The Effects of Breathing Exercise on Respiratory Synergist Muscle Activity and SpO2 in Patients with Chronic Obstructive Pulmonary Disease

  • 투고 : 2015.07.23
  • 심사 : 2015.08.18
  • 발행 : 2015.08.25

초록

Purpose: This study is not a fragmentary study on characteristics of respiratory synergist when breathing, however it was intended to determine the effect of currently available respiratory exercise and to provide basic clinical information through investigation of oxygen demand and respiratory synergist that mobilizes for respiration during application of respiratory exercise. Methods: Experimental group I was selected from second grade of severity classification of GOLD, which has the highest percentage among patients with COPD, and experimental group II was selected from third grade of severity classification as a clinical sampling. After respiration pursing up lips and diaphragm respiration exercise were mediated together for six weeks, activity of respiratory muscles and oxygen saturation were measured and analyzed. Results: In comparison of change of respiratory synergist and oxygen saturation, activity of respiratory synergist in sternocleidomastoid muscle and scalene muscle showed a meaningful decrease in experimental group I. And, in comparison of change of respiratory synergist and oxygen saturation, activity of respiratory synergist in rectus abdominis muscle showed a meaningful increase in experimental group II. In comparison of change of respiratory synergist and oxygen saturation, activity of respiratory synergist in sternocleidomastoid muscle, scalene muscle, and rectus abdominis muscle showed a meaningful difference between experimental groups. Conclusion: Respiratory synergists work mainly as agonist of chest and upper limbs. Therefore it is very important to lower mobilization of respiratory synergist when breathing. It is considered that a multilateral approach and continued clinical research for improvement of respiratory function for patients with COPD will be needed in the future.

