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研究生:張玉珍
研究生(外文):Yu Chen Chang
論文名稱:肢體運動訓練對脫離呼吸器病患成效之前趨性研究
論文名稱(外文):A pilot study on limbs exercise training in patients recently weaned from mechanical ventilation
指導教授:馬素華馬素華引用關係
指導教授(外文):S. H. Maa
學位類別:碩士
校院名稱:長庚大學
系所名稱:護理學研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2009
畢業學年度:97
論文頁數:114
中文關鍵詞:肢體運動訓練慢性阻塞性肺部疾病脫離呼吸器St. George 呼吸問卷
外文關鍵詞:limbs exercise trainingCOPDweaningSt. George respiratory questionnaire
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本研究主要目的在探討早期肢體運動訓練對剛脫離呼吸器之慢性阻塞性肺部疾病病患在呼吸道狀況、呼吸困難、疲憊、運動能力、生活品質、肌肉力量的成效。採單組重複測量之類實驗性研究設計。共收胸腔內科病房14位脫離呼吸器之慢性阻塞性肺部疾病病患,接受肢體運動訓練,每天一次,每次最長運動時間不超過30分鐘,一週五天,總共10到14天不等的肢體運動訓練。於運動前(前測)、第一週結束時(後測1)、第二週結束或出院時(後測2)執行成果測量。成果測量包括呼吸道清除失效定義特徵量表、modified Borg呼吸困難量表、modified Borg疲憊量表、6分鐘走路距離、St. George呼吸問卷、肌肉力量測量。研究結果顯示,在調整了BMI效應後,呼吸道狀況、呼吸困難程度、疲憊程度、生活品質、運動能力、和四肢肌肉力量(p < .001)均達顯著性差異。結論為早期肢體運動訓練對改善剛脫離呼吸器之慢性阻塞性肺部疾病患者的呼吸道狀況、呼吸困難、疲憊、生活品質、運動能力、肌肉力量可能扮演重要的角色。
This study seeks to evaluate the effects of early limbs exercise training in chronic obstructive pulmonary disease (COPD) patients recovering from acute respiratory failure needing mechanical ventilation. A quasi-experimental, one group repeated-measures study design was used. Fourteen patients weaned from MV from longer than 48 to less than 96 hours were considered eligible and enrolled in the study. Each patient performed limbs exercise training daily for ten to fourteen days at hospital. Outcome measures included defining characteristics of ineffective airway clearance, modified Borg dyspnea scale, modified Borg fatique scale, St. George respiratory questionnaire, 6-minute walking distance, and hand-held myometry. Data were recorded just prior to the limbs exercise at Day 1 as baseline, at the end of the first week, and at the end of the second week or before discharge. Result of this study showed that after adjustment for the effect of body mass index, defining characteristics of ineffective airway clearance, modified Borg dyspnea scale, modified Borg fatique scale, St. George respiratory questionnaire, 6-minute walking distance and hand-held myometry (p < .001) were significantly improved. Fourteen days of early limbs exercise training could be useful in improving airway clearance, dyspnea, fatique, and quality of life, and increasing exercise tolerance and muscles strength in COPD patients recovering from acute respiratory failure needing mechanical ventilation.
目錄
論文指導教授推薦書
論文口試委員審定書
授權書…………………………………………………………… iii
致謝………………………………………………………………… iv
中文摘要…………………………………………………………… v
英文摘要…………………………………………………………… vi
第一章 緒論……………………………………………………1
第一節 研究動機與重要性……………………………………1
第二節 研究目的………………………………………………2
第三節 研究假設………………………………………………2
第四節 名詞解釋………………………………………………3
第五節 研究限制………………………………………………3
第二章 文獻查證………………………………………………5
第一節 慢性阻塞性肺病概述…………………………………5
第二節 慢性阻塞性肺病急性惡化併呼吸衰竭………………8
第三節 慢性阻塞性肺病患者之肺部復健……………………9
第四節 慢性阻塞性肺病與肢體運動訓練成效的相關研究.17
第三章 研究方法與步驟……………………………………22
第一節 研究架構……………………………………………22
第二節 研究設計……………………………………………22
第三節 研究對象與研究場所………………………………25
第四節 肢體運動……………………………………………26
第五節 研究工具及工具之信效度…………………………30
