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PubMed1994

[The effects of incentive spirometry on pulmonary functions].

The effects of incentive spirometry on pulmonary functions were studied in 46 normal adults of advanced age ('N' group) and 42 patients with chronic pulmonary emphysema ('E' group). Subjects of the both groups carried out deep breathing exercises by using incentive spirometry, 'Souffle', for five minutes, five times daily for four weeks. Pulmonary functions and arterial blood gases were measured at the start of exercise program, and at two and four weeks after the start. Both groups showed significant increases in VC, FEV1.0, peak expiratory flow, the flow at 75 percent VC (V75), maximal voluntary ventilation and PaO2, and a significant decrease in A-aDO2 at both two and four weeks after the start. In addition, V25 increased significantly in 'E' group. It is concluded that 'Souffle' is one of the useful preoperative respiratory managements for elderly patients and those with chronic pulmonary emphysema.

Aged↗
PubMed1993

Effects of qigong on cardiorespiratory changes: a preliminary study.

Qigong, a special form of breathing exercise, was investigated to examine its effect on cardiorespiratory changes. Ten volunteers (five males and five females) participated in a 20-minute group instructional session for 10 consecutive days before testing of its treatment effects. The testing protocol followed a C1-T-C2 design, where C1, T, and C2 represented the first, treatment, and second control period, respectively. Each period consisted of a 5-minute interval, and thus each testing session consisted of 15 minutes. The results indicated there were no statistically significant differences (p > 0.05) in heart rate or tidal volume for the three 5-minute periods. There was a significant decrease (p < 0.05) in respiratory exchange ratio between T and C2. A significant increase in ventilatory efficiency for carbon dioxide production was found between C1 and T. Statistically significant differences (p < 0.05) were found in the volume of oxygen consumed and carbon dioxide produced, frequency of breath, expired ventilation, and ventilatory efficiency for oxygen produced between the T and the two control periods. This preliminary study of Qigong demonstrates that the subjects were able to learn the technique in a short period of time. The data also suggest that, with an improvement of nearly 20% in ventilatory efficiency for oxygen uptake and carbon dioxide production, this technique may have useful therapeutic value.

Adult↗
PubMed1990

No effect of oral high frequency oscillation combined with forced expiration manoeuvres on tracheobronchial clearance in chronic bronchitis.

This study compared the effect of oral high frequency oscillation (OHFO) with the effect of the forced expiration technique (FET) on tracheobronchial clearance. Eight patients with chronic bronchitis were investigated (mean age 60 +/- 10 yrs, mean forced expiratory volume in one second (FEV1) 68 +/- 27% predicted, mean sputum production 33 +/- 9 g.day-1). OHFO was applied at the respiratory system resonant frequency of each patient (range 9.2-25 Hz) and combined with huffing. FET included breathing exercises, huffing and postural drainage. Duration of both OHFO and FET was 30 minutes. Tracheobronchial clearance was measured by means of a radio-aerosol technique. At 60 mins after start of the treatment mean tracheobronchial retention was 70 +/- 26% after OHFO, 54 +/- 26% after FET and 76 +/- 18% in the control run, which included huffing only. OHFO was not significantly different from control. FET was significantly different (p less than 0.02) from both OHFO and control. It is concluded that OHFO has no effect on tracheobronchial clearance in chronic bronchitis.

Adult↗
PubMed1996

Chest physical therapy for patients in the intensive care unit.

Chest physical therapy is used in the intensive care unit (ICU) to minimize pulmonary secretion retention, to maximize oxygenation, and to reexpand atelectatic lung segments. This article reviews how chest physical therapy is used with patients who are critically ill. A brief historical review of the literature is presented. Chest physical therapy treatments applicable to patients in the ICU are discussed. Postural drainage, percussion, vibration, breathing exercises, cough stimulation techniques, and airway suctioning are described in detail, with current references. The importance of patient mobilization is emphasized. The advantages of chest physical therapy over therapeutic bronchoscopy also are discussed. Two patient examples are used to demonstrate the beneficial effects that may be obtained with chest physical therapy. Following the removal of retained secretions, arterial oxygenation and partial pressure of arterial oxygen/fraction of inspired oxygen concentration ratios improved, and atelectasis resolved without the negative hemodynamic side effects of therapeutic bronchoscopy. Physical therapists trained in the ICU can safely perform chest physical therapy with the majority of patients who are critically ill.

