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"Pulmonary rehabilitation"

Original Articles

Cardiopulmonary rehabilitation

Would Integrating Inspiratory Muscle Training into Pulmonary Rehabilitation of Adults with Burn Injuries Have Any Advantageous Effects? a Randomized, Double-Blind, Sham-controlled Study
Nabil Mahmoud Abdel-Aal, Maged A. Basha, Saleh M. Aloraini, Alshimaa R. Azab, FatmaAlzahraa H. Kamel
Ann Rehabil Med 2025;49(1):30-39.   Published online February 28, 2025
DOI: https://doi.org/10.5535/arm.240092
Objective
To determine the effectiveness of adding inspiratory muscle training (IMT) alongside a pulmonary rehabilitation protocol in terms of inspiratory muscle strength, lung function, and exercise capacity in burned adults.
Methods
A randomized, double-blinded, sham-controlled study. Fifty-two adult patients with burn injuries, more than 20 years old and at least 20% total body surface area, were assigned randomly either to the experimental or the conventional group. The participants in the experimental group were given IMT plus a pulmonary rehabilitation program; the conventional group received only a pulmonary rehabilitation program. The interventions were performed for 8 weeks. At the beginning and after 8 weeks of training, the respiratory muscles’ strength, lung function and exercise capacity were all examined.
Results
After 2 months of training, the experimental group demonstrated statistically significant improvements than conventional group in maximum inspiratory pressure, maximum expiratory pressure, 6-minute walk test, forced vital capacity, and forced expiratory volume in 1 second (p<0.05).
Conclusion
An 8-week IMT program coupled with pulmonary rehabilitation increases respiratory muscle strength, pulmonary functions, and functional capacity in burn patients. IMT is a beneficial and efficient therapy that can be easily implemented for burn patients.
  • 1,606 View
  • 47 Download

Cardiopulmonary rehabilitation

A Pulmonary Telerehabilitation Program Improves Exercise Capacity and Quality of Life in Young Females Post-COVID-19 Patients
Ashwag S. Alsharidah, FatmaAlzahraa H. Kamel, Afrah A. Alanazi, Enas A. Alhawsah, Hajar K. Alharbi, Zahrah O. Alrshedi, Maged A. Basha
Ann Rehabil Med 2023;47(6):502-510.   Published online November 20, 2023
DOI: https://doi.org/10.5535/arm.23060
Objective
To examine the impact of telerehabilitation training on exercise capacity, lung function, and health-related quality of life (HRQOL) in comparison to no rehabilitation for post-COVID-19 symptoms in adult females.
Methods
A randomized controlled trial of 48 females after mild to moderate COVID-19 survival were equally and randomly assigned to one of two groups: intervention group or control group. Three sessions per week for 6 weeks of a telerehabilitation program provided via a smartphone to the intervention group. Spirometry was used to quantify lung function, a 6-minute walk test (6MWT) measured in meters to measure exercise capacity, and the Short Form Health Survey-36 was used to assess HRQOL.
Results
After treatment, there was no statistically significant difference in forced vital capacity (FVC) or forced expiratory volume in 1 second (FEV1) between groups (p>0.05), but the 6MWT of the intervention group increased significantly more than that of the control group (p=0.001). The percent of change in 6MWT for the intervention group and control group was 14.22% and 4.21%, respectively. After therapy, the intervention group’s HRQOL significantly improved when compared to the control group’s (p=0.001).
Conclusion
This study showed that a telerehabilitation programs improved exercise capacity and HRQOL in young females post-COVID-19 compared to no rehabilitation.

