BackgroundRespiratory rehabilitation reduces breathlessness from patient with respiratory dysfunction. Chest expansion score, which represents the circumference magnitude of the thoracic cage, is used for a target when treating patients with respiratory disease. However, it is often difficult for patients to understand the changes in the respiratory status and be motivated for therapy continuously. We developed a new measurement system with biofeedback named BREATH which shows chest expansion scores in real time. The purpose of this study was to determine the reliability and validity of the novel system in advance of clinical application.MethodsThree evaluators measured chest expansion in 33 healthy individuals using tape measure, which is used for the measurement traditionally, and BREATH. The wire for BREATH system was threaded over the thoracic continuously and the data was recorded automatically; whereas the tape was winded and measured each maximal expiration and inspiration timing by evaluator. All participants were performed both measurement simultaneously for three times during deep breath. In this study, we studied chest expansion score without using biofeedback data of BREATH to check the validity of the result. To confirm intra- and inter-evaluator reliability, we computed intra-class correlations (ICCs). We used Pearson’s correlation coefficient to evaluate the validity of measurement result by BREATH with reference to the tape measure results.ResultsThe average (standard deviation) chest expansion scores for all, men and women by the tape measure were 5.53 (1.88), 6.40 (1.69) and 5.22 (1.39) cm, respectively, and those by BREATH were 3.89 (2.04), 4.36 (1.83) and 2.89 (1.66) cm, respectively. ICC within and among the three evaluators for BREATH and the tape measure were 0.90-0.94 and 0.85-0.94 and 0.85 and 0.82, respectively. The correlation coefficient between the two methods was 0.76-0.87.ConclusionThe novel measurement system, BREATH, has high intra- and inter-evaluator reliabilities and validity; therefore it can lead us more effective respiratory exercise. Using its biofeedback data, this system may help patients with respiratory disease to do exercises more efficiently and clinicians to assess the respiratory exercise more accurately.

The toileting performance assessment test has acceptable psychometric properties and proved useful in assessing toileting performance ability of patients in the early phase after stroke. Implications for rehabilitation Toileting performance assessment test demonstrated acceptable psychometric properties, and it can be useful for assessing the toileting ability of patients in the early phase after stroke. Toileting performance assessment test should provide information that leads to lowered risk of falls while toileting, and the information gathered can assist patients in achieving early toileting independence after stroke. As the development of toileting performance assessment test excluded patients with cognitive disabilities, the item for cognitive function should be developed as well.

Improvement of thoracic mobility is important for patients with diseases such as chronic obstructive pulmonary disease (COPD). Chest expansion training is often conducted to increase the thoracic excursion. However, it is difficult for the patients to keep the motivation for rehabilitation, because the chest excursion is only measured. In this paper, we analyze the effect of real-time biofeedback on thoracic excursion. In 30 healthy subjects, thoracic excursion was increased by 6 mm (17%) when using the biofeedback system. Our results confirmed that we have developed an effective system for rehabilitation of respiratory function.

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A case of language disorders owing to the presence of right cerebellar hemorrhage