Adult↗
PubMedDate not supplied

How image quality can be improved: our experience with multidetector computed tomography coronary angiography.

PURPOSE: The objective of this study was to investigate the factors that may influence image quality on multidetector computed tomography (MDCT) coronary angiography (CA). MATERIALS AND METHODS: Two hundred twenty-four consecutive patients (161 men and 63 women; mean age, 52 years; age range, 34-76 years) evaluated with MDCT CA were included in the study. The evaluation of the quality of the patients' images was mainly based on the contrast material phase (early phase, optimal phase, or late phase) and the level of stepladder artifact (none, acceptable, or unacceptable). In addition, factors such as patient selection, patient preparation, scanning, processing, and steps of analysis, which may be affecting the quality of a final image, were examined independently. RESULTS: Patients who could not achieve sufficient breath-holding despite multiple breath exercises, those with a calcium score of 500 or higher, those with a heart rate greater than 90 bpm after metoprolol administration (because of shortening of the diastolic phase in the most still period), and those whose scanning was not completed were excluded from the study. The results for the remaining 224 patients were evaluated. Based on the contrast phase, there were 66 (29.5%) patients in the first group (early), 93 (41.5%) in the second group (optimal), and 65 (29%) in the third group (late). Among the 224 patients, the images of 152 (67.9%) had no stepladder artifact, those of 67 (29.9%) were of acceptable image quality, and those of 5 (2.2%) were of unacceptable image quality. CONCLUSION: It is important to obtain high-quality images to achieve correct interpretation with coronary artery CT angiography. This study aimed to describe a technique performed on 224 patients based on an array of factors ranging from patient selection to postprocessing. The results show that patient selection, cooperation with the patient, and breath-holding exercises play a very important role in obtaining the best images. In addition, a proper scanning technique (e.g., placement of electrocardiographic electrodes and contrast material phase) and postprocessing (e.g., reconstruction interval) may also contribute to obtaining high-quality images.

Adult↗
PubMed1985

Self-report and psychophysiological effects of Lamaze preparation: an analogue of labor pain.

Eighty nulliparous college female undergraduates were cast randomly into a series of eight treatment conditions representing all possible combinations of the three major components of the Lamaze method of childbirth preparation (relaxation training, informative lectures, and breathing exercises). Assessments of the efficacy of these pain coping strategies were subsequently made in the context of a 1-hour session involving twenty 80-second exposures to a laboratory pain stimulus, patterned so as to resemble labor contractions. Dependent variables included self-reported pain, systolic and diastolic blood pressure, frontalis EMG, and heart rate. Results of the study indicated that relaxation training comprises the most therapeutically active component of the Lamaze treatment regimen, with significant effects (treatments X trials) on self-reported pain, frontalis EMG, and heart rate. The implications of these findings are discussed from the perspective of designing new, and hopefully more efficacious, methods of preparing women for labor and delivery.

Blood Pressure↗
PubMed1984

Prophylaxis against pulmonary complications in patients undergoing gall-bladder surgery. A comparison between early mobilization, physiotherapy with and without bronchodilatation.

A random comparison of early mobilization and chest physiotherapy (mainly breathing exercises) with or without bronchodilatating inhalations for prophylaxis against pulmonary complications in patients undergoing elective gall-bladder surgery is presented. The operation was performed with a subcostal incision and peroperatively, intercostal nerve block was administered. Preoperative pulmonary status (dynamic volume spirometry, peak expiratory flow rate, arterial blood gas analysis) showed no differences between the groups, and postoperative blood gas analysis and pulmonary X-ray or evident clinical findings did also not show any differences between the groups. Thus early mobilization was as effective in our study as the other prophylactic treatments. In patients without pulmonary disease perhaps early mobilization and efficient analgesia after surgery is as effective as more resource demanding physiotherapy for prophylaxis against postoperative pulmonary complications.

Aged↗
PubMedDate not supplied

Control of the end-tidal PCO2 in the hyperventilation syndrome: effects of biofeedback and breathing instructions compared.