Citations

Citations to this article as recorded by  
  • Physical Therapy Outcome Measures Used in Persons With Long Covid: A Systematic Review of Interventional Studies Up to 1-Year Postglobal Health Emergency
    Andrea Lopes Sauers, Liana Johnson, Marissa Mortensen, Laura Bianca Dorásio da Silva, Luciana Angélica da Silva de Jesus, Jaime González, Cristino Oliveira
    Cardiopulmonary Physical Therapy Journal.2025; 36(2): 105.     CrossRef
  • Efficacy of Telerehabilitation Protocols for Improving Functionality in Post-COVID-19 Patients
    Jose Luis Estela-Zape, Valeria Sanclemente-Cardoza, Leidy Tatiana Ordoñez-Mora
    Life.2025; 15(1): 44.     CrossRef
  • Practical Recommendations for Exercise Training in Patients with Long COVID with or without Post-exertional Malaise: A Best Practice Proposal
    Rainer Gloeckl, Ralf H. Zwick, Ulrich Fürlinger, Tessa Schneeberger, Daniela Leitl, Inga Jarosch, Uta Behrends, Carmen Scheibenbogen, Andreas Rembert Koczulla
    Sports Medicine - Open.2024;[Epub]     CrossRef
  • Effectiveness of telerehabilitation in patients with post-COVID-19: a systematic review and meta-analysis of randomised controlled trials
    Jiang Yang, Huiru Li, Hulei Zhao, Yang Xie, Jiansheng Li, Minghang Wang
    BMJ Open.2024; 14(7): e074325.     CrossRef
  • Effectiveness of telerehabilitation versus face-to-face pulmonary rehabilitation on physical function and quality of life in people with post COVID-19 condition: a systematic review and network meta-analysis
    Oliver MARTÍNEZ-POZAS, Camilo CORBELLINI, Juan N. CUENCA-ZALDÍVAR, Érika MELÉNDEZ-OLIVA, Pierluigi SINATTI, Eleuterio A. SÁNCHEZ ROMERO
    European Journal of Physical and Rehabilitation Medicine.2024;[Epub]     CrossRef
  • 6,606 View
  • 100 Download
  • 4 Web of Science
  • 5 Crossref
Efficacy of Systemic Postoperative Pulmonary Rehabilitation After Lung Resection Surgery
Soo Koun Kim, Young Hyun Ahn, Jin A Yoon, Myung Jun Shin, Jae Hyeok Chang, Jeong Su Cho, Min Ki Lee, Mi Hyun Kim, Eun Young Yun, Jong-Hwa Jeong, Yong Beom Shin
Ann Rehabil Med 2015;39(3):366-373.   Published online June 30, 2015
DOI: https://doi.org/10.5535/arm.2015.39.3.366
Objective

To investigate the efficacy of systemic pulmonary rehabilitation (PR) after lung resection in patients with lung cancer.

Methods

Forty-one patients undergoing lung resection were enrolled and classified into the experimental (n=31) and control groups (n=10). The experimental group underwent post-operative systemic PR which was conducted 30 min/day on every hospitalization day by an expert physical therapist. The control group received the same education about the PR exercises and were encouraged to self-exercise without supervision of the physical therapist. The PR group was taught a self-PR program and feedback was provided regularly until 6 months after surgery. We conducted pulmonary function testing (PFT) and used a visual analog scale (VAS) to evaluate pain, and the modified Borg Dyspnea Scale (mBS) to measure perceived respiratory exertion shortly before and 2 weeks, 1, 3, and 6 months after surgery.

Results

A significant improvement on the VAS was observed in patients who received systemic PR >3 months. Significant improvements in forced vital capacity (FVC) and mBS score were observed in patients who received systemic PR >6 months (p<0.05). Other PFT results were not different compared with those in the control group.

Conclusion

Patients who received lung resection suffered a significant decline in functional reserve and increases in pain and subjective dyspnea deteriorating quality of life (QoL). Systemic PR supervised by a therapist helped improve reduced pulmonary FVC and QoL and minimized discomfort during the postoperative periods in patients who underwent lung resection.

