呼吸機能，咳嗽能力はどれほど体位の影響を受けるのか 若年者と高齢者での比較検討
【目的】背臥位（P0），45°ギャッジアップ臥位（P45），端坐位（PS）間における呼吸機能，咳嗽能力の変化に着目し，若年者と高齢者で比較することを目的とした．【対象と方法】対象者は，若年者22名と高齢者17名とした．呼吸機能と咳嗽能力を測定した．測定時の姿勢条件は，P0，P45およびPSの計3条件とした．【結果】若年者では肺活量や咳嗽時最大呼気流速において各姿勢間で有意差がみられ，1秒量やピークフロー（PEF）の項目でもP0とPSの比較で有意差があり，すべての項目でPSが最高値を示した．高齢者ではPEFにおいてP0とP45に有意差がみられ，P45が最高値を示した．【結語】呼吸機能や咳嗽能力は...
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| Published in | 日本呼吸ケア・リハビリテーション学会誌 Vol. 30; no. 3; pp. 311 - 315 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人 日本呼吸ケア・リハビリテーション学会
30.09.2022
|
| Subjects | |
| Online Access | Get full text |
| ISSN | 1881-7319 2189-4760 |
| DOI | 10.15032/jsrcr.30.3_311 |
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| Abstract | 【目的】背臥位（P0），45°ギャッジアップ臥位（P45），端坐位（PS）間における呼吸機能，咳嗽能力の変化に着目し，若年者と高齢者で比較することを目的とした．【対象と方法】対象者は，若年者22名と高齢者17名とした．呼吸機能と咳嗽能力を測定した．測定時の姿勢条件は，P0，P45およびPSの計3条件とした．【結果】若年者では肺活量や咳嗽時最大呼気流速において各姿勢間で有意差がみられ，1秒量やピークフロー（PEF）の項目でもP0とPSの比較で有意差があり，すべての項目でPSが最高値を示した．高齢者ではPEFにおいてP0とP45に有意差がみられ，P45が最高値を示した．【結語】呼吸機能や咳嗽能力は，PSが最も高値を示すとする研究が多い．しかし高齢者では咳嗽に関係する指標はP45が最も高値を示した．これは体幹の安定性向上により，呼気筋をうまく使用できた可能性があるのではないかと考える． |
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| AbstractList | 【目的】背臥位（P0），45°ギャッジアップ臥位（P45），端坐位（PS）間における呼吸機能，咳嗽能力の変化に着目し，若年者と高齢者で比較することを目的とした．【対象と方法】対象者は，若年者22名と高齢者17名とした．呼吸機能と咳嗽能力を測定した．測定時の姿勢条件は，P0，P45およびPSの計3条件とした．【結果】若年者では肺活量や咳嗽時最大呼気流速において各姿勢間で有意差がみられ，1秒量やピークフロー（PEF）の項目でもP0とPSの比較で有意差があり，すべての項目でPSが最高値を示した．高齢者ではPEFにおいてP0とP45に有意差がみられ，P45が最高値を示した．【結語】呼吸機能や咳嗽能力は，PSが最も高値を示すとする研究が多い．しかし高齢者では咳嗽に関係する指標はP45が最も高値を示した．これは体幹の安定性向上により，呼気筋をうまく使用できた可能性があるのではないかと考える． |
| Author | 千木良, 佑介 小田, 貴弘 宮崎, 郁里 土橋, 邦生 |
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| References | 9) Tsubaki A, Deguchi S, Yoneda Y: Influence of posture on respiratory function and respiratory muscle strength in normal subjects. J Phys Ther Sci 21: 71-74, 2009. 16) Bach JR, Gonçalves MR, Páez S, et al.: Expiratory flow maneuvers in patients with neuromuscular diseases. Am J Phys Med Rehabil 85: 105-111, 2006. 12) Badr CI, Elkins MR, Ellis ER: The effect of body position on maximal expiratory pressure and flow. Aust J Physiother 48: 95-102, 2002. 19) Hanayama K, Ishikawa Y, Bach JR: Amyotrophic lateral sclerosis. Successful treatment of mucous plugging by mechanical insufflation-exsufflation. Am J Phys Med Rehabil 76: 338-339, 1997. 15) Bach JR: Amyotrophic lateral sclerosis: predictors for prolongation of life by noninvasive respiratory aids. Arch Phys Med Rehabil 76: 828-832, 1995. 11) Meysman M, Vincken W: Effect of body posture on spirometric values and upper airway obstruction indices derived from the flow-volume loop in young nonobese subjects. Chest 114: 1042-1047, 1998. 6) Patel AK, Thakar HM: Spirometric values in sitting, standing, and supine position. Lung Pulm Resp Res 2: 26, 2015. 5) Landers M, Barker G, Wallentine S, et al.: A comparison of tidal volume, breathing frequency, and minute ventilation between two sitting postures in healthy adults. Physiother Theory Pract 19: 109-119, 2003. 18) Suárez AA, Pessolano FA, Monteiro SG, et al.: Peak flow and peak cough flow in the evaluation of expiratorymuscle weakness and bulbar impairment in patients with neuromuscular disease. Am J Phys Med Rehabil 81: 506-511, 2002. 14) Littlejohns P, Ebrahim S, Anderson R: Prevalence and diagnosis of chronic respiratory symptoms in adults. Br Med J 298: 1556-1560, 1989. 8) Ng GY, Stokes MJ: Maximal inspiratory and expiratory mouth pressures in sitting and half-lying positions in normal subjects. Respir Med 85: 209-211, 1991. 3) Vilke GM, Chan TC, Neuman T, et al.: Spirometry in normal subjects in sitting, prone, and supine positions. Respir Care 45: 407-410, 2000. 17) Bach JR, Saporito LR: Criteria for extubation and tracheostomy tube removal for patients with ventilatory failure. A different approach to weaning. Chest 110: 1566-1571, 1996. 13) Elkins MR, Alison JA, Bye PT: Effect of body position on maximal expiratory pressure and flow in adults with cystic fibrosis. Pediatr Pulmonol 40: 385-391, 2005. 2) Kim J, Davenport P, Sapienza C: Effect of expiratory muscle strength training on elderly cough function. Arch Gerontol Geriatr 48: 361-366, 2009. 4) Lin F, Parthasarathy S, Taylor SJ, et al.: Effect of different sitting postures on lung capacity, expiratory flow, and lumbar lordosis. Arch Phys Med Rehabil 87: 504-509, 2006. 7) Vilke GM, Chan TC, Neuman T, et al.: Spirometry in normal subjects in sitting, prone, and supine positions. Respir Care 45: 407-410, 2000. 1) Teramoto S, Fukuchi Y, Sasaki H, et al.: High incidence of aspiration pneumonia in community–and hospital–acquired pneumonia in hospitalized patients: amulticenter, prospective study in Japan. J Am Geriatr Soc 56: 577-579, 2008. 10) Talwar A, Sood S, Sethi J: Effect of body posture on dynamic lung functions in young non-obese Indian subjects. Indian J Med Sci 56: 607-612, 2002. |
