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Fundamental verification of pulmonary rehabilitation technique and its establishment of the significance

肺康复技术的基础验证及其意义的确立

基本信息

批准号：
17300180
负责人：
KUROSAWA Hajime
金额：
$ 4.75万
依托单位：
Tohoku University
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B)
财政年份：
2005
资助国家：
日本
起止时间：
2005 至 2007
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-17300180/
关键词：
respiratory physiotherapy pursed lip breathing IOS dead space loading inspiratory resistance loading sternocleidomastoid muscle frequency dependence tissue oxygen saturation 気道弾性特性 α波オシレーション法

项目摘要

In patients with COPD, we elucidated that respiratory resistance (Rrs) was increased and respiratory reactance (Xrs) was shifted toward negative direction during expiration using impulse oscillation system (IOS). Frequency dependence of impedance (Zrs) was more remarkable in COPD and those respiratory cycle dependency was also profound. In this process of this research, we developed new apparatus to measure Rrs, Xrs, and Zrs at multiple frequency that can be used as alternative to IOS (patent in application).We measured intra-mouth pressure during PLB, and found the positive pressure that is assumed to be effective for bronchus was around 3 to 4 cmH2O. Electro encephalogram (EEG) during PLB was studied, and we found up-ward slid in alfa-wave Frequency and decrease in heart rate. During PLB, we confirmed oropharyngeal closure using flexible laryngeal fiber Scope. This explain why nose clipping is unnecessary during PLRPreviously we confirmed that manual chest physiotherapy (CPT) to pati … More ents with COPD significantly reduced lung volume. In the present research period, we further Confirmed that the effects persisted for at least 3 hours. We also observed the decrease in oxygen consumption of the respiratory muscle after CPT, and the prolongation in the endurance time for the incremental dead space loading. From these experiences, we newly developed respiratory gymnastics "Sendai city respiratory rehabilitation gymnastics" for alleviation of dyspnea in patients with chronic respiratory disease, which was already introduced to citizens in Sendai city.We developed inspiratory resistance apparatus that enables multi step resistance loading. Using that machine, ventilatory response to inspiratory resistance was found to be a response of ventilatory pattern, and these results support the historical instruction about dyspnea alleviation by a kind of respiratory training.To clarify the approximate amount of oxygen supply during exercise, we tried to measure tissue oxygen saturation (StO2) at sternocleidomastoid (SCM) muscles, and established those methods. StO2 at SCM in patients with COPD decreased during deep inspiratory muscle works whereas those in healthy subjects did not. The decrease was canceled by oxygen supply. Submission of paper about these are being prepared.In patients with COPD, we elucidated that respiratory resistance (Rrs) was increased and respiratory reactance (Xrs) was shifted toward negative direction during expiration using impulse oscillation system (IOS). Frequency dependence of impedance (Zrs) was more remarkable in COPD and those respiratory cycle dependency was also profound. In this process of this research, we developed new apparatus to measure Rrs, Xrs, and Zrs at multiple frequency that can be used as alternative to IOS (patent in application).We measured intra-mouth pressure during PLB, and frnmd the positive pressure that is assumed to be eective for bronchus was around 3 to 4 cmH2O. Electro encephalogr$ Less

本文应用脉冲振荡系统（IOS）研究了COPD患者呼气时呼吸阻力（Rrs）的增加和呼吸阻抗（Xrs）的负移。COPD患者阻抗的频率依赖性更明显，呼吸周期依赖性也更强。在这项研究的过程中，我们开发了一种新的仪器，可以在多个频率下测量Rrs，Xrs和Zrs，可以用作IOS的替代品（申请中的专利）。我们在PLB期间测量了口内压，发现对支气管有效的正压约为3至4 cmH 2 O。本文对PLB过程中的脑电图进行了研究，发现其α波频率明显上升，心率减慢。在PLB期间，我们使用柔性喉纤维内镜确认口咽闭合。这就解释了为什么在PLR过程中不需要修剪鼻子。以前我们证实，对帕蒂进行手动胸部物理治疗（CPT） ...更多信息 COPD患者的肺容量显著减少。在目前的研究期间，我们进一步证实，这种影响至少持续3小时。我们还观察到CPT后呼吸肌的耗氧量降低，并且对递增死腔负荷的耐受时间延长。根据这些经验，我们开发了新的呼吸体操“仙台市呼吸康复体操”，以缓解慢性呼吸系统疾病患者的呼吸困难，并已向仙台市市民介绍。我们开发了能够进行多步阻力负荷的吸气阻力装置。本研究采用胸锁乳突肌组织氧饱和度（StO_2）测定方法，探讨了运动中运动员的氧供应量，并建立了相应的方法。COPD患者深吸气肌工作时SCM的StO 2降低，而健康受试者则无此现象。供氧可抵消这种下降。在COPD患者中，我们阐明了呼吸阻力（Rrs）增加，呼吸阻抗（Xrs）在呼气过程中使用脉冲振荡系统（IOS）向负方向移动。COPD患者阻抗的频率依赖性更明显，呼吸周期依赖性也更强。在本研究的过程中，我们开发了一种新的仪器，可以在多个频率下测量Rrs，Xrs和Zrs，可以用作IOS的替代品（申请中的专利）。我们在PLB期间测量了口内压，并且从假定对支气管有效的正压约为3至4 cmH 2 O。Electro encephalogr$减