Citations

Citations to this article as recorded by  
  • Efficacy of a smartphone application assisting home-based rehabilitation and symptom management for patients with lung cancer undergoing video-assisted thoracoscopic lobectomy: a prospective, single-blinded, randomised control trial (POPPER study)
    Chao Lv, Fangliang Lu, Xiugeng Zhou, Xiang Li, Wenhua Yu, Chune Zhang, Kaishen Chen, Songtao Du, Chao Han, Jia Wang, Yuzhao Wang, Shaolei Li, Liang Wang, Yinan Liu, Shanyuan Zhang, Miao Huang, Dongdong Song, Dachuan Zhao, Bing Liu, Yaqi Wang, Xinrun Cui,
    International Journal of Surgery.2025; 111(1): 597.     CrossRef
  • Efficacy of digital therapeutics for perioperative management in patients with lung cancer: a randomized controlled trial
    Jinming Xu, Heng Ni, Hanyu Zhan, Hongfan Yu, Zhongjie Lu, Jieping Zhang, Hongbo Meng, Lin Hang, Lin Mao, Xiaoying Xu, Xiaojian Ma, Qiongyin Wu, Wen Xu, Danyu Xiang, Yufang Zeng, Di Meng, Xiao Teng, Li Yu, Liping Zeng, Pengzhi Ni, Huiwen Miao, Shaozi Fu, L
    BMC Medicine.2025;[Epub]     CrossRef
  • Feasibility of postoperative home-based pulmonary function training for lung cancer patients: a real-world study
    Ziqing Xu, Yizhuo Chen, Zhouqi Zhang, Dongfang Qiao, Ming Dong
    Journal of Cardiothoracic Surgery.2025;[Epub]     CrossRef
  • Compensatory function change by segment-counting method in predicted postoperative pulmonary function at 1 year after surgery: systematic review and meta-analysis
    Teng-Wei Wang, Qiang Zhang, Zhihong Cai, Qinhong Xu, Jinrong Lin, Huilong Yeh
    BMJ Open Respiratory Research.2024; 11(1): e001855.     CrossRef
  • Thoracic Paravertebral Block Ameliorates Postoperative Delirium in Geriatric Patients
    Lei Heng, Mingyu Wang, Mingquan Wang, Li Li, Shanshan Zhu
    The Thoracic and Cardiovascular Surgeon.2022; 70(05): 439.     CrossRef
  • Home-Based Pulmonary Rehabilitation in Aged Individuals With Lung Tumor After Thoracoscopic Surgery
    Nai-Ying Kuo, Jui-Fang Liu, Hung-I Lu, Chien-Ming Lo, Li-Chiu Hsien, Chia-Ling Chang, Miaoju Hsu
    Topics in Geriatric Rehabilitation.2022; 38(2): 110.     CrossRef
  • Comparative effectiveness of smartphone healthcare applications for improving quality of life in lung cancer patients: study protocol
    Jang Ho Lee, Jae Hwa Jeong, Wonjun Ji, Hui Jeong Lee, Yura Lee, Min-Woo Jo, Seockhoon Chung, Sung-Cheol Yun, Chang-Min Choi, Geun Dong Lee, Sei Won Lee, Jong Won Lee
    BMC Pulmonary Medicine.2022;[Epub]     CrossRef
  • Recent Trends in Rehabilitation for Cancer Patients
    Kwan-Sik Seo
    Annals of Rehabilitation Medicine.2022; 46(3): 111.     CrossRef
  • Pre- and Post-Operative Pulmonary Rehabilitation in Patients with Non-Small Cell Lung Cancer
    Mi Ri Suh
    Annals of CardioPulmonary Rehabilitation.2022; 2(1): 13.     CrossRef
  • Recovery of respiratory muscle strength, physical function, and dyspnoea after lobectomy in lung cancer patients undergoing pulmonary rehabilitation: A retrospective study
    Tsuyoshi Ichikawa, Masanori Yokoba, Yu Horimizu, Saki Yamaguchi, Akiko Kawakami, Satoru Oikawa, Haruka Takeichi, Masato Katagiri, Minoru Toyokura
    European Journal of Cancer Care.2022;[Epub]     CrossRef
  • Outcomes of pulmonary rehabilitation after lung resection in patients with lung cancer
    Hülya Şahin, İlknur Naz, Nimet Aksel, Filiz Güldaval, Mine Gayaf, Serkan Yazgan, Kenan Can Ceylan
    Turkish Journal of Thoracic and Cardiovascular Surgery.2022; 30(2): 227.     CrossRef
  • A Combat Journey With Pulmonary Rehabilitation and Palliative Care in a Patient With Pleural Effusion, Secondary to Metaplastic Breast Carcinoma
    Nikita Kaple, Moli Jain, Vaishnavi Yadav, Pallavi Bhakaney
    Cureus.2022;[Epub]     CrossRef
  • Application of rehabilitation nursing technology in the pulmonary rehabilitation of the patients after lung cancer operation
    Yuzhen XU, Lin HAN
    Journal of Integrative Nursing.2021; 3(2): 79.     CrossRef
  • Cardiopulmonary exercise testing in thoracic surgery
    Irina Pele, Florin-Dumitru Mihălțan
    Pneumologia.2020; 69(1): 3.     CrossRef
  • Effect of Squat Exercises on Lung Function in Elderly Women with Sarcopenia
    Yun Jeon, Myung Shin, Cheol Kim, Byeong-Ju Lee, Sang Kim, Da Chae, Jong-Hwan Park, Yong So, Hyuntae Park, Chang Lee, Byoung Kim, Jae Chang, Yong Shin, In Kim
    Journal of Clinical Medicine.2018; 7(7): 167.     CrossRef
  • Short-term preoperative exercise therapy does not improve long-term outcome after lung cancer surgery: a randomized controlled study†
    Wolfram Karenovics, Marc Licker, Christoph Ellenberger, Michel Christodoulou, John Diaper, Chetna Bhatia, John Robert, Pierre-Olivier Bridevaux, Frédéric Triponez
    European Journal of Cardio-Thoracic Surgery.2017; 52(1): 47.     CrossRef
  • Effects of exercise training on patients with lung cancer who underwent lung resection: a meta-analysis
    Jie Li, Nan-Nan Guo, Hai-Rong Jin, Hua Yu, Peng Wang, Guo-Gang Xu
    World Journal of Surgical Oncology.2017;[Epub]     CrossRef
  • Management of surgical challenges in actively treated cancer patients
    David A. Santos, Adnan Alseidi, Vickie R. Shannon, Craig Messick, Guobin Song, Celia Robinson Ledet, Hun Lee, An Ngo-Huang, George J. Francis, Arash Asher
    Current Problems in Surgery.2017; 54(12): 612.     CrossRef
  • Perioperative physical exercise interventions for patients undergoing lung cancer surgery: What is the evidence?
    Carlotta Mainini, Patrícia FS Rebelo, Roberta Bardelli, Besa Kopliku, Sara Tenconi, Stefania Costi, Claudio Tedeschi, Stefania Fugazzaro
    SAGE Open Medicine.2016;[Epub]     CrossRef
  • 5,139 View
  • 97 Download
  • 21 Web of Science
  • 19 Crossref

