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Biomedical subjects

P C Imle

Publications and source records attributed to P C Imle.

5 recordsLinked to original sources

A comparison of two breathing exercise programs for patients with quadriplegia.

This study compared the use of abdominal weights (AbWts) to inspiratory resistive muscle training (IMT) on selected measures of pulmonary function. Eleven patients, aged 16 to 41 years (mean = 27.8, SD = 8.3) with complete cervical injuries were randomly assigned to either an AbWts or IMT treatment group. Subjects in both treatment groups received daily treatments (five times weekly) for 7 weeks. Forced vital capacity (FVC), inspiratory capacity (IC), maximal voluntary ventilation (MVV), peak expiratory flow rate (PEFR), and inspiratory mouth pressure (PImax) were measured weekly. Analysis of variance for repeated measures showed no difference between the AbWts and IMT treatments; there were significant differences within each respective treatment group for all five variables. Although the data did not support the effectiveness of one method of training over the other, the larger increase in MVV with the IMT protocol may be indicative of an endurance training effect with this protocol. Future research should compare the effects of breathing exercise training to spontaneous recovery of the respiratory muscles in control subjects.

Adolescent↗

Dependencies of respiratory system resistance and elastance on amplitude and frequency in the normal range of breathing.

We calculated respiratory system resistance (Rrs) and elastance (Ers) from pressure and flow at the mouth in six seated subjects relaxed at FRC (cheeks tightly compressed) during sinusoidal volume forcing (250, 500, and 750 ml) at 0.2, 0.4, and 0.6 Hz. Dependencies of Rrs and Ers on frequency and tidal volume were generally the same in each subject; Rrs tended to decrease with frequency and tidal volume, whereas Ers tended to increase with frequency and decrease with tidal volume. Multiple linear regression of combined data indicated that the frequency and tidal volume effects on Rrs and Ers were significant (p less than 0.05), and that the effects on Rrs decreased at higher flows. Average Rrs was highest (4.43 cm H2O/L/s +/- 0.21 SE) at 0.2 Hz-250 ml, and lowest (3.07 cm H2O/L/s +/- 0.37) at 0.6 Hz-750 ml. Average Ers was highest (12.1 cm H2O/L +/- 1.1) at 0.6 Hz-250 ml, and lowest (7.1 cm H2O/L +/- 0.6) at 0.2 Hz-750 ml. We conclude that frequency and tidal volume dependencies in Rrs and Ers in the normal range of breathing should be considered when interpreting measurements of respiratory system impedance or developing models to describe the mechanical behavior of the respiratory system.

Airway Resistance↗

Chest physical therapy to the patient with multiple trauma. Two case studies.

Chest physical therapy is the preferred treatment in the MIEMSS for both preventing and treating pulmonary complications caused by retained secretions. The beneficial results of chest physical therapy in our facility, including improvement in chest roentgenogram appearance, arterial blood gases, and lung compliance, have been documented. The cases presented illustrate the successful use of chest physical therapy despite the presence of severe trauma and possible contraindications. The potential benefits of chest physical therapy may outweigh the existing possible contraindications.

Adult↗

Changes in total lung/thorax compliance following chest physiotherapy.

To quantitate and obtain objective assessment of the effect of secretion clearance following chest physiotherapy (CPT), total lung/thorax complicance (CT) was calculated immediately before and for 2 hours after one treatment with CPT. Forty-two patients who were mechanically ventilated because of respiratory failure were studied. Therapy averaged 57 minutes and included postural drainage, percussion, vibration, and endotracheal suctioning. The increase in CT following CPT was statistically significant (p less than 0.01) and remained so for at least 2 hours after CPT. There was no difference in the degree to which CT changed in patients with different indications for CPT or in patients ventilated with positive end-expiratory pressure. Largest mean values for CT were obtained 2 hours following CPT, the duration of our measurement of CT. Chest x-ray identification of affected areas of lung before CPT is necessary to allow the physiotherapist to produce the CT changes noted in this study. CT, which can be readily calculated from many recently designed ventilators, may be monitored during CPT to evaluate the efficacy of treatment and to quantitate the effect of secretion clearance following CPT. Duration of CPT should be determined by CT and auscultation.

Adolescent↗