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Morino A, Shida M, Tanaka M, Sato K, Seko T, Ito S, Ogawa S, Takahashi N. Parameters affecting the tidal volume during expiratory abdominal compression in patients with prolonged tracheostomy mechanical ventilation. J Phys Ther Sci 2015; 27:2167-9. [PMID: 26311947 PMCID: PMC4540842 DOI: 10.1589/jpts.27.2167] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 04/03/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of this study was to clarify physical parameters affecting the tidal
volume during expiratory abdominal compression in patients with prolonged tracheostomy
mechanical ventilation. [Methods] Eighteen patients with prolonged mechanical ventilation
were included in this study. Expiratory abdominal compression was performed on patients
lying in a supine position. The abdomen above the navel was vertically compressed in
synchronization with expiration and released with inspiration. We measured the tidal
volume during expiratory abdominal compression. [Results] The mean tidal volume during
expiratory abdominal compression was higher than that at rest (430.6 ± 127.1 mL vs. 344.0
± 94.3 mL). The tidal volume during expiratory abdominal compression was correlated with
weight, days of ventilator support, dynamic compliance and abdominal expansion. Stepwise
multiple regression analysis revealed that weight (β = 0.499), dynamic compliance (β =
0.387), and abdominal expansion (β = 0.365) were factors contributing to the tidal volume
during expiratory abdominal compression. [Conclusion] Expiratory abdominal compression
increased the tidal volume in patients with prolonged tracheostomy mechanical ventilation.
The tidal volume during expiratory abdominal compression was influenced by each of the
pulmonary conditions and the physical characteristics.
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Affiliation(s)
- Akira Morino
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Japan
| | - Masahiro Shida
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Japan
| | - Masashi Tanaka
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Japan
| | - Kimihiro Sato
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Japan
| | - Toshiaki Seko
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Japan
| | - Shunsuke Ito
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Japan
| | - Shunichi Ogawa
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology, Japan
| | - Naoaki Takahashi
- Department of Physical Therapy, Health Sciences, School of Rehabilitation Sciences, University of Hokkaido, Japan
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Morino A, Shida M, Tanaka M, Sato K, Seko T, Ito S, Ogawa S, Yokoi Y, Takahashi N. Upper extremity muscle tone and response of tidal volume during manually assisted breathing for patients requiring prolonged mechanical ventilation. J Phys Ther Sci 2015; 27:2509-13. [PMID: 26357431 PMCID: PMC4563302 DOI: 10.1589/jpts.27.2509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 05/05/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of the present study was to examine, in patients requiring prolonged
mechanical ventilation, if the response of tidal volume during manually assisted breathing
is dependent upon both upper extremity muscle tone and the pressure intensity of manually
assisted breathing. [Subjects] We recruited 13 patients on prolonged mechanical
ventilation, and assessed their upper extremity muscle tone using the modified Ashworth
scale (MAS). The subjects were assigned to either the low MAS group (MAS≤2, n=7) or the
high MAS group (MAS≥3, n=6). [Methods] The manually assisted breathing technique was
applied at a pressure of 2 kgf and 4 kgf. A split-plot ANOVA was performed to compare the
tidal volume of each pressure during manually assisted breathing between the low and the
high MAS groups. [Results] Statistical analysis showed there were main effects of the
upper extremity muscle tone and the pressure intensity of the manually assisted breathing
technique. There was no interaction between these factors. [Conclusion] Our findings
reveal that the tidal volume during the manually assisted breathing technique for patients
with prolonged mechanical ventilation depends upon the patient’s upper extremity muscle
tone and the pressure intensity.
