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All Journal Indonesia Journal of Physical Medicine and Rehabilitation Indonesia Journal Physical Medicine and Rehabilitation
Nury Nusdwinuringtyas
Department of Physical Medicine and Rehabilitation, Dr. Cipto Mangunkusumo Hospital, Faculty of Medicine, University of Indonesia, Jakarta
Decision Sciences, Operations Research & Management Neuroscience Physics

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Expiration Training Maneuver for Chronic Obstructive Pulmonary Disease with Congestive Heart Failure Grade II: A Case Report Nury Nusdwinuringtyas; Siti Chandra Widjanantie
Indonesian Journal of Physical Medicine & Rehabilitation Vol 7 No 01 (2018): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (294.534 KB) | DOI: 10.36803/ijpmr.v7i01.131

Abstract

Introduction: Chronic Obstructive Pulmonary Disease (COPD) was characteristic by the inflammatory process in the airway which causes air trapping and hyperinflation, then followed by decreasing the respiratory muscle strength. Breathing training using the positive expiratory pressure (PEP) increasing respiratory muscle strength.Methods: A case presentation of a male, age was 60 years old diagnosed as COPD by The Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade 4 group D, and Chronic Heart Failure (CHF) grade II, with complication of excessive phlegm, underweight, and weakness of respiratory muscle, have PEP for 8 weeks.Results: Spirometry evaluation before and after eight week of PEP have found; FEV1 22.12 and 22.42%, FVC 34.24 and 56%, FEV1/FVC 76.8 and 64%. Respiratory muscle strength before and after PEP showed the Muscle Inspiratory Pressure (MIP) 46 and 71 cmH2O, Muscle Expiratory Pressure (MEP) 48 and 104 cmH2O.The values of Six Minute Walk Test (6MWT) evaluation by BORG modified scale before and after PEP were 11 and 13 ( efforts), 2 and 3 (dyspnea), 0 and 1 (Leg Fatigue). The six-minute walking distance (6MWD) before and after PED were 170 and 190 m, equation reference with Nury’s formula showed percentage prediction before and after PEP respectively 29.2 and 32%, VO2Max; 4.96 and 6L, METs; 1.41 and 1.7. The St GeorgeRespiratory Questionnaire (SGRQ) before and after PEP were 20.6 and 49.5% (symptom), 86.6 and 45.1% (activity), 45.5 and 18.4% (impact) and 53.6 and 42% for total.Conclusion: Positive airway pressure exercise had beneficial effect on reducing air-trapping process in COPD and increasing the respiratory muscle strength for both expiratory and inspiratory muscle strength.Keywords: Chronic obstructive pulmonary disease, positive expiratory pressure device, respiratory muscle strength, six minutes walking distance
The Effects of Inspiratory Muscle Training in Neuromuscular Disorders: Review Article Okta Hariza; Budiati Lasmitasari; Siti Chandra Widjanantie; Nury Nusdwinuringtyas
Indonesian Journal of Physical Medicine & Rehabilitation Vol 7 No 01 (2018): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (299.191 KB) | DOI: 10.36803/ijpmr.v7i01.134

Abstract

Introduction: Progressive inspiratory muscles weakness in neuromuscular disorders (NMD) can lead to respiratory impairments, from restrictive lung to respiratory failure. Inspiratory muscle training (IMT) is an exercise with a device to increase inspiratory muscles strength and/or endurance. This article wasaimed to review the effect and prescription of IMT in NMD subjects.Methods: Searching method was done in PubMed and Google Scholar using keywords: “inspiratory muscle training” AND “neuromuscular disorders” AND “MIP” OR “PImax”.Results: Seven related studies were found. These studies shown that IMT increased inspiratory muscles strength and/or endurance in chronic progressive NMD. Most studies used threshold type. The intensities varied from 30% through 70% of maximum inspiratory pressure (MIP), minimum twice a day. Therepetition for strengthening was 10 times with 20-seconds rest between repetitions. Endurance trainings were done in 10 cycles of 1-minute breathing or for total 20 m inutes.Conclusion: Several evidences reported that IMT significantly improve strength and endurance of inspiratory muscles in chronic progressive NMD. It was effective in earlier phase of NMD. The minimum load intensity was 30% MIP.Keywords: Inspiratory muscle training (IMT), neuromuscular disorders (NMD), maximum inspiratory pressure (MIP)
Expiration Training Maneuver for Chronic Obstructive Pulmonary Disease with Congestive Heart Failure Grade II: A Case Report Nury Nusdwinuringtyas; Siti Chandra Widjanantie
Indonesian Journal of Physical Medicine & Rehabilitation Vol 7 No 01 (2018): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (294.534 KB) | DOI: 10.36803/ijpmr.v7i01.131

