The Science Journal of the American Association for Respiratory Care

1996 OPEN FORUM Abstracts

EFFECTS OF RESPIRATORY MUSCLE STRETCH GYMNASTICS ON CHEST WALL MOTION IN PATIENTS WITH CHRONIC ASTHMA

F. Kakizaki, R.P.T. ^{1}), ^{2}), T. Yamazaki, R.P.T. ^{1)}, K. Tanaka, M.D.^{2}), M. Yamada, M.D. ^{2}), ^{4}), M. Sibuya, M.D. ^{2)}, M. Narushima, M.D. ^{4)}, H. Suzuki, M.D. ^{4)}, I. Homma, M.D. ^{2)}. 1) Department of Rehabilitation, Fujigaoka Rehabilitation Hospital, Yokohama, Japan 2) Department of Physiology, Showa University School of Medicine, Tokyo, Japan 3) Department of Internal Medicine, Toyosu Hospital, Tokyo, Japan 4) Department of Respiratory Medicine, Fujigaoka Hospital, Yokohama, Japan

Introduction: We studied the effects of 8 weeks of training in respiratory muscle stretch gymnastics (RMSG) on chest wall motion and peak expiratory flow (PEF) in patients with chronic asthma. Methods: The subjects were 10 patients with chronic asthma (mean age 60.4 years, mean FEV_{1} 1.88L, mean FEV_{1}% 46.7%). The patients were taught to do 5 different RMSG exercises. They were instructed to do each exercise 10 times each morning and each evening for 8 weeks. To ensure that the training was being done correctly, the patients' technique was evaluated 1 week and 4 weeks after the study began. They were instructed again on the correct technique whenever necessary. Cest wall motion and PEF were measured before and after the 8 weeks of training. The diameter of the chest was measured with a tape measure, at the levels of the axilla, the xiphoid process, and the 10th rib. At each level, each measurement was made twice: at residual volume and at total lung capacity. The difference between the two was used as an index of the ability to move the chest wall. PEF was measured three times, with a Mini-Wright^{R} peak flow meter, and the hightest value was used. Results:

Cest wall motion

Before training(cm) After training(cm)

Axilla 4.5 ± 0.4 7.2 ± 0.4*

Xiphoid process 5.9 ± 0.5 7.5 ± 0.6**

10th rib 5.7 ± 0.7 7.7 ± 0.6**

Data shown are mean ± SEM, *p < 0.001, **p < 0.005 PEF increased significantly: the base-line value was 375 ± 34 L/min and the value measured after training was 429 ± 43 L/min. Conclusions: In these patients with chronic asthma, 8 weeks RMSG training increased the ability to move the chest wall, and also increased PEF. RMSG may be a very useful form of physical conditioning in patients with chronic asthma.

Reference: OF-96-177

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