Case Report

Successful Surgery for Scoliosis Supported by Pulmonary Rehabilitation in a Duchenne Muscular Dystrophy Patient With Forced Vital Capacity Below 10%
Jang Woo Lee, Yu Hui Won, Won Ah Choi, Soon Kyu Lee, Seong Woong Kang
Ann Rehabil Med 2013;37(6):875-878.   Published online December 23, 2013
DOI: https://doi.org/10.5535/arm.2013.37.6.875

Low vital capacity is a risk factor for scoliosis correction operation in Duchenne muscular dystrophy (DMD) patients, but pulmonary rehabilitation, including noninvasive intermittent positive pressure ventilator application, air stacking exercise, and assisted coughing technique, reduces the pulmonary complications and perioperative mortality risk. In this case, the patient's preoperative forced vital capacity (FVC) was 8.6% of normal predicted value in sitting position and 9.4% in supine position. He started pulmonary rehabilitation before the operation and continued right after the operation. Scoliosis correction operation was successful without any pulmonary complications, and his discomfort in sitting position was improved. If pulmonary rehabilitative support is provided properly, FVC below 10% of normal predicted value is not a contraindication of scoliosis correction operation in DMD patients.

Citations

Citations to this article as recorded by  
  • Letter to the Editor Regarding “An Optimized Enhanced Recovery After Surgery (ERAS) Pathway Improved Patient Care in Adolescent Idiopathic Scoliosis Surgery: A Retrospective Cohort Study”
    Di Zhu, Gen-ying Zhu
    World Neurosurgery.2021; 156: 153.     CrossRef
  • Successful surgery for a neuromuscular scoliosis patient by pulmonary rehabilitation with forced vital capacity below 30%
    Kai Han, Yongqian Wang, Shangbin Cui, Caixia Xu, Peiqiang Su
    European Spine Journal.2018; 27(9): 2072.     CrossRef
  • Systemic Antisense Therapeutics for Dystrophin and Myostatin Exon Splice Modulation Improve Muscle Pathology of Adult mdx Mice
    Ngoc Lu-Nguyen, Alberto Malerba, Linda Popplewell, Fred Schnell, Gunnar Hanson, George Dickson
    Molecular Therapy - Nucleic Acids.2017; 6: 15.     CrossRef
  • Link between MHC Fiber Type and Restoration of Dystrophin Expression and Key Components of the DAPC by Tricyclo-DNA-Mediated Exon Skipping
    Saleh Omairi, Kwan-Leong Hau, Henry Collin-Hooper, Federica Montanaro, Aurelie Goyenvalle, Luis Garcia, Ketan Patel
    Molecular Therapy - Nucleic Acids.2017; 9: 409.     CrossRef
  • Complications respiratoires de l’enfant polyhandicapé et leur prise en charge
    N. Stremler-Le Bel, A. Carsin, E. Sauvaget
    Archives de Pédiatrie.2014; 21(5): 145.     CrossRef
  • 4,493 View
  • 60 Download
  • 3 Web of Science
  • 5 Crossref