Twenty chronic hyperventilation syndrome patients were assigned to biofeedback training to raise end-tidal PCO2 level or received a breathing exercise schedule for home practice. Both methods offered equal opportunity for improving end-tidal PCO2 significantly. Alleviation of complaints, however, was only noticeable in the biofeedback group. This may be due to the fact that improvement in the severity of the hyperventilation syndrome was not only significantly related to increase in end-tidal PCO2 but also to initial end-tidal PCO2 level and state of the ventilatory controlling system. A follow-up evaluation three months after the end of the therapy programs showed an unchanged end-tidal PCO2 level in both groups as compared with post-treatment evaluation, but a significant relapse in complaints in the biofeedback group. Implications of these findings are discussed in the final section of this paper.

Biofeedback, Psychology↗
PubMed1987

Nursing management of postoperative pain: use of relaxation techniques with female cholecystectomy patients.

The purpose of this study was to assess the effectiveness of two different relaxation techniques in the management of postoperative pain. The sample consisted of 40 women between the ages of 21 and 65 years who were undergoing elective cholecystectomy. Using an experimental design, participants were randomly assigned to four groups: an experimental group who received a taped recording of a rhythmic breathing exercise (RB); an experimental group who received a taped recording of Benson's Relaxation Technique (BRT); an attention-distraction control group (CA) who received a taped recording of a history of the hospital; and a standard control (CB) group who had only the routine perioperative care which all groups received. Data were collected on postoperative sensation and distress at five time points during the first 72 postoperative hours, number of doses of analgesic medication during the same time period, and number of postoperative hospital days. Data were analysed using multivariate and univariate analyses of variance. The BRT group was significantly different from the CA group on a combined sensation and distress factor (P = 0.011). No significant differences were found among groups for doses of analgesics (P = 0.068) or postoperative hospital days (P = 0.56).

Adult↗
PubMed2001

[Respiratory rehabilitation in patients with bronchial asthma and chronic obstructive pulmonary disease (COPD) in Kinshasa].

A number of studies in western countries have shown that respiratory and physical rehabilitation of patients with chronic obstructive pulmonary disease (COPD) only has a minimal effect on respiratory function but can significantly improve physical capacity. The aim of our study was to apply these methods to patients in Kinshasa, Democratic Republic of Congo. We treated 38 patients (20 women) who had bronchial asthma (n=14) or COPD (n=24). These ambulatory patients were treated in two different hospitals in Kinshasa, the university hospital and the general hospital, three times per week for twelve weeks. The patients were treated with kinestherapy and inhaled bronchodilator drugs (salbutamol, and/or ipratropium bromide with a boreal nebulizer) as well as bronchial hygiene and performed breathing exercises on a Bodyguard Ergometer 990 with walking, running and climbing steps until exhaustion. After the rehabilitation program FEV1 increased from 1.37 +/- 0.62 (50% expected) to 1.54 +/- 0.69 (56% expected) (p<0.01). The same trend was observed for walking distance (from 644 +/- 459 m to 1213 +/- 569 m, p<0.001) and for maximal power developed on the cycloergometer (from 45 +/- 20 w to 73 +/- 37 w, p<0.001). In contrast, the maximal work load performed during climbing steps (from 106 +/- 44 w to 115 +/- 23 w) did not improve significantly. COPD patients improved their FEV1 significantly compared with asthma patients. Our study show that pulmonary rehabilitaion increase the level of spontaneous physical activity. The pulmonary rehabilitation program changes the quality of life of COPD patients who are able to move about better for longer periods of time, have a longer walking distance, and improved physical activity level.

Activities of Daily Living↗
PubMed2006

Antidepressant efficacy and hormonal effects of Sudarshana Kriya Yoga (SKY) in alcohol dependent individuals.

BACKGROUND: Sudarshana Kriya Yoga (SKY) has demonstrable antidepressant effects. SKY was tested for this effect in inpatients of alcohol dependence. METHODS: Following a week of detoxification management consenting subjects (n=60) were equally randomized to receive SKY therapy or not (controls) for a two-week study. SKY therapy included alternate day practice of specified breathing exercise under supervision of a trained therapist. Subjects completed the Beck Depression Inventory (BDI) before and after the two weeks of this intervention. Morning plasma cortisol, ACTH and prolactin too were measured before and at the end of two weeks. RESULTS: In both groups reductions in BDI scores occurred but significantly more so in SKY group. Likewise, in both groups plasma cortisol as well as ACTH fell after two weeks but significantly more so in SKY group. Reduction in BDI scores correlated with that in cortisol in SKY but not in control group. LIMITATIONS: Antidepressant effects of SKY were demonstrated in early abstinence that also had substantial spontaneous improvement. It is not known if this effect contributes to sustained abstinence. CONCLUSION: Results extend the antidepressant effects of SKY in alcohol dependence subjects. Reduction in stress-hormone levels (cortisol and ACTH) along with BDI reductions possibly support a biological mechanism of SKY in producing beneficial effects.

