ABSTRACT
Background:During exercise, the expiratory phase plays an equally important role in improving endurance as it helps in reducing the exercise-induced breathlessness. Therefore this study aims at specifically strengthening the expiratory muscles to study the effect of expiratory muscle strengthening on exercise-induced breathlessness. Aims and objectives: To evaluate the effect of 4 weeks of expiratory muscle strengthening on exercise-induced breathlessness in normal individuals. Methodology:Study was carried out on a total of 13 subjects ranging in the age group of 20-35yrs, where pre-intervention the Maximum Expiratory Pressure (MEP) and 1.5mile walk distance was calculated after which the subjects underwent a 4 week intervention protocol using Expiratory Muscle Strength Trainer 150 ( EMST-150) where the subjects performed 25 training breaths in one session where there were a total of 5 sessions in a day, 5days/week for a total of 4 weeks. Post the intervention the MEP and 1.5mile walk values were recalculated and compared to check for the difference. Result:Data was analyzed in terms of the mean difference. Statistically significant change was seen in the MEP and 1.5 mile walk test values post-intervention, i.e at the end of 4 weeks, where the values obtained were, MEP : pre –77.537 ±13.67 and post –88.063 ±18.39 with a p-value of 0.0019 , 1.5 mile walk(vo2max.) : pre –35.810 ±14.56 and post –39.810 ±11.8 with a p-value of 0.0038 and RPE: pre –3.80 ±0.5 and post –1.7 ±0.5 with a p-value of 0.0057, thereby proving a statically significant improvement in the outcome measures. Conclusion: The study concludes that Expiratory muscle strengthening improves the maximum expiratory strength thereby reducing the exercise-induced breathlessness leading to an improvement in the endurance level.
ABSTRACT
Background:The patients who have done CABG are prone to pulmonary complications. Various physiotherapy man-agement is present for prevention of lung complication. Literature shows lots of technique as treatment of choice, incentive spirometry is one of them. AIM: To asses immediate effect of incentive spirometry on arterial blood gas analysis in patient recently underwent coronary artery bypass surgery. Method:There was 30 patients. Blood was drawn from arterial line for pre-treatment ABG. Incentive spirometry was given 10 reps and 3 sets. Patient was prop up 30-40 degree. Romsons tri colour volume spirometry is used. Mouthpiece was placed in patient’s mouth and made a good seal over the mouthpiece with lips. Exhaled through nose normally then breathe in slowly through mouth. Ball in the incentive spirometer will go up. The patient to hold or rise the ball as high as possible and hold it for 3 or 5 seconds the slowly exhale. This was done for 10 to 15 times. Blood was drawn from arterial line for post treatment ABG. Result: There was statistically extremely significant change in value of PaO2 (112.54 ±39.46 vs133.01 ±42.13) p value <0.0001, PaCO2 (38.75 ±4.2 vs 36.9 ±3.7) p value 0.0003 and SaO2 (96.8 ±1.84 vs 98.93 ±1.11) p val-ue <0.0001 Conclusion:This study shows that there is immediate effect of Incentive Spirometry on ABG analysis in CABG surgery patient by significant improvement of PaO2 and SaO2 and decrease in PaCO2
ABSTRACT
To evaluate serum pleural effusion albumin gradient (SEAG) as method of differentiating pleural transudates from exudates.Cases admitted in AMCH with diagnosed pleural effusion were divided into 2 groups based on etiology. Group I (transudates): Comprising 14 patients of congestive heart failure (n=6) and nephrotic syndrome (n=3), Cirrhosis (n=4), pericardial effusion (n=1). Group II (exudates): comprising 26 cases of tuberculous (n=15), malignant (n=8) and parapneumonic effusion (n=2), rheumatoid arthritis (n=1). In all patients estimation of pleural fluid to plasma protein ratio, pleural fluid to serum LDH ratio & pleural fluid LDH level, plasma-pleural effusion gradient were evaluated. All these parameters were compared in differentiating pleural transudates from exudates. A total of 40 patients having pleural effusion were divided into 2 groups. Group I (Transudates),Group II (Exudates). Pleural fluid to serum protein of .5 misclassified 20%, pleural fluid LDH OF 200 U/L misclassified 17.5%, pleural fluid LDH to serum LDH misclassified 12.5%, & serum effusion albumin gradient misclassified 5% while differentiating transudates from exudates. Serum pleural effusion albumin gradient (SEAG) is a very useful parameter to differentiate between exudates and transudates esp. in cases misclassified by Light’s criteria.