• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.585-590
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• 2022

Objective: The purpose of this study was to investigate the effects of neuromuscular training of ballet dancers with chronic ankle instability on ankle stability and posture controlability. Design: A randomized controlled trial. Methods: A total of Thirty-twoyoung female ballet dancers with chronic ankle instability have voluntarily participated in the study. The participants were randomized to the neuromuscular training group(n₁=11), elastic resistance squat group(n₂=11), and control group(n₃=10). The intervention was applied to a total of 18 exercises per six weeks and conducted in each group for one hour a day, three times a week. All subjects were evaluated for Cumberland ankle instability tool(CAIT), static balance at before-after intervention. Results: In the comparison of the effects within the groups, the effect of the intervention on CAIT and posture control was significantly increased in the neuromuscular training group and elastic resistance squat group (p <0.05). In the comparison of the effects between the groups, the neuromuscular training group, and elastic resistance squat group were found to significantly increase more than the control group (p <0.05). The effect of ankle stability is similar in neuromuscular training and elastic resistance squat training, neuromuscular training is more effective in improving posture control rather than elastic resistance squat training. Conclusions: When planning a rehabilitation training program for a ballet dancer with chronic ankle instability, neuromuscular training can be applied as an intervention method to improve ankle stability and posture control ability.

• Restorative Dentistry and Endodontics
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• v.25 no.2
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• pp.193-201
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• 2000

Prostaglandins (PGs) and Leukotrienes (LTs) have been implicated in the genesis of pulpal and periapical inflammation. In this study, the relationships among $PGE_2$, 6-keto-PG $F_1{\alpha}$ (a stable metabolite of $PGI_2$) and $LTB_4$ concentrations in inflamed pulp and periapical lesions were discussed. Pulp tissue were obtained in routine endodontic treatment and periapical lesions in periapical surgery after clinical diagnoses were made. These specimens were divided into four groups as normal pulp group (Control group), acute pulpitis group, chronic pulpitis group, and periapical lesion group. Pulp tissue and periapical lesions were stored in liquid nitrogen. The concentration of $PGE_2$, $PGI_2$ and $LTB_4$ were measured with ELISA. The data were analyzed by one-way ANOVA. Significantly higher levels of $PGE_2$, 6-keto-PG $F_1{\alpha}$ a and $LTB_4$ were found in acute pulpitis group than chronic pulpitis group and periapical lesion group(p<0.05). Periapical lesion group showed significantly higher mean concentrations of $PGE_2$ and $LTB_4$ than chronic pulpitis group. In control and chronic pulpitis group, significant higher levels of $PGI_2$ than $PGE_2$ and $LTB_4$ were found. These results suggested that the high levels of $PGE_2$ and $LTB_4$ in periapical lesions may be due to rich endothelium., fibroblast and lymphocyte known as the main producers of $PGE_2$ and $LTB_4$. $PGI_2$ may be thought to one of the most abundant PGs in normal pulp tissue.

• Korean Journal of Radiology
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• v.22 no.10
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• pp.1719-1729
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• 2021

Objective: Emphysema and small-airway disease are the two major components of chronic obstructive pulmonary disease (COPD). We propose a novel method of quantitative computed tomography (CT) emphysema air-trapping composite (EAtC) mapping to assess each COPD component. We analyzed the potential use of this method for assessing lung function in patients with COPD. Materials and Methods: A total of 584 patients with COPD underwent inspiration and expiration CTs. Using pairwise analysis of inspiration and expiration CTs with non-rigid registration, EAtC mapping classified lung parenchyma into three areas: Normal, functional air trapping (fAT), and emphysema (Emph). We defined fAT as the area with a density change of less than 60 Hounsfield units (HU) between inspiration and expiration CTs among areas with a density less than -856 HU on inspiration CT. The volume fraction of each area was compared with clinical parameters and pulmonary function tests (PFTs). The results were compared with those of parametric response mapping (PRM) analysis. Results: The relative volumes of the EAtC classes differed according to the Global Initiative for Chronic Obstructive Lung Disease stages (p < 0.001). Each class showed moderate correlations with forced expiratory volume in 1 second (FEV₁) and FEV₁/forced vital capacity (FVC) (r = -0.659-0.674, p < 0.001). Both fAT and Emph were significant predictors of FEV₁ and FEV₁/FVC (R² = 0.352 and 0.488, respectively; p < 0.001). fAT was a significant predictor of mean forced expiratory flow between 25% and 75% and residual volume/total vital capacity (R² = 0.264 and 0.233, respectively; p < 0.001), while Emph and age were significant predictors of carbon monoxide diffusing capacity (R² = 0.303; p < 0.001). fAT showed better correlations with PFTs than with small-airway disease on PRM. Conclusion: The proposed quantitative CT EAtC mapping provides comprehensive lung functional information on each disease component of COPD, which may serve as an imaging biomarker of lung function.

