Although previously proposed that chronic scleroderma should be cared for clinically and early rehabilitation should be performed in hospital by a chest physical therapist, little evidence is currently available on its benefits. Therefore, this study demonstrated the benefits of short-term pulmonary rehabilitation during hospitalization in a female patient with chronic scleroderma. The aim of rehabilitation was to improve ventilation and gas exchange by using airway clearance, chest mobilization, and breathing-relearning techniques, including strengthening the respiratory system and the muscles of the limbs by using the BreathMax® device and elastic bands. Gross motor function and activities of daily life were regained by balancing, sitting, and standing practices. Data on minimal chest expansion, high dyspnea, high respiratory rate, and low maximal inspiratory mouth pressure were recorded seven days before rehabilitation or at the baseline period. But there was a clinically significant improvement in dyspnea, chest expansion, maximal inspiratory mouth pressure, and respiratory rate, when compared to baseline data, which were recorded by a chest physical therapist during seven days of rehabilitation. Furthermore, physicians decided to stop using a mechanical ventilator, and improvement in functional capacity was noted. Therefore, in the case of chronic and stable scleroderma, short-term rehabilitation during hospitalization for chest physical therapy possibly shows clinical benefits by improving both pulmonary function and physical performance.
Chronic obstructive lung disease (COPD) is a chronic lung pathology that leads to respiratory muscle weakness and decreased function capacity. Patients need to have pulmonary rehabilitation to increase respiratory muscle strength. The aim of the study was to assess the effect of artificial respiratory muscle training (ARMT) on respiratory muscle function and exercise performance in chronic obstructive pulmonary disease (COPD). Thirty patients in the mild to moderate COPD stage were randomly classified into an ARMT (n = 10), a control group (n = 10), and a standard respiratory muscle training group (SRMT; n = 10) by following the blind procedure. The control group received no training. The training groups, however, were trained at home for 30 min per day, every day, for 6 weeks. The measurement analyses included spirometry, an inspiratory muscle strength examination, and an exercise performance test. Exercise performance was evaluated by a 6 min walk test (SWT). The results showed that the maximal inspiratory pressure (PImax) and the maximal expiratory pressure (PEmax) were observed to have significantly increased in both the ARMT group and the SRMT group compared with the control group (p < 0.05). Moreover, the ARMT group was found to have significantly increased the 6 min walking distance in comparison with the control group. However, the ARMT group and the SRMT group did not differ significantly in those parameters. We conclude that it would be possible for the ARMT group among COPD patients to have improved respiratory muscle strength and increased capacity to walk.
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