키워드

참고문헌

  1. Kim YN. Comparison of Effectiveness of Breathing Intervention Program for Improvement of Pulmonary Functions according to Prevalence Period in Patients with COPD. J Kor Phys Ther. 2012:24(5):355-61. https://doi.org/10.1589/jpts.24.355
  2. Moon JW, Oak JS, An KO. The Effect of 12 Week Exercise Training on Cardiopulmonary and Muscular Function in COPD Patients. Journal of the Korean Association of Certified Exercise Professionals. 2013;15(1):97-108.
  3. Coutinho Myrrha MA, Vieira DS, Moraes KS et al. Chest wall volumes during inspiratory loaded breathing in COPD patients. Respiratory physiology & Neurobiology. 2013;188(1):15-20. https://doi.org/10.1016/j.resp.2013.04.017
  4. Ottenheijm CA, Jenniskens GJ, Geraedts MC et al. Diaphragm dysfunction in chronic obstructive pulmonary disease: A role for heparan sulphate? The European Respiratory Journal. 2007;30(1):80-9. https://doi.org/10.1183/09031936.00125106
  5. Orozco-Levi M. Structure and function of the respiratory muscles in patients with COPD: Impairment or adaptation? The European Respiratory Journal. 2003;46:41S-51S.
  6. Barbera JA. Roca J, Ferrer A et al. Mechanisms of worsening gas exchange during acute exacerbations of chronic obstructive pulmonary disease. European Respiratory Journal. 1997;10(6):1285-91. https://doi.org/10.1183/09031936.97.10061285
  7. Anna S, Nidia T, Hernandes A et al. Pulmonary rehabilitation and COPD: is nonlinear exercise better? Expert Rev. Respir. Med. 2013;7(4):323-5. https://doi.org/10.1586/17476348.2013.814395
  8. Kang Jl, Jeong DK, Park SK et al. Effects of Chest Resistance Exercise on Forced Expiratory Volume in One Second and Fatigue in Patients with COPD. J Kor Phys Ther. 2011;23(2):37-43. https://doi.org/10.1589/jpts.23.37
  9. Kang Jl, Jeong DK, Choi H. A Survey on Awareness of Physical Therapists about Cardiopulmonary Physical Therapy. J Kor Phys Ther. 2014;26(4):262-8.
  10. Ong KC. Chronic Obstructive Pulmonary Disease-Current Concepts and Practice. In Tech, Published. 2012;399-422.
  11. Bianchi R, Gigliotti F, Romagnoli I et al. Chest wall kinematics and breathlessness during pursed-lip breathing in patients with COPD. Chest. 2004;125(2):459-65. https://doi.org/10.1378/chest.125.2.459
  12. Ahmed MNU, Begum S, Sultana S et al. Effects of Pulmonary Rehabilitation on Lung Functions in Patients with COPD. Journal of Bangladesh Society of Physiologist. 2013;8(2):70-6.
  13. Legrand A, Schneider E, Gevenois PA et al. Respiratory effects of the scalene and sternomastoid muscles in humans. J Appl Physiol. 2003;94:1467-72. https://doi.org/10.1152/japplphysiol.00869.2002
  14. Duiverman ML, de Boer EW, van Eykern LA et al. Respiratory muscle activity and dyspnea during exercise in chronic obstructive pulmonary disease. Respiratory Phisiology & Neurobiology. 2009;167(2):195-200. https://doi.org/10.1016/j.resp.2009.04.018
  15. Gandevia SC, Leeper JB, McKenzie DK et al. Discharge frequencies of parasternal intercostal and scalene motor units during breathing in normal and COPD subjects. Am J Respir Crit Care Med. 1996;153:622-8. https://doi.org/10.1164/ajrccm.153.2.8564108
  16. Guedes LU, Parreira VF, Diorio AC et al. Electromyographic activity of sternocleidomastoid muscle in patients with Parkinson's disease. Journal of Electromyography and Kinesiology. 2009;19(4):591-7. https://doi.org/10.1016/j.jelekin.2008.01.005
  17. Ikehara C, Matsuura C, Dongmei Li et al. Validating the Impact of Teaching Pursed-Lips Breathing With Skype: A Pilot Study. Diabetes. 2012;15(8):424-32.
  18. Toppin VA.L, Harris MB, Anna K et al. Persistence of eupnea and gasping following blockade of both serotonin type 1 and 2 receptors in the in situ juvenile rat preparation. Journal of applied physiology. 2007;103(1):220-7. https://doi.org/10.1152/japplphysiol.00071.2007
  19. Shim SW, Jo JY, Kwon YS et al. Factors Related to Exertional Oxygen Desaturation in Patients with COPD. Tuberculosis and Respiratory Diseases. 2011;70(6):498-503. https://doi.org/10.4046/trd.2011.70.6.498
  20. Jehn M, Donaldson G, Kiran B et al. Tele-monitoring reduces exacerbation of COPD in the context of climate change--a randomized controlled trial. Environmental Health. 2013;12:99-107. https://doi.org/10.1186/1476-069X-12-99
  21. Mariana ACM, Danielle SRV, Karoline SM et al. Chest wall volumes during inspiratory loaded breathing in COPD patients. Respiratory Physiology & Neurobiology. 2013;188:15-20. https://doi.org/10.1016/j.resp.2013.04.017
  22. Xuemin W, Hou L, Bai W et al. Effects of breathing training on quality of life and activities of daily living in elderly patients with stable severe chronic obstructive pulmonary disease. Chinese Journal of Rehabilitation Medicine. 2006;21:307-10
  23. Muhammad SW, Arshad NM, Muhammad J. Effectiveness of conventional chest physiotherapy versus manual hyperinflation during postural drainage of ventilated COPD patients. Pawal Med J. 2014;39:32-4.
  24. Katayama K, Iwamoto E, Ishida K et al. Inspiratory muscle fatigue increases sympathetic vasomotor outflow and blood pressure during submaximal exercise. American Journal of Physiology. Regulatory, Integrative and Comparative Physiology. 2012;302(10):R1167-R75. https://doi.org/10.1152/ajpregu.00006.2012
  25. Suh KH. Updates in applications and effects of the progressive muscle relaxation. Korean J Stress Res. 2008;16(2):167-73.