The Science Journal of the American Association for Respiratory Care

2004 OPEN FORUM Abstracts

APPLICATION OF THE NEW FACILITATION SYSTEM OF LOCOMOTOR RESPIRATORY COUPLING FOR PULMONARY REHABILITATION OF PATIENTS WITH RESPIRATORY FAILURE

Akira Tamaki, MS, RPT, RCET; Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kyoto University, Kyoto, Japan. Satoshi Hasegawa, RPT, Kazuo Chin, MD; Rehabilitation units, Kyoto University Hospital. Kyoto, Japan. Michiaki Mishima, MD; Department of Respiratory Medicine, Kyoto University, Kyoto, Japan.

INTRODUCTION: It is known that respiratory rhythm entrains to rhythmical movement, a phenomenon called Locomotor Respiratory Coupling (LRC). We investigated and reported on LRC in healthy subjects, and noted that the LRC phenomenon enhances ventilation efficiency during exercise. Another study has shown that LRC decreases oxygen consumption (VO2) during cycling at a moderate workload. Therefore, we investigated whether LRC phenomenon may be applied to exercise training for patients with respiratory failure. We developed new ergometer system software (Strength Ergo 240BK-ERG003: SE, Mitsubishi Electric Engineering, Japan), which facilitates LRC using visual and acoustic signals. The aim of our study was to investigate the effect of this system for pulmonary rehabilitation of patients with respiratory failure.

METHODS: The properties of this new system software are as follow. 1) Voice and word signal such as "breathe in" , "breathe out", appear on the PC display which is synchronized with the pedaling angle. 2) The signal always appears at a settled pedaling position, because timing of the signal is controlled by the pedaling position. Therefore, the slower the pedaling rate per min.,the slower the signal appearance. 3) This software can create various ratios (locomotion/respiration) and choose from the following:1:1,3:2,2:1, 5:2,3:1,7:2,4:1. 4) The software can change the signal setting during exercise. Four patients with respiratory failure (LAM 1, COPD 3) participated in this study. We measured SpO2, RPE (Borg Scale), HR, and exercise tolerance (maximum duration of continuous exercise) both with and without this system during pedaling exercise, and compared the differences between outcome measures with and without this system.

RESULTS: With this system, SpO2 was higher than without this system during exercise. RPE and HR with this system were lower than without this system during exercise. Exercise tolerance (duration) with this system was longer than without.

CONCLUSIONS: We concluded that this LRC facilitatory system can be applied to pulmonary rehabilitation of patients with respiratory failure.

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