Adolescent↗
PubMed2002

Changes in EEG of children during brain respiration-training.

Brain Respiration (BR)-training is a unique form of breathing exercise that develops potential ability by facilitating brain function. It is recognized as an effective method of improving the scholastic aptitude and emotional stability of children. The present study was designed to investigate the characteristics of the EEG during this training. Spectral analysis was used to examine the relative power in the EEG of 12 children while they practiced BR-training, and these were compared to those of 12 matched controls. BR-trainees showed a lower theta rhythm than the controls before the training session began and lower beta2 power before, during and after the session. In contrast, the BR subjects showed greater relative alpha1 power than the controls in the left frontal region during BR-training, which persisted throughout the BR-training schedule. There is evidence that decreased theta and beta waves may be correlated with emotional maturation, whilst increased alpha waves are associated with educational achievement. These findings enhance our understanding of the neurophysiological basis of the effects of BR-training upon emotion and maturation.

Brain↗
PubMed2000

Incentive spirometry does not enhance recovery after thoracic surgery.

OBJECTIVE: To investigate the additional effect of incentive spirometry to chest physiotherapy to prevent postoperative pulmonary complications after thoracic surgery for lung and esophageal resections. DESIGN: Randomized controlled trial. SETTING: University hospital, intensive care unit, and surgical department. PATIENTS: Sixty-seven patients (age, 59 +/- 13 yrs; forced expiratory volume in 1 sec, 93% +/- 22% predicted) undergoing elective thoracic surgery for lung (n = 40) or esophagus (n = 27) resection. INTERVENTIONS: Physiotherapy (breathing exercises, huffing, and coughing) (PT) plus incentive spirometry (IS) was compared with PT alone. MEASUREMENTS AND MAIN RESULTS: Lung function, body temperature, chest radiograph, white blood cell count, and number of hospital and intensive care unit days were all measured. Pulmonary function was significantly reduced after surgery (55% of the initial value) and improved significantly in the postoperative period in both groups. However, no differences were observed in the recovery of pulmonary function between the groups. The overall score of the chest radiograph, based on the presence of atelectasis, was similar in both treatment groups. Eight patients (12%) (three patients with lobectomy and five with esophagus resection) developed a pulmonary complication (abnormal chest radiograph, elevated body temperature and white blood cell count), four in each treatment group. Adding IS to regular PT did not reduce hospital or intensive care unit stay. CONCLUSIONS: Pulmonary complications after lung and esophagus surgery were relatively low. The addition of IS to PT did not further reduce pulmonary complications or hospital stay. Although we cannot rule out beneficial effects in a subgroup of high-risk patients, routine use of IS after thoracic surgery seems to be ineffective.

Analysis of Variance↗
PubMed2000

Respiratory muscle weakness and respiratory muscle training in severely disabled multiple sclerosis patients.

OBJECTIVE: To evaluate the contribution of respiratory muscle weakness (part 1) and respiratory muscle training (part 2) to pulmonary function, cough efficacy, and functional status in patients with advanced multiple sclerosis (MS). DESIGN: Survey (part 1) and randomized controlled trial (part 2). SETTING: Rehabilitation center for MS. PATIENTS: Twenty-eight bedridden or wheelchair-bound MS patients (part 1); 18 patients were randomly assigned to a training group (n = 9) or a control group (n = 9) (part 2). INTERVENTION: The training group (part 2) performed three series of 15 contractions against an expiratory resistance (60% maximum expiratory pressure [PEmax]) two times a day, whereas the control group performed breathing exercises to enhance maximal inspirations. MAIN OUTCOME MEASURES: Forced vital capacity (FVC), inspiratory, and expiratory muscle strength (PImax and PEmax), neck flexion force (NFF), cough efficacy by means of the Pulmonary Index (PI), and functional status by means of the Extended Disability Status Scale (EDSS). RESULTS: Part 1 revealed a significantly reduced FVC (43% +/- 26% predicted), PEmax (18% +/- 8% predicted), and PImax (27% +/- 11% predicted), whereas NFF was only mildly reduced (93% +/- 26% predicted). The PI (median score, 10) and EDSS (median score, 8.5) were severely reduced. PEmax was significantly correlated to FVC, EDSS, and PI (r = .77, -.79, and -.47, respectively). In stepwise multiple regression analysis. PEmax was the only factor contributing to the explained variance in FVC (R2 = .60), whereas body weight (R2 = .41) was the only factor for the PI. In part 2, changes in PImax and PEmax tended to be higher in the training group (p = .06 and p = .07, respectively). The PI was significantly improved after 3 months of training compared with the control group (p < .05). After 6 months, the PI remained significantly better in the training group. CONCLUSIONS: Expiratory muscle strength was significantly reduced and related to FVC, cough efficacy, and functional status. Expiratory muscle training tended to enhance inspiratory and expiratory muscle strength. In addition, subjectively and objectively rated cough efficacy improved significantly and lasted for 3 months after training cessation.