• Physical Therapy Rehabilitation Science
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• v.9 no.1
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• pp.25-35
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• 2020

Objective: To compare the effects of joint mobilization, gym ball exercises, and breathing exercises on breathing pattern disorders and joint position sense in persons with chronic lower back pain. Design: Three-group pretest-posttest design. Methods: Thirty-six individuals with chronic low back pain who were undergoing a postural correction and vertebral movement at a rehabilitation center participated in this study. The subjects were randomly divided into the joint mobilization group (n=12), gym ball exercises group (n=12), and the breathing exercises group (n=12). The exercises were applied for 40 minutes a day, twice a week for a total of 12 weeks. Measurement tools included the end-tidal CO₂ (ETCO₂), respiration rate (RR), breath hold time, Nijmegen Questionnaire (NQ), excursion, and joint position error (JPE). Results: The groups showed significant differences in the ETCO₂, RR, NQ, Excursion and JPE test before and after the intervention (p<0.05). The differences between the groups were significant in the group that received the gym ball and breathing exercises in ETCO₂ and RR (p<0.05). The differences between the groups were most significant in the group that received breathing exercises in NQ and excursion (p<0.05). The differences between the groups were significant in the group that received the gym ball and breathing exercises in JPE Lt. and Rt. (p<0.05). Conclusions: All three interventions had a significant impact on the biomechanical changes, respiratory variables, and joint position sense in participants with chronic lower back pain. Breathing exercises were found to be particularly effective in improving respiratory parameters.

• Tuberculosis and Respiratory Diseases
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• v.87 no.2
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• pp.165-175
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• 2024

Background: The prevalence of small airway dysfunction (SAD) in patients with chronic obstructive pulmonary disease (COPD) across different ethnicities is poorly understood. This study aimed to estimate the prevalence of SAD in stable COPD patients. Methods: We conducted a cross-sectional study of 196 consecutive stable COPD patients. We measured pre- and post-bronchodilator (BD) lung function and respiratory impedance. The severity of COPD and lung function abnormalities was graded in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. SAD was defined as either difference in whole-breath resistance at 5 and 19 Hz > upper limit of normal or respiratory system reactance at 5 Hz < lower limit of normal. Results: The cohort consisted of 95.9% men, with an average age of 66.3 years. The mean forced expiratory volume 1 second (FEV₁) % predicted was 56.4%. The median COPD assessment test (CAT) scores were 14. The prevalence of post-BD SAD across the GOLD grades 1 to 4 was 14.3%, 51.1%, 91%, and 100%, respectively. The post-BD SAD and expiratory flow limitation at tidal breath (EFL_T) were present in 62.8% (95% confidence interval [CI], 56.1 to 69.9) and 28.1% (95% CI, 21.9 to 34.2), respectively. COPD patients with SAD had higher CAT scores (15.5 vs. 12.8, p<0.01); poor lung function (FEV₁% predicted 46.6% vs. 72.8%, p<0.01); lower diffusion capacity for CO (4.8 mmol/min/kPa vs. 5.6 mmol/min/kPa, p<0.01); hyperinflation (ratio of residual volume to total lung capacity % predicted: 159.7% vs. 129%, p<0.01), and shorter 6-minute walk distance (367.5 m vs. 390 m, p=0.02). Conclusion: SAD is present across all severities of COPD. The prevalence of SAD increases with disease severity. SAD is associated with poor lung function and higher symptom burden. Severe SAD is indicated by the presence of EFL_T.