| References_xml | – reference: 9) Tsubaki A, Deguchi S, Yoneda Y: Influence of posture on respiratory function and respiratory muscle strength in normal subjects. J Phys Ther Sci 21: 71-74, 2009. – reference: 13) Elkins MR, Alison JA, Bye PT: Effect of body position on maximal expiratory pressure and flow in adults with cystic fibrosis. Pediatr Pulmonol 40: 385-391, 2005. – reference: 14) Littlejohns P, Ebrahim S, Anderson R: Prevalence and diagnosis of chronic respiratory symptoms in adults. Br Med J 298: 1556-1560, 1989. – reference: 8) Ng GY, Stokes MJ: Maximal inspiratory and expiratory mouth pressures in sitting and half-lying positions in normal subjects. Respir Med 85: 209-211, 1991. – reference: 19) Hanayama K, Ishikawa Y, Bach JR: Amyotrophic lateral sclerosis. Successful treatment of mucous plugging by mechanical insufflation-exsufflation. Am J Phys Med Rehabil 76: 338-339, 1997. – reference: 1) Teramoto S, Fukuchi Y, Sasaki H, et al.: High incidence of aspiration pneumonia in community–and hospital–acquired pneumonia in hospitalized patients: amulticenter, prospective study in Japan. J Am Geriatr Soc 56: 577-579, 2008. – reference: 16) Bach JR, Gonçalves MR, Páez S, et al.: Expiratory flow maneuvers in patients with neuromuscular diseases. Am J Phys Med Rehabil 85: 105-111, 2006. – reference: 18) Suárez AA, Pessolano FA, Monteiro SG, et al.: Peak flow and peak cough flow in the evaluation of expiratorymuscle weakness and bulbar impairment in patients with neuromuscular disease. Am J Phys Med Rehabil 81: 506-511, 2002. – reference: 7) Vilke GM, Chan TC, Neuman T, et al.: Spirometry in normal subjects in sitting, prone, and supine positions. Respir Care 45: 407-410, 2000. – reference: 10) Talwar A, Sood S, Sethi J: Effect of body posture on dynamic lung functions in young non-obese Indian subjects. Indian J Med Sci 56: 607-612, 2002. – reference: 12) Badr CI, Elkins MR, Ellis ER: The effect of body position on maximal expiratory pressure and flow. Aust J Physiother 48: 95-102, 2002. – reference: 6) Patel AK, Thakar HM: Spirometric values in sitting, standing, and supine position. Lung Pulm Resp Res 2: 26, 2015. – reference: 15) Bach JR: Amyotrophic lateral sclerosis: predictors for prolongation of life by noninvasive respiratory aids. Arch Phys Med Rehabil 76: 828-832, 1995. – reference: 11) Meysman M, Vincken W: Effect of body posture on spirometric values and upper airway obstruction indices derived from the flow-volume loop in young nonobese subjects. Chest 114: 1042-1047, 1998. – reference: 17) Bach JR, Saporito LR: Criteria for extubation and tracheostomy tube removal for patients with ventilatory failure. A different approach to weaning. Chest 110: 1566-1571, 1996. – reference: 4) Lin F, Parthasarathy S, Taylor SJ, et al.: Effect of different sitting postures on lung capacity, expiratory flow, and lumbar lordosis. Arch Phys Med Rehabil 87: 504-509, 2006. – reference: 3) Vilke GM, Chan TC, Neuman T, et al.: Spirometry in normal subjects in sitting, prone, and supine positions. Respir Care 45: 407-410, 2000. – reference: 2) Kim J, Davenport P, Sapienza C: Effect of expiratory muscle strength training on elderly cough function. Arch Gerontol Geriatr 48: 361-366, 2009. – reference: 5) Landers M, Barker G, Wallentine S, et al.: A comparison of tidal volume, breathing frequency, and minute ventilation between two sitting postures in healthy adults. Physiother Theory Pract 19: 109-119, 2003. |
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| Subtitle | 若年者と高齢者での比較検討 |
| Title | 呼吸機能，咳嗽能力はどれほど体位の影響を受けるのか |
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