to those at pre-test. Moreover, both MIP and MEP in the FB group were significantly higher than those in the DB group. Conclusion: FB exercise improved respiratory functions and COPD symptoms of patients with COPD. It might be an alternative breathing exercise in pulmonary rehabilitation programs for patients with COPD.

• Journal of Preventive Medicine and Public Health
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• v.28 no.1 s.49
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• pp.43-57
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• 1995

In order to study the effect of welding fume exposure upon the pulmonary function test, we examined 131 shielded arc welding workers, and 152 $CO_2$ arc welding workers as cases and 177 control workers for their general characteristics, and forced vital capacity (FVC), forced expiratory volume in one second $(FEV_{1.0})$, forced expiratory volume in one second as a percent of FVC $(FEV_{1.0}%)$, and maximal mid-expiratory flow (MMF) were obtained from the spirogram. In shielded arc welding group and $CO_2$ arc welding group, FVC, $FEV_{1.0},\;FEV_{1.0}%$, and MMF were significantly decreased than control group, especially marked in the MMF finding. The distribution of workers below normal range was as follows. in the shielded arc welding group, 2 workers(1.5%) for FVC, 17 workers(13.0%) for $FEV_{1.0}$, 5 workers(3.8%) for $FEV_{1.0}%$, 28 workers(21.4%) for MMF, and in the $CO_2$ arc welding group, 3 workers(2.0%) for FVC, 25 workers(16.4%) for $FEV_{1.0}$, 8 workers(5.3%) for $FEV_{1.0}%$, and 37 workers(24.3%) for MMF, and significant increase by exposure duration was found in MMF. The distribution of workers who had ventilation impairment was as follows: 5 workers(3.8%) for obstructive type, 2 workers(1.5%) for restrictive type in the shielded arc welding group, and 7 workers(4.6%) for obstructive type, 2 workers(1.3%) for restrictive type, and 1 worker(0.6%) was combined type of the $CO_2$ arc welding group. In the respect of these results, the significant pulmonary function and ventilatory impairment were observed in welding fume exposed workers who had not abnormal finding in chest X-ray, and MMF considered as the most sensitive pulmonary function index by welding fume exposure. Therefore even if it is hard to doing pulmonary function test in the first health examination of workers according to the Industrial Safety Health Act in the welding fume exposure workers, it is desirable to consider doing PFT. Also evaluating the ventilation impairment, it is necessary, to observe the change of MMF that marker of effort-independent portion.

• Tuberculosis and Respiratory Diseases
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• v.40 no.5
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• pp.548-557
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• 1993

Background: Bronchiectasis is a irreversible disease, a lot of cases of which are associated with chronic bronchitis, pulmonary emphysema and bronchial asthma due to chronic recurrent pulmonary infection. Therefore, pulmonary functions in bronchiectasis may also vary with associated diseases or involved segments. Methods: For the evaluation of ventilatory dynamics in bronchiectasis with respect to the pathoanatomic types of bronchiectasis and the degree of dyspnea, a total of 93 cases comprising 45 cases of tubular, 30 saccular and 18 mixed type of bronchiectasis whose clinical diagnosis was confirmed by bronchography were analyzed retrospectively. They were also divided into two groups: those with Hugh-Jones dyspnea grade 1 & 2 (group I) and those with Hugh-Jones dyspnea grade 3 & 4 (group II). Pulmonary functions tested in this study were analyses of curves of forced expiratory volume and flow-volume, and determinations of maximal voluntary ventilation and closing volumes. Results: The results were as follows; 1) The vital capacity and parameters reflecting expiratory flow rate except PEF were significantly reduced in saccular and mixed type than that in tubular type of bronchiectasis. 2) In saccular and mixed type, the maximal voluntary ventilation tended to decrease while CV/VC tended to increase. 3) As the degree of dyspnea became serious, the involved segments were progressively increased. In contrast, ventilatory functions were significantly reduced in proportion to the severity of dyspnea. Conclusion: These findings suggest that in bronchiectasis, there be obstructive ventilatory impairment combined with mild restrictive ventilatory impairment, which becomes more prominent in saccular and mixed type and also as the degree of dyspnea progresses.

• The Journal of Korean Physical Therapy
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• v.26 no.3
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• pp.169-174
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• 2014

Purpose: This study demonstrated a postural alignment exercise as conservative management strategy for a woman with excessive thoracic kyphosis presenting decreased chest function, and reports its results. Methods: A 21-year-old woman with thoracic kyphosis presenting limited chest function. The exercise program underwent for 30 min in the intervention phase, which consisted of exercises to improve the strength of back extensor and to stretch anterior chest region. Outcome measures comprised the severity of thoracic kyphosis and chest function (vital capacity [VC], forced expiratory volume in a second [FEV1], and chest expansion length). Results: The thoracic kyphotic angle decreased by 23.6% ($9.38^{\circ}$) and 25.4% ($10.58^{\circ}$) in the intervention and follow-up phases respectively. Also, chest function was improved in the intervention (VC: 3.7% [$0.10{\ell}$], FEV1: 17.1% [$0.39{\ell}$], and chest expansion length: 17.1% [0.96 cm]), and the improvement was maintained during the follow-up phase (VC: 4.8% [$0.13{\ell}$], FEV1: 17.1% [$0.39{\ell}$], and chest expansion length: 64.3% [1.81 cm]). Conclusion: These findings suggest that the postural alignment exercise was favorable for improving chest function of a woman with thoracic kyphosis.

• Journal of Korean Academy of Nursing
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• v.33 no.5
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• pp.570-579
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• 2003

Purpose: The purpose of this study is to exam the effects of a short-term pulmonary program on lung function, exercise tolerance, and quality of life in chronic lung patients. Method: Randomized controlled pre-post test design was used. The outcome measures were forced expiratory volume in one second (FEV1, % predicted), 6 min walking distance (6MWD), Borg score after 6MWD, and Chronic Respiratory Disease Questionnaire (CRDQ). Experimental group performed the 4-week home-based pulmonary rehabilitation program composed of inspiratory muscle training, upper and lower extremity exercise, relaxation, and telephone visit. Patients in control group were only given education about self-management strategies. Thirty four patients with moderate-to-severe respiratory impairment were recruited, and 28 patients (19 in experiments, 15 in control) completed the study. Result: Significant improvements in lung function, exercise tolerance, and health related quality of life were found only in the experiment group. Conclusion: This study yielded evidence for the potential and beneficial effects of home-based pulmonary rehabilitation program in patients with moderate to severe chronic lung disease. The program could be adequately utilized for improvement of health related quality of life in chronic lung patients.