Original Articles

A Research on the Management of Ventilatory Insufficiency in Patients with Neuromuscular Diseases.
Kim, Dong Hyun , Kang, Seong Woong , Choi, Wonah , Moon, Jae Ho , Baek, Jong Hoon , Choi, Seung Ho , Park, Jung Hyun , Shin, Yong Beom , Seo, Jung Hwan
J Korean Acad Rehabil Med 2010;34(3):347-354.
Objective
To investigate the real condition of pulmonary rehabilitation for patients with advanced neuromuscular diseases (NMDs) on mechanical ventilation in Korea. Method: In order to estimate current state of pulmonary rehabilitative management, chart review and pulmonary function evaluation were conducted in a total of 267 NMD patients who had applied mechanical home ventilator in our center from March 2001 to December 2008. Results: Total 267 patients were included: 95 with Duchenne muscular dystrophy, 69 with other types of myopathy, 83 with amyotrophic lateral sclerosis (ALS), 20 with spinal muscular atrophy. Among them, 18 who were previously intubated and 17 patients who had undergone tracheostomy were switched into volume-limited non-invasive ventilation (NIV). At the time of hospital discharge, 234 patients were applied NIV successfully. Twenty other patients who once used continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) ventilators inappropriately were switched into volume-limited NIV. However, 20 patients who had successfully applied NIV first underwent tracheostomy due to exacerbation of underlying disease. Conclusion: Adequate pulmonary management is the only promising method to prevent lethal complications, and to prolong life span of advanced NMD patients. We assume that more NMD patients can improve their quality of life and prolong their life through proper pulmonary rehabilitation including regular pulmonary function check-ups and ventilatory state monitoring as well as early NIV application. (J Korean Acad Rehab Med 2010; 34: 347-354)
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The Effectiveness of Pulmonary Rehabilitation Program on Functional Improvement in Patients with Spinal Cord Injury.
Ryu, Su Ra , Shin, A Young , Han, Jae Young , Choi, In Sung , Kim, Jae Hyung , Lee, Sam Gyu
J Korean Acad Rehabil Med 2008;32(1):32-37.
Objective: To investigate the effectiveness of pulmonary rehabilitation program on functional improvement in patients with spinal cord injury and the difference between tetraplegics and paraplegics. Method: Twenty one patients without previous history of pulmonary pathology were recruited for this study. Fourteen patients were tetraplegic (12 males, 2 female; mean duration of disease, 42.2±7.9 days; mean age, 52.7±3.4 years old), seven patients were paraplegic (6 males, 1 female; mean duration of disease, 48.8±6.3 days; mean age, 42.1±3.7 years old). All patients received pulmonary rehabilitation composed of respiratory muscles strengthening exercise, positive inflation exercise, and breathing exercise with Breather for 30 minutes a session, twice a day, five days per week for 4 weeks. We evaluated arterial blood gas analysis, pulmonary function test (PFT), modified Borg scale (MBS), Spinal Cord Independence Measure (SCIM), and Functional Independence Measure (FIM) as outcome measures at the beginning and 4 weeks after treatment. Results: After the pulmonary rehabilitation program, both of PaO2 and SaO2 increased in tetraplegia and paraplegia groups. MBS improved at rest and on exercise in both of paraplegia and tetraplegia groups (p<0.05). FEV1 and FVC increased in both groups (p<0.05). Both SCIM and FIM scores increased in both groups (p<0.05). The difference of the improvement ratio of PFT, MBS and functional scales between tetraplegia and paraplegia groups was not significant. Conclusion: It is suggested that pulmonary rehabilitation program would be useful to improve the functional improvement including of pulmonary function and subjective dyspnea scale in both of tetraplegia and paraplegia groups. (J Korean Acad Rehab Med 2008; 32: 32-37)
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Case Report