第六節 資料收集過程………………………………………37
第七節 資料處理與統計分析………………………………40
第四章 研究結果……………………………………………41
第一節 研究對象基本資料…………………………………41
第二節 肢體運動訓練前後各項參數之狀況………………45
第三節 肢體運動訓練前後各項參數之成效………………55
第五章 討論…………………………………………………60
第一節 病患之特性…………………………………………60
第二節 呼吸道狀況..………………………………………60
第三節 呼吸困難程度………………………………………61
第四節 疲憊程度……………………………………………62
第五節 生活品質……………………………………………62
第六節 運動能力……………………………………………63
第七節 肌肉力量狀況………………………………………64
第六章 結論與建議…………………………………………66
第一節 結論…………………………………………………66
第二節 研究限制與建議……………………………………67
第三節 護理運用……………………………………………68
參考資料………………………………………………………69
附錄………………………………………………………………81

圖目錄
圖1 研究架構圖……………………………………………………22
圖2 資料收集流程圖………………………………………………39
圖3 肢體運動訓練呼吸道狀況隨介入週數變化圖………………46
圖4 肢體運動訓練呼吸困難程度隨介入週數變化圖……………47
圖5 肢體運動訓練疲憊程度隨介入週數變化圖…………………48
圖6 肢體運動訓練生活品質隨介入週數變化圖…………………50
圖7 肢體運動訓練運動能力隨介入週數變化圖…………………51
圖8 右上肢前三角肌肌力隨介入週數變化圖……………………52
圖9 右上肢側三角肌肌力隨介入週數變化圖……………………53
圖10 左上肢前三角肌肌力隨介入週數變化圖………………… 53
圖11 左上肢側三角肌肌力隨介入週數變化圖 …………………54
圖12 右下肢股四頭肌肌力隨介入週數變化圖 …………………54
圖13 左下肢股四頭肌肌力隨介入週數變化圖 …………………55

表目錄
表一 探討肢體運動訓練成效的相關研究………………………18
表二 研究設計……………………………………………………24
表三 肢體運動訓練進度表………………………………………27
表四 受試者之人口學特徵一……………………………………43
表五 受試者之人口學特徵二……………………………………44
表六 受試者之人口學特徵三……………………………………45
表七 運動前後呼吸道狀況………………………………………46
表八 運動前後呼吸困難程度……………………………………47
表九 運動前後疲憊程度…………………………………………48
表十 運動前後生活品質狀況……………………………………49
表十一 運動前後的運動能力……………………………………50
表十二 運動前後的肌肉力量狀況………………………………52
表十三 以GEE方法調整BMI效應後運動前後各項參數之成效.57
表十四 以GEE方法調整BMI效應後運動前後運動能力及肌肉
力量成效…………………………………………………59
行政院衛生署(2002)‧衛生統計資訊網‧http://www.doh.gov.tw/statistic/data/全民健康保險統計年報/90醫療統計年報/9128.xls。
行政院衛生署(2003)‧衛生統計資訊網‧http://www.doh.gov.tw/statistic/data/全民健康保險統計年報/91醫療統計年報/9128.xls。
行政院衛生署(2004)‧衛生統計資訊網‧http://www.doh.gov.tw/statistic/data/死因摘要/92年/92htm。
許麗齡(2003)‧慢性阻塞性肺疾病患者肺部復健手冊之設計‧護理雜誌,50(3),77-82。
邱艷芬、唐修平、曾詩雯(2003)‧改良式腹式呼吸法促進慢性阻塞性肺疾病病患肺功能與活動能力之效果‧台灣醫學,7(4),492-501。
徐敏芳(1997)‧慢性呼吸道阻塞患者實施肺部復健運動方案成效之探討‧私立長庚大學護理研究所,未發表之碩士論文,桃園縣。
馬素華、高紀惠 (1990)‧呼吸道清除失效的導因及定義特徵之臨床效度測定‧護理雜誌,37(2),71-82。
陳夏蓮,葉明珍(1998)‧常見呼吸系統疾病之醫療與護理措施‧於許淑連總校閱‧當代內外科護理 (pp.745-765)‧台北:華杏。
黃景鶴,黃明祥 (2003) ‧ Micro FET 於頸部肌力測試上的信度與效度之評估‧國立台灣體育學院學報第九期,563-571。
葉秀逸 (2002) ‧ 慢性阻塞性肺部疾病患者之臨床指標與生活品質之相關性:評值聖喬治呼吸問卷的適用性‧新台北護理期刊,4 (2),19-28。
蕭光明(1996)‧ 慢性阻塞性肺疾病‧胸腔醫學,11 (4),230-239。
American Thoracic Society statement: guidelines for the six- minute walk test. (2002). Am J Respir Crit Care Med, 166(1), 111-117.
American College of Sports Medicne (ACSM). (2006). ACSM’s guidlins for exercise testing and prescription, 7th ed. Philadelphia: Lippincott Willians & Wilkins.
Antonelli Incalzi, R., Fuso, L., De Rosa, M., Forastiere, F., Rapiti, E., Nardecchia, B., & Pistelli, R. (1997). Co-morbidity contributes to predict mortality of patients with chronic obstructive pulmonary disease. European Respiratory Journal, 10 (12), 2794-2800.
Apps, C. P., Ahmed, R., Jubber, A. S., Weatherstone, R. M., & Fowler, R. W. (2005). Comorbidity in Patients with Chronic Obstructive Pulmonary Disease and Its Influence on Admission to Hospital. Throax, 60 (2), 70-75.
Barach, A. L., & Beck, G. J. (1954). The ventilatory sffects of the head-down position in pulmonary emphysema. American Journal of medicine, