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The Effects of Breathing Retraining on Asymmetry of Diaphragm Thickness in Stroke Patients

호흡훈련이 뇌졸중 환자의 횡격막 비대칭에 미치는 영향

  • Kim, Nan-Soo (Department of Physical Therapy, Catholic University of Pusan) ;
  • Jung, Ju-Hyeon (Department of Physical Therapy, Gimhae Good morning Hospital)
  • 김난수 (부산가톨릭대학교 물리치료학과) ;
  • 정주현 (김해굿모닝병원)
  • Received : 2013.03.13
  • Accepted : 2013.05.14
  • Published : 2013.05.31

Abstract

PURPOSE: The purpose of this study was to examine the effects of breathing retraining on asymmetry of diaphragm thickness in stroke patients. METHODS: This study was nonequivalent control group pre-post test design. Subjects were assigned to two different groups(intervention group=10, control group=12). Intervention group conducted breathing retraining program for six-week. Diaphragm thickness was assessed by ultrasound in B-mode with a 7.5 MHz linea probe. The collected data analyzed by Wilcoxon signed rank test and Mann-Whitney U test. RESULTS: The intervention group significantly increased diaphragm thickness ratio on paretic side but the control group showed no significant difference in diaphragm thickness ratio. The control group significantly increased asymmetry of diaphragm thickness, but intervention group showed no significant difference in asymmetry of diaphragm thickness. CONCLUSION: This study showed that breathing retraining increased diaphragm thickness ratio in stroke patients and prevent the increase of asymmetry in diaphragm thickness with stroke patients.

Keywords

References

  1. American Thoracic Society. Lung function testing :selection of reference values and interpretative strategies. Am Rev Respir Dis. 1991;144(5):1202-18. https://doi.org/10.1164/ajrccm/144.5.1202
  2. Britto RR, Rezende NR, Marinho KC et al. Inspiratory muscular training in chronic stroke survivors: a randomized controlled trial. Arch Phys Med Rehabil. 2011;92(2):184-90. https://doi.org/10.1016/j.apmr.2010.09.029
  3. Cohen E, Mier A, Heywood P et al. Diaphragmatic movement in hemiplegic patients measured by ultrasonography. Thorax. 1994;49(9):890-5. https://doi.org/10.1136/thx.49.9.890
  4. Duncan PW, Homer RD, Reker DM et al. Adherence to post acute rehabilitation guidelines is associated with functional recovery in stroke. Stroke. 2002;33(1):169-77.
  5. De Almeida IC, Clementino AC, Rocha EH et al. Effects of hemiplegy on pulmonary function and diaphragmatic dome displacement. Respir Physiol Neurobiol. 2011;178(2):196-201. https://doi.org/10.1016/j.resp.2011.05.017
  6. Enright SJ, Unnithan VB, Heward C et al. Effect of high-intensity inspiratory muscle training on lung volumes, diaphragm thickness, and exercise capacity in subjects who are healthy. Phys Ther. 2006;86(3):345-54.
  7. Enright SJ, Unnithan VB. Effect of inspiratory muscle training intensities on pulmonary function and work capacity in people who are healthy: a randomized controlled trial. Phys Ther. 2011;91(3):894-905. https://doi.org/10.2522/ptj.20090413
  8. Kaneko H, Yamamura K, Mori S et al. Ultrasonographic Evaluation of the Function of Respiratory Muscles during Breathing Exercises. Journal of Physical Therapy Science. 2009;21(2):135 https://doi.org/10.1589/jpts.21.135
  9. Kaneko H, Otsuka M, Kawashima Y et al. The Effect of Upper Chest Wall Restriction on Diaphragmatic Function. Journal of Physical Therapy Science. 2010;22(4):375-80. https://doi.org/10.1589/jpts.22.375
  10. Hsu AL, Tang PF, Jan MH. Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke. Arch Phys Med Rehabil. 2003;84(8):1185-93. https://doi.org/10.1016/S0003-9993(03)00030-3
  11. Howarda RS, Ruddb AG, Wolfec CD et al. Pathophysiological and clinical aspects of breathing after stroke. Postgrad Med J. 2001;77(913):700-2. https://doi.org/10.1136/pmj.77.913.700
  12. Jung JH, Kim NS. Effects of Inspiratory Muscle Training on Diaphragm Thickness, Pulmonary Function, and Chest Expansion in Chronic Stroke Patients. Journal of The Korean Society of Physical Medicine. 2013;8(1):59-69. https://doi.org/10.13066/kspm.2013.8.1.059
  13. Khedr EM, El Shinawy O, Khedr T et al. Assessment of corticodiaphragmatic pathway and pulmonary function in acute ischemic stroke patients. Eur J Neurol. 2000;7(5):509-16. https://doi.org/10.1046/j.1468-1331.2000.00104.x
  14. Kim JH, Park HK, Jeon SY et al. Initial Effect of an Elastic Chest Band during Inspiratory Exercise on Chest Function Improvement in People with Limited Rib Mobility A Randomized Controlled Pilot Trial. Physiother Res Int. 2012;17(4):208-13 https://doi.org/10.1002/pri.1520
  15. Kisner C, Colby LA. Therapeutic exercise: foundations and technique. 5rd ed Philadelphia. FA Davis Company. 2010;993-1031.
  16. Korczyn AD, Hermann G, Don R. Diaphragmatic involvement in hemiplegia and hemiparesis. J Neurol Neurosurg Psychiatry. 1969;32(6):588-90. https://doi.org/10.1136/jnnp.32.6.588
  17. Lanini B, Bianchi R, Romagnoli I et al. Chest wall kinematics in patients with hemiplegia. Am J Respir Crit Care Med. 2003;168(1):109-13. https://doi.org/10.1164/rccm.200207-745OC
  18. Lee JH, Kwon YJ, Kim K, The Effect of Chest Expansion and Pulmonary Function of Stroke Patients after Breathing Exercise. J Kor Soc Phys Ther. 2009;.21(3):25-32.
  19. Lim SW, Seo KC. The effect of treadmill training with elastic band on the chest expansion and pulmonary function of young adults. J Int Acad Phys Ther Res. 2011;2(2):301-7. https://doi.org/10.5854/JIAPTR.2011.2.2.301
  20. Seo KC. The Effect of Pulmonary Function and Respiratory Muscle Activity in the Stroke Patients after Complex Breathing Exercise. Graduate School of Rehabilitation Science. Daegu University Doctor's thesis. 2012.
  21. Sezer N, Ordu NK, Sutbeyaz ST et al. Cardiopulmonary and metabolic responses to maximum exercise and aerobic capacity in hemiplegic patients. Funct Neurol. 2004;19(4):233-8.
  22. Sutbeyaz ST, Koseoglu F, Inan L et al. Respiratory muscle training improves cardiopulmonary function and exercise tolerance in subjects with subacute stroke: a randomized controlled trial. Clin Rehabil. 2010;24(3):240-50. https://doi.org/10.1177/0269215509358932
  23. Ueki J, De Bruin PF, Pride NB. In vivo assessment of diaphragm contraction by ultrasound in normal subjects. Thorax. 1995;50(11):1157-61. https://doi.org/10.1136/thx.50.11.1157

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