Non-invasive Intermittent Positive Pressure Ventilation Apply to Complete Tetraplegia due to C1 Spinal Cord Injury: A case report.
Park, Jung Hyun , Kang, Seong Woong , Cho, Dong Hee
J Korean Acad Rehabil Med 2004;28(5):501-504.
The patients who have high cervical cord injury with paralysis of diaphragm are not able to live without mechanical ventilatory support. In conventional concept, tracheostomy is necessary for long-term use of mechanical ventilation. We reported a 33-year-old man diagnosed with complete tetraplegia due to C1 spinal cord injury. He had used intermittent mechanical ventilation via tracheostomy tube. He had no movement of diaphragm and showed hypercapnia and hypoxemia without ventilatory support for several hours. He showed 400 ml of vital capacity and un-obtainable peak cough flow level but it could be obtained 300 L/min of assisted peak cough flow. Noninvasive intermittent positive pressure ventilation (NIPPV) was applied from invasive method and decannulation and tracheostomy closure was performed successfully. He had no pulmonary complications for six months. This case could be a good model for the indication of NIPPV application and decannulation. (J Korean Acad Rehab Med 2004; 28: 501-504)
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Original Articles
Quality of Life in Patients with Neuromuscular Disease Using Mechanical Ventilatory Support.
Park, Jung Hyun , Kang, Seong Woong , Kim, Eun Joo , Ha, Young Ran
J Korean Acad Rehabil Med 2004;28(2):157-162.
Objective
To estimate the quality of lives in neuromuscular disease patients using mechanical ventilators by comparing their 'Index of Well-being' reported their own and caregivers.Method: The Semantic Differential Scale of General Affect and Life Domain Satisfaction Measures were instruments to measure perceived well-being. They were used to survey 33 ventilator-assisted patients and their caregivers. A third instrument was devised to study the satisfaction of rehabilitative management including mechanical ventilation. Results: The caregivers significantly underestimated their patients' scores in the general affect instruments and lifesatisfaction (p<0.05). Twenty-six of 33 responding patients (78.8%) expressed satisfaction with present rehabilitative management.Conclusion: The most disabled ventilator-assisted patients with neuromuscular disease rated their quality of life as satisfying. The dependence on ventilation was not a predictor of a low quality of life. But the rating of the patient's quality of life from significant others was underestimated. This was important because patients' decision making concerning ventilation care was influenced by significant others. (J Korean Acad Rehab Med 2004; 28: 157-162)
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Non-invasive Mechanical Ventilator Care for the Patients with Advanced Neuromuscular Disease.
Kang, Seong Woong , Park, Jung Hyun , Ryu, Ho Hyun , Kang, Yeoun Seung , Moon, Jae Ho
J Korean Acad Rehabil Med 2004;28(1):71-77.
Objective
The usage of mechanical ventilator has been an issue in advanced stage of most neuromuscular diseases. The patients experience hypoventilation symptoms and usually die from pulmonary complications at last. Besides traditional invasive mechanical ventilation, non-invasive intermittent positive pressure ventilation (NIPPV) has provided an alternative treatment option. We evaluated the effects of NIPPV. Method: We applied NIPPV method to the patients with advanced neuromuscular disease who were hospitalized due to ventilatory failure, who visit our outpatient clinic due to hypercapnic symptoms, or who showed hypercapnia on a routine follow-up. To evaluate ventilatory status, blood gas tensions were analyzed by the arterial blood gas analysis and/or pulse-oxymeter and capnometer. Overnight pulse- oxymeter monitorings were done whenever necessary. Results: Thirty patients were managed with NIPPV successfully. In five cases, invasive IPPV with tracheostomy at admission was switched to NIPPV. Three patients who had been intubated to receive IPPV were transferred to NIPPV without being tracheostomized. Conclusion: NIPPV can be used safely and effectively as an alternative method of ventilatory support for the patients with advanced neuromuscular disease who show ventilatory failure. It would relieve symptoms and signs of hypoventilation and prevent the acute respiratory muscle decompensation, if applied before overt ventilatory failure. (J Korean Acad Rehab Med 2004; 28: 71-77)
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The Significance of Posture on Assessment of Pulmonary Function after Pulmonary Rehabilitation in Tetraplegia.
Kim, Yong Rae , Lee, Sang Jin , Kim, Hyung Jun , Lee, Sung Beom
J Korean Acad Rehabil Med 2003;27(4):513-518.
OBJECTIVE
In patients with cervical spinal cord injury (SCI), it is known that vital capacity of the supine position is larger than that of the sitting position, but after pulmonary rehabilitation treatment, the effect on assessment of vital capacity according to the posture is not yet clearly known. In this study, we evaluated the significance of posture on assessment of pulmonary function after pulmonary rehabilitation treatment in patients with cervical SCI. METHOD: Twenty-eight patients with cervical SCI were participated in this study. The pulmonary function was evaluated by measuring vital capacity (VC), tidal volume (TV), maximum insufflation capacity (MIC) and forced expiratory volume at the first second (FEV1) in both supine and sitting position, before and after the 4 weeks pulmonary rehabilitation treatment. The parameters of pulmonary function were analyzed and compared according to the posture. RESULTS: Before pulmonary rehabilitation treatment, VC, TV, MIC and FEV1 of the supine position were significantly larger than those of the sitting position (p<0.05). After pulmonary rehabilitation treatment, VC, TV, MIC and FEV1 of the supine position were also significantly larger than those of the sitting position (p<0.05). Vital capacity, TV, MIC and FEV1 were significantly improved after pulmonary rehabilitation treatment both supine and sitting position (p<0.05), but the improvement ratio of VC, TV, MIC and FEV1 between supine and sitting position were not significantly different (p>0.05). CONCLUSION: For the proper assessment of the pulmonary function after pulmonary rehabilitation treatment in patients with cervical SCI, the significance of posture should be considered.
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The Efficacy of Pulmonary Rehabilitation Using Mechanical In-Exsufflator in Cervical Cord Injured Patients.
Park, Chang Il , Shin, Ji Cheol , Kang, Seong Woong , Lee, Byung Ho , choi, Young Seok , Kim, Yong Rae , Jeon, Sang Chul
J Korean Acad Rehabil Med 2002;26(4):403-408.