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Affiliation(s)
- Akira Morino
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Masahiro Shida
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Masashi Tanaka
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Kimihiro Sato
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Toshiaki Seko
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Shunsuke Ito
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Shunichi Ogawa
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Yuka Yokoi
- School of Physical Therapy, Koriyama Institute of Health Sciences, Japan
| | - Naoaki Takahashi
- Department of Physical Therapy, Health Sciences University of Hokkaido School of Rehabilitation Sciences, Japan
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Morino A, Shida M, Tanaka M, Sato K, Seko T, Ito S, Ogawa S, Takahashi N. Test-retest reliability of expiratory abdominal compression with a handheld dynamometer in patients with prolonged mechanical ventilation. J Phys Ther Sci 2015; 27:2163-5. [PMID: 26311946 PMCID: PMC4540841 DOI: 10.1589/jpts.27.2163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 04/03/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The present study aimed to examine the test-retest reliability of expiratory
abdominal compression with a handheld dynamometer in patients with prolonged mechanical
ventilation. [Subjects and Methods] We recruited 18 patients with prolonged mechanical
ventilation. All patients had impaired consciousness. The mode of the ventilator was
synchronized intermittent mandatory ventilation. The abdomen above the navel was
vertically compressed using a handheld dynamometer in synchronization with expiration.
Expiratory abdominal compression was performed two times. We measured the tidal volume
during expiratory abdominal compression. There was an interval of 5 minutes between the
first and second measurements. Intraclass correlation coefficient (ICC) and Bland-Altman
analysis were performed to examine the test-retest reliability of expiratory abdominal
compression with a handheld dynamometer. [Results] The test-retest reliability of
expiratory abdominal compression was excellent (ICC(1, 1): 0.987). Bland-Altman analysis
showed that there was no fixed bias and no proportional bias. [Conclusion] The findings of
this study suggest that expiratory abdominal compression with a handheld dynamometer is
reliable and useful for patients with respiratory failure and prolonged mechanical
ventilation.
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Affiliation(s)
- Akira Morino
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Masahiro Shida
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Masashi Tanaka
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Kimihiro Sato
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Toshiaki Seko
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Shunsuke Ito
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Shunichi Ogawa
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Naoaki Takahashi
- Department of Physical Therapy, School of Rehabilitation Sciences, Health Sciences University of Hokkaido, Japan
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Morino A, Shida M, Tanaka M, Sato K, Seko T, Ito S, Ogawa S, Takahashi N. Comparison of changes in tidal volume associated with expiratory rib cage compression and expiratory abdominal compression in patients on prolonged mechanical ventilation. J Phys Ther Sci 2015; 27:2253-6. [PMID: 26311963 PMCID: PMC4540858 DOI: 10.1589/jpts.27.2253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Accepted: 04/13/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study was designed to compare and clarify the relationship between
expiratory rib cage compression and expiratory abdominal compression in patients on
prolonged mechanical ventilation, with a focus on tidal volume. [Subjects and Methods] The
subjects were 18 patients on prolonged mechanical ventilation, who had undergone
tracheostomy. Each patient received expiratory rib cage compression and expiratory
abdominal compression; the order of implementation was randomized. Subjects were
positioned in a 30° lateral recumbent position, and a 2-kgf compression was applied. For
expiratory rib cage compression, the rib cage was compressed unilaterally; for expiratory
abdominal compression, the area directly above the navel was compressed. Tidal volume
values were the actual measured values divided by body weight. [Results] Tidal volume
values were as follows: at rest, 7.2 ± 1.7 mL/kg; during expiratory rib cage compression,
8.3 ± 2.1 mL/kg; during expiratory abdominal compression, 9.1 ± 2.2 mL/kg. There was a
significant difference between the tidal volume during expiratory abdominal compression
and that at rest. The tidal volume in expiratory rib cage compression was strongly
correlated with that in expiratory abdominal compression. [Conclusion] These results
indicate that expiratory abdominal compression may be an effective alternative to the
manual breathing assist procedure.
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Affiliation(s)
- Akira Morino
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Masahiro Shida
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Masashi Tanaka
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Kimihiro Sato
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Toshiaki Seko
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Shunsuke Ito
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Shunichi Ogawa
- Department of Physical Therapy, Hokkaido Chitose Institute of Rehabilitation Technology: 10 Satomi 2-chome, Chitose 066-0055, Japan
| | - Naoaki Takahashi
- Department of Physical Therapy, Health Sciences University of Hokkaido School of Rehabilitation Sciences, Japan
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