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KMID : 0350519960490010487
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Journal of Catholic Medical College
1996 Volume.49 No. 1 p.487 ~ p.498
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Effect of the Positive Expiratory Pressure Breath Training on Ventilatory Function of Patients with Chronic Obstructive Lung Disease
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Abstract
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Chronic obstructive lung disease (COPD) is an irreversible respiratory diseases characterized by the permanent ventilatory dysfunction. Rehabilitation training is one of the most important managements to decrease their mortality and to improve
their
ventilatory dysfunction in patients with COPD because conventional medical therapies including drug therapy and oxygen therapy used to improve their prognoses are controversial. We studied the effect of the positive expiratory pressure breath
known
as
one of the expiratory muscle raining methods on ventilatory function of patients with COPD. For this study 18 patients with COPD and with PaCO2 above 50 mmHg were selected. The control group (7 patients with COPD and with PaCO2 above 50
mmHg
were
selected. The control group (7 patients) used conventional treatment and the experimental group (11 patients) used Mini Peep for expiratory muscle training. Pulmonary function tests, arterial blood gas analysis and visual analogue scale (VAS) for
dyspnea measurement were performed every week. The canges in PaCO2 ration (PaCO2 at each point-PaCO2 at basal/PaCO2 at basal×100) at each point were analyzed
@ES The results were as follows :
@EN 1. During the study period, there was no significant difference in the change FEV1 and FVC between two groups, but the experimental group showed a gradual increasing tendency although the control group showed a transient increse in the change
of
FEV1 and FVC in the week. However, the peak expiratory flow rate (PEFR) was significantly increased compared with the control group (F=5.39, P<0.05). There was no significant difference in the change of PaCO2 level between two groups, but the
PaCO2
ration was significantly decreased during the study in the experimental group compared with the control group (F=21.77, P<0.001). There was no significant difference in the change of PaO2 level between two groups. The VAS for dyspnea was
significantly
decreased in the experimental group compared with the control group (F=6.27, P<0.05).
2. In the experimental group, FEV1 (F=11.41, P<0.001), FVE (F=12.68, P<0.001) and PEFR (F=31.85, P<0.001) were significantly increased from the second week compared with the baseline. The PaCO2 level (F=24.15, P<0.001) and the VAS for dyspnea
(F=39.40,
P<0.001) were significantly decreased since the first week compared with the baseline.
3. After completion of the study, FEV1 FVC and PEFR were significantly increased in the experimental group ocmpared with the control group (FEV1 : t=2.18, P<0.05) ; FVC : t=3.68, P<0.01 ; PEFR : t=4.21, P<0.001). The PaCO2 level was
significantly
decreased in the experimental group compared with the control group (t=-5.64, P<0.001). The VAS for dyspnea was significantly decreased in the experimental group compared with the control group (t=-3.38, P<0.01).
4. FEV1 and FVC (FEV1 : t=2.70, P<0.05 ; FVC : t=2.84, P<0.05) were significantly increased at the third week and PEFR (t=2.98. P<0.01) was significantly increased form the second week compared with the control group. The PaCo2 ratio (t=-3.19,
P<0.01)
and the VAS for dyspnea (t=-2.60, P<0.05) were significantly decreased from the second week compared with the control.
5. Multiple regression analysis showed that smoking history (R(=0.3286), and sex(R(=0.1510) may contribute to the important variables in ventilatory dysfunction of patients with COPD.
These results suggest that the positive expiratory pressure breath training may be useful to improve ventilatory dysfunction of patients with COPD.
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KEYWORD
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