摘要 崇仁科技呼吸治療師黃淑玲 1976 Leith Brodley (respiratroy care center, RCC) 壹 呼吸肌在人體的功能 ( ) ( ) 一 呼吸肌在人體具備兩大功能 ( 一 ) 呼吸功能 ( 二 ) 非呼吸功能 貳 呼吸肌力與測量 1976 Leith Bradley 藥學雜誌 124 21 綜合評論呼吸肌訓練增強表現與應用
綜Commentary 合評論1 ( ) ( )(maximal respiratory pressure) (maximal inspiratory pressure PImax) (maximal expiratory pressure PEmax) 2 3 參 呼吸肌訓練的應用族群 4 Fundamental Training ( ) Functional Training ( ) 圖三呼吸肌基礎訓練 圖一壓力測量儀器 圖四呼吸肌功能訓練 圖二口部最大呼吸壓力測量 MIP < 60 cm H 2 O or < 50% pred. MEP < 60 cm H 2 O < 70 cm H 2 O 一 運動族群 (adenosine triphosphate, ATP) ATP 22 THE JOURNAL OF TAIWAN PHARMACY Vol.31 No.3
5 5 ATP 二 音樂族群 ( ) 三 醫療族群 ( 一 ) 慢性阻塞性肺病 (chronic obstructive pulmonary disease COPD) 6 COPD 綜合評論 ( ) COPD 7 ( 二 ) 慢性心臟衰竭 (CHF chronic heart failure) CHF (deoxygenation) (fatigue) (dyspnea) CHF 8 (metaboreflex) 9 (cardiac vagal tone) (27%) 10 24 8 mmhg 5 mmhg ( ) 11 ( 三 ) 呼吸器脫離 1985 Alderich Karpel (weaning) 藥學雜誌 124 23
綜Commentary 合評論 RCW (respratory care ward) RCC (respratory care center) 肆 呼吸肌訓練工具介紹一 訓練工具 Dofin Breathing Strength Builder ( ) (threshold loading) 10 30 ( ) ( ) 圖五手持呼吸肌訓練器結構 二 呼吸肌訓練器的原理 伍 結論 24 THE JOURNAL OF TAIWAN PHARMACY Vol.31 No.3
Abstract Respiratory Muscle Training Annie Huang Respiratory Therapist, Galemed Corporation The first research on respiratory muscle training was published in the United States in 1976. Over the last decades, research on the efficacy of respiratory muscle training in the field of preventive medicine and long-term care of acutely ill patients in other countries expanded from focusing on cardiopulmonary and respiratory disorders, to swallowing training of patients with neuromuscular disorders and sleep apnea syndromes. In Taiwan, respiratory muscle training was first used in respiratory care center to reduce the depending on mechanical ventilator following failure in weaning, which is often a result of respiratory muscle weakness after prolonged use of mechanical ventilators. With the introduction of a new regulation in regards to long-term care in Taiwan, hospitals and medical practitioners started to examine ways to assist post-hospital pulmonary rehabilitation to prevent relapse or exacerbation. Respiratory muscle strength building is related to reestablishing patients breathing autonomy and efficiency. Thus, development in the clinical applications of respiratory muscle training is again starting to receive more attention from cardiopulmonary rehabilitation specialists. 參考資料 : 1. 2012 271 2. American Thoracic Society/European Respiratory Society. Statement on Respiratory Muscle Testing, Am J Respir Crit Care Med Vol 166. pp 518-624, 2002 3. Teresa Pitts MA, Donald Bolser PhD, John Rosenbek, et al: Impact of Expiratory Muscle Strength Training on Voluntary Cough and Swallow Function in Parkinson Disease. CHEST 2009; 135:1301-1308. 4. McConnell, Alison : Respiratory Muscle Training - Theory Part II : p134. 5. Thomas H Shaffer, Marla R Wolfson,Vinod K Bhutani : Respiratory Muscle Function, Assessment, and Training.PHYS THER. 1981; 61:1711-1723. 6. 2012.. 2012 7. McConnell, Alison : Respiratory Muscle Training - Theory Chapter4:98-99. 8. McConnell, Alison : Respiratory Muscle Training - Theory Chapter3:63-64. 9. Gaspar R, Chiappa PT: Inspiratory Muscle Training Improves Blood Flow to Resting and Exercising Limbs in Patients With Chronic Heart Failure. Journal of the American College of Cardiology 2008; Vol. 51, No. 17. 10. Mello PR, Guerra GM, Suellen B: Inspiratory Muscle Training Reduces Sympathetic Nervous Activity and Improves Inspiratory Muscle Weakness and Quality of Life In: Patients With Chronic Heart Failure. Journal of Cardiopulmonary Rehabilitation and Prevention. 2012;32:255-261. 11. Janaína Barcellos Ferreira a, Rodrigo Della Méa Plentz a, Cinara Stein a: Inspiratory muscle training reduces blood pressure and sympathetic activity in hypertensive patients. International Journal of Cardiology 2013; 166 61-67. 藥學雜誌 124 25 綜合評論Functional Benefits and Application of