척수손상 환자의 자세 변화 후 시간경과와복대사용이 폐기능에 미치는 영향

Abstract

The objective of this study was to identify pulmonary functional variations in relation to postural changes, lapse after changing position, and the use of abdominalband in the cervical cord injured. The subjects of this study were 19 quadriplegicpatients who had been admitted to the department of the Rehabilitation Hospital, College of Medicine, Yousei University, from April, 1997 through May 3, 1997. A spiroanalyzer was used to measure pulmonary function in supine, standing, time after changing position, and recording to the position, application method, and tightness of theabdominal band. The data were analyzed by the repeated measure one-way ANOVA, and Wilcoxon signed rank test. The findings were as follows: 1. All phase of the patients ’ pulmonary function improved significantly in supineposture in contrast to standing (vital capacity by 0.46 Q and expiratory reserve volume by 0.09 Q ). 2. The longer the time lapsed from supine posture to standing, the patient' s expiratoryreserve volume, maximum ventilation volume, vital capacity, and forced expiratoryvolume increased. 3. When the patient lay in supine position, the maximum ventilation volume, vitalcapacity, and the forced vital capacity increased then the center line of the abdominal band was placed along iliac crest; on the other hand, when the patient was standing,placing the bottom line of the abdominal band along iliac crest increased themaximum ventilation volume, vital capacity, and forced expiratory volume. 4. In placing the abdominal band in the patients, leaving space between the top andbottom lines of the band helped increased in maximum ventilation volume, vital ca•pacity, and forced vital capacity for patient in supine as well as in standing. 5. When placing the abdominal band to patients in supine posture, reducing the lengthof the band by 2.5% along the patient' s waist line increased the patients' vital capacity,while reducing the length by 10% to patients in standing increased themaximum ventilation volume. The abdominal band should be placed in such a way that the bottom part of theband should be more tightly fastened while leaving enough room for a hand to beplaced in between the body and the band for the top part of the hand. It should alsobe noted that in a supine position, the bottom line of the band should be placedalong the iliac crest, while in standing, the center line should be placed along theiliac crest. The length of the band should also be reduced by 2.5% of the waist linein supine position, and in standing, the length should be reduced by 10%. It shouldalso be noted that the pulmonary function of the patients should be measured at least 10 minutes after one position change.