• Korean Journal of Radiology
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• v.21 no.7
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• pp.880-890
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• 2020

Objective: Patients with chronic obstructive pulmonary disease (COPD) are known to be at risk of osteoporosis. The purpose of this study was to evaluate the association between thoracic vertebral bone density measured on chest CT (D_Thorax) and clinical variables, including survival, in patients with COPD. Materials and Methods: A total of 322 patients with COPD were selected from the Korean Obstructive Lung Disease (KOLD) cohort. D_Thorax was measured by averaging the CT values of three consecutive vertebral bodies at the level of the left main coronary artery with a round region of interest as large as possible within the anterior column of each vertebral body using an in-house software. Associations between D_Thorax and clinical variables, including survival, pulmonary function test (PFT) results, and CT densitometry, were evaluated. Results: The median follow-up time was 7.3 years (range: 0.1-12.4 years). Fifty-six patients (17.4%) died. D_Thorax differed significantly between the different Global Initiative for Chronic Obstructive Lung Disease stages. D_Thorax correlated positively with body mass index (BMI), some PFT results, and the six-minute walk distance, and correlated negatively with the emphysema index (EI) (all p < 0.05). In the univariate Cox analysis, older age (hazard ratio [HR], 3.617; 95% confidence interval [CI], 2.119-6.173, p < 0.001), lower BMI (HR, 3.589; 95% CI, 2.122-6.071, p < 0.001), lower forced expiratory volume in one second (FEV₁) (HR, 2.975; 95% CI, 1.682-5.262, p < 0.001), lower diffusing capacity of the lung for carbon monoxide corrected with hemoglobin (DL_CO) (HR, 4.595; 95% CI, 2.665-7.924, p < 0.001), higher EI (HR, 3.722; 95% CI, 2.192-6.319, p < 0.001), presence of vertebral fractures (HR, 2.062; 95% CI, 1.154-3.683, p = 0.015), and lower D_Thorax (HR, 2.773; 95% CI, 1.620-4.746, p < 0.001) were significantly associated with all-cause mortality and lung-related mortality. In the multivariate Cox analysis, lower D_Thorax (HR, 1.957; 95% CI, 1.075-3.563, p = 0.028) along with older age, lower BMI, lower FEV₁, and lower DL_CO were independent predictors of all-cause mortality. Conclusion: The thoracic vertebral bone density measured on chest CT demonstrated significant associations with the patients' mortality and clinical variables of disease severity in the COPD patients included in KOLD cohort.

• Journal of Korea Entertainment Industry Association
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• v.14 no.4
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• pp.355-363
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• 2020

To investigate the relationship between breathing pattern disorder and pain in patients with chronic low back pain(CLBP). One hundred four patients were measured the End-tidal CO₂(EtCO₂) and respiration rate(RR) using capnography. Also, The Breathing-hold time(BHT), Nijmegen Questionnaire(NQ), and Thoracic excursion examinated. There was a significant correlation between EtCO₂ and BHT, thoracic excursion(r=.302, r=.281)(p<.01), and a low negative correlation with RR, VAS(r=-.253, -200)(p<.05). There was a significant correlation between NQ and RR(r=.237)(p<.05). There was a low correlation between thoracic excursion and VAS(r=-.370)(p<.01). There was a significant difference in the EtCO₂, RR, BHT, thoracic excursion, and VAS between the thoracic and diaphragm breathing pattern(p<.05). There were no significant differences in the NQ(p>.05). There was a correlation between EtCO₂ and BHT, thoracic excursion, RR, VAS in patients with CLBP. In addition, There was a correlation between RR and NQ, thoracic excursion, and VAS. As a result, it was found that there is a close relationship between breathing pattern disorder and pain. There was a significant difference in the EtCO₂ level, RR, BHT, thoracic excursion and VAS value in the comparison of thoracic breathing pattern and diaphragm breathing pattern. This is a meaningful result of suggesting a breathing pattern treatment approach in the rehabilitation and pain management of chronic low back pain patients in clinical practice.