Abstract

Introduction: Chronic Obstructive Pulmonary Disease (COPD) was characteristic by the inflammatory process in the airway which causes air trapping and hyperinflation, then followed by decreasing the respiratory muscle strength. Breathing training using the positive expiratory pressure (PEP) increasing respiratory muscle strength.Methods: A case presentation of a male, age was 60 years old diagnosed as COPD by The Global Initiative for Chronic Obstructive Lung Disease (GOLD) grade 4 group D, and Chronic Heart Failure (CHF) grade II, with complication of excessive phlegm, underweight, and weakness of respiratory muscle, have PEP for 8 weeks.Results: Spirometry evaluation before and after eight week of PEP have found; FEV1 22.12 and 22.42%, FVC 34.24 and 56%, FEV1/FVC 76.8 and 64%. Respiratory muscle strength before and after PEP showed the Muscle Inspiratory Pressure (MIP) 46 and 71 cmH2O, Muscle Expiratory Pressure (MEP) 48 and 104 cmH2O.The values of Six Minute Walk Test (6MWT) evaluation by BORG modified scale before and after PEP were 11 and 13 ( efforts), 2 and 3 (dyspnea), 0 and 1 (Leg Fatigue). The six-minute walking distance (6MWD) before and after PED were 170 and 190 m, equation reference with Nury’s formula showed percentage prediction before and after PEP respectively 29.2 and 32%, VO2Max; 4.96 and 6L, METs; 1.41 and 1.7. The St GeorgeRespiratory Questionnaire (SGRQ) before and after PEP were 20.6 and 49.5% (symptom), 86.6 and 45.1% (activity), 45.5 and 18.4% (impact) and 53.6 and 42% for total.Conclusion: Positive airway pressure exercise had beneficial effect on reducing air-trapping process in COPD and increasing the respiratory muscle strength for both expiratory and inspiratory muscle strength.Keywords: Chronic obstructive pulmonary disease, positive expiratory pressure device, respiratory muscle strength, six minutes walking distance
The Effects of Inspiratory Muscle Training in Neuromuscular Disorders: Review Article Okta Hariza; Budiati Lasmitasari; Siti Chandra Widjanantie; Nury Nusdwinuringtyas
Indonesian Journal of Physical Medicine & Rehabilitation Vol 7 No 01 (2018): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (299.191 KB) | DOI: 10.36803/ijpmr.v7i01.134

Abstract

Introduction: Progressive inspiratory muscles weakness in neuromuscular disorders (NMD) can lead to respiratory impairments, from restrictive lung to respiratory failure. Inspiratory muscle training (IMT) is an exercise with a device to increase inspiratory muscles strength and/or endurance. This article wasaimed to review the effect and prescription of IMT in NMD subjects.Methods: Searching method was done in PubMed and Google Scholar using keywords: “inspiratory muscle training” AND “neuromuscular disorders” AND “MIP” OR “PImax”.Results: Seven related studies were found. These studies shown that IMT increased inspiratory muscles strength and/or endurance in chronic progressive NMD. Most studies used threshold type. The intensities varied from 30% through 70% of maximum inspiratory pressure (MIP), minimum twice a day. Therepetition for strengthening was 10 times with 20-seconds rest between repetitions. Endurance trainings were done in 10 cycles of 1-minute breathing or for total 20 m inutes.Conclusion: Several evidences reported that IMT significantly improve strength and endurance of inspiratory muscles in chronic progressive NMD. It was effective in earlier phase of NMD. The minimum load intensity was 30% MIP.Keywords: Inspiratory muscle training (IMT), neuromuscular disorders (NMD), maximum inspiratory pressure (MIP)
Co-Authors Budiati Lasmitasari Okta Hariza Siti Chandra Widjanantie Siti Chandra Widjanantie