Objective: It is known that Mechanical in-exsufflator (MI-E) can reduce pulmonary complications such as pneumonia, atelectasis in tetraplegia by increasing inspiratory and expiratory capacity. The aim of this study is to clarify the effectiveness of MI-E on pulmonary function and coughing capacity in tetraplegia.

Method: Thirty tetraplegic patients who had neither history nor radiologic finding of pulmonary disease were divided into two groups; control (n=15) and experimental (n=15) groups. Control group received conventional pulmonary rehabilitation, while experimental group received additional MI-E therapy for one month. The pulmonary function was evaluated by measuring percentage of predicted value of vital capacity (% VC), maximal insufflation capacity (MIC), unassisted peak cough flow (UPCF), volume assisted peak cough flow (VPCF), manual assisted peak cough flow (MPCF), manual and volume assisted peak cough flow (MVPCF). These data of pulmonary function before and after treatment were compared between two groups.

Results: 1) There are significant improvement of pulmonary function in both groups (p<0.05) except UPCF in control group before and after treatment. 2) The experimental group showed more improvement in MIC, VPCF, MPCF and MVPCF than control group (p<0.05).

Conclusion: MI-E therapy can be used as an effective therapeutic modality for the improvement of pulmonary function in combination with conventional pulmonary rehabilitation. (J Korean Acad Rehab Med 2002; 26: 403-408)

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Short-Term Inpatient Pulmonary Rehabilitation for Pneumoconiosis.
Ryu, Sang Yeol , Park, Cheol Beom , Lim, Jun Kyeong , Lee, Ho , Yu, Hyun Joo , Cho, Kang Hee
J Korean Acad Rehabil Med 1998;22(3):705-710.

Objective: To evaluate the effectiveness of a short-term inpatient pulmonary rehabilitation treatment program including inspiratory muscle training and reconditioning exercise in pneumoconiosis patients.

Method: Thirty pneumoconiosis patients have undergone a 3-week inpatient pulmonary rehabilitation program. The program included a inspiratory muscle strengthening, relaxation technique and reconditioning exercise such as walking and upper extremity strengthening. The effectiveness of treatment was evaluated by a pulmonary function test, 6-minute walk distance and 150 mm-visual analog dyspnea scale before and after the program.

Results: After the 3-week inpatient pulmonary rehabilitation program, there was a significant increase in 6-minute walk distance(p<0.01) and a significant decrease in 150 mm-visual analog dyspnea scale(p<0.01). However the pulmonary function test showed no significant change.

Conclusion: We concluded that the short-term inpatient pulmonary rehabilitation program can improve the exercise tolerance by reduction of dyspnea and increase of walk distance, and ultimately increase the quality of life in pneumoconiosis patients.

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