• Korean Journal of Radiology
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• v.20 no.4
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• pp.683-692
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• 2019

Objective: We aimed to evaluate correlations between computed tomography (CT) parameters and pulmonary function test (PFT) parameters according to disease severity in patients with chronic obstructive pulmonary disease (COPD), and to determine whether CT parameters can be used to predict PFT indices. Materials and Methods: A total of 370 patients with COPD were grouped based on disease severity according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) I-IV criteria. Emphysema index (EI), air-trapping index, and airway parameters such as the square root of wall area of a hypothetical airway with an internal perimeter of 10 mm (Pi10) were measured using automatic segmentation software. Clinical characteristics including PFT results and quantitative CT parameters according to GOLD criteria were compared using ANOVA. The correlations between CT parameters and PFT indices, including the ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) and FEV₁, were assessed. To evaluate whether CT parameters can be used to predict PFT indices, multiple linear regression analyses were performed for all patients, Group 1 (GOLD I and II), and Group 2 (GOLD III and IV). Results: Pulmonary function deteriorated with increase in disease severity according to the GOLD criteria (p < 0.001). Parenchymal attenuation parameters were significantly worse in patients with higher GOLD stages (P < 0.001), and Pi10 was highest for patients with GOLD III (4.41 ± 0.94 mm). Airway parameters were nonlinearly correlated with PFT results, and Pi10 demonstrated mild correlation with FEV1/FVC in patients with GOLD II and III (r = 0.16, p = 0.06 and r = 0.21, p = 0.04, respectively). Parenchymal attenuation parameters, airway parameters, EI, and Pi10 were identified as predictors of FEV₁/FVC for the entire study sample and for Group 1 (R² = 0.38 and 0.22, respectively; p < 0.001). However, only parenchymal attenuation parameter, EI, was identified as a predictor of FEV₁/FVC for Group 2 (R² = 0.37, p < 0.001). Similar results were obtained for FEV₁. Conclusion: Airway and parenchymal attenuation parameters are independent predictors of pulmonary function in patients with mild COPD, whereas parenchymal attenuation parameters are dominant independent predictors of pulmonary function in patients with severe COPD.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.30 no.2
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• pp.196-204
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• 2020

Objective: Chronic obstructive pulmonary disease(COPD) is characterized by persistent airflow limitations associated with chronic inflammatory response due to noxious particles or gases in the lung. Increasing oxidative stress associated with COPD. The aim of this study was to evaluate the influencing factors of biomarkers for oxidative stress in retired miners with COPD. Methods: The levels of total peroxide(TPx), total antioxidant capacity(TAC), and oxidative stress index(TPx/TAC ratio, OSI) in plasma as biomarkers for oxidative stress, serum C-reactive protein(CRP) as a biomarker for inflammation, and general characteristics were measured in 93 male subjects with COPD. COPD was defined as post bronchodilator FEV₁/FVC<0.7 by spirometry. Results: Mean levels of TPx(p=0.013), TAC(p=0.010), OSI(p=0.040), and CRP(p=0.024) were higher in current smokers. Levels of TPx(β=0.445, p<0.001), TAC(β=0.490, p<0.001), and OSI(β=0.351, p<0.001) were related to CRP levels, and CRP levels were related to %FEV₁ predicted(β=-0.295, p=0.003) and current smoking(β=0.214, p=0.032). Conclusions: These results suggest that oxidative stress was related to inflammation, and inflammation were related to decreasing %FEV₁ predicted and current smoking in retired miners with COPD.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.4
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• pp.77-83
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• 2021

PURPOSE: This study examined the changes in the respiratory function when PNF chopping and lifting patterns were used in chronic stroke patients METHOD: The subjects were 30 patients diagnosed with chronic stroke. The respiratory function (FVC, FEV₁, and FEV₁/FVC) were measured by spirometry. Thirty subjects were divided randomly into an experimental group to which 15 PNF chopping and lifting were applied and a control group to which chest breathing exercise was performed. The intervention was conducted three times a week for six 6 weeks. To examine the effects of intervention, the pre- and post-intervention values for each group were compared using a paired t-test. An independent t-test was used to compare the differences in the values of changes pre- and post-intervention in the two groups. Statistical significance was set to .05. RESULTS: Satistically significant differences in FVC and FEV₁ were observed in both the experimental group and control group according to the intervention (p < .05). A statistically significant difference was found in FVC and FEV₁ compared to values of changes pre- and post-intervnetion between the experimental and control groups. There was no difference in FEV₁/FVC. CONCLUSION: The results suggest that PNF chopping and lifting can be applied as an excellent respiratory intervention program compared to general chest breathing exercises to improve respiratory function in stroke patients.