Body Mass Index↗
PubMed2001

[Surgical treatment of rupture of the coracoclavicular ligament and postoperative rehabilitation].

The aim of this paper is to present the results of the operative treatment of the coracoclavicular ligament. According to Tossy, the injuries are classified into thre degrees. Younger patients and sportsmen (57) with the injury of the third degree were operated in the period from 1987-2000. The diagnostic methods were clinical examination and x-ray in the frontal and sagital plane. The patients were operated by Bosworth method. The operation technique which is described is slightly modified as it facilitates the surgeon's work and gives excellent post-operative results. The immobilisation was not used in the post-operative treatment. During the first week after operation a patient does static isometric exercises using the muscles of shoulders and arms, breathing exercises and passive exercises of the arm up to pain limit. The screw was removed under the local anesthesia after minimum of 6 weeks. Upon the removal of the osteosynthetic material we applied kynetic, hydro, magnetic and electrotherapy. The results of the operation were estimated after 2.5 months. Taking into consideration the functions of coracoclavicular ligament (the regulation of angle between clavicle and shoulder-blade, the limitation of rotation and elevation of clavicle, the support in bearing arm weight, the relaxation of joint between clavicle and shoulder-blade and the lateral reinforcement of acromioclavicular joint) its complete reconstruction is very important, and with the appropriate fixation of clavicle and shoulder-blade, accompanied by physical therapy, makes the basis for good results after the operation.

Acromioclavicular Joint↗
PubMed1994

Effect of hypoxaemia on the resting electrocardiogram (ECG) in patients with cardiac ischaemia.

The effect of hypoxaemia on the heart at rest was studied using the electrocardiogram (ECG) in 38 patients. The majority had symptoms of cardiac disease and all were scheduled to have an exercise ECG test under standard conditions. Two ECG variables were examined; (i) depression of the ST segment at the point 60 ms after the QRS-ST junction as well as (ii) the slope of the J-60 ms segment. During exercise breathing air, 11 patients showed positive changes of cardiac ischaemia, 5 were equivocal and 22 showed little or no change. When the patients had recovered from the exercise study they breathed a hypoxic mixture to lower their arterial oxygen saturation to 85% for 3 minutes. No changes were seen in the ST segment in any subject. We conclude that a 3-minute period of hypoxaemia at an oxygen saturation of 85% with subjects at rest did not cause ST segment depression in patients with either positive or negative exercise tests.

Adult↗
PubMed1977

The entrainment of breathing frequency by exercise rhythm.

1. The incidence of entrainment of breathing frequency by the rhythm of exercise was detected by a cross-correlation of the two frequencies. 2. During moderate, steady-state exercise on a bicycle ergometer at 50 rev/min, eight of fifteen volunteers (53%) showed entrainment when pedalling speed was kept constant with a metronome, and three of fifteen volunteers (20%) showed entrainment when pedalling speed was kept constant with a speedometer. 3. At 70 rev/min, in a second group of fifteen volunteers, the results were nine of fifteen (60%) and five of fifteen (33%) respectively. 4. During moderate, steady state exercise on a treadmill, in a third group of fifteen volunteers, eight of 15 volunteers (53%) showed entrainment while walking, and twelve of fifteen volunteers (80%) showed entrainment while running. 5. It is concluded that the rhythm of exercise is likely to affect the rhythm of breathing and that this controlling factor must be considered during studies of breathing pattern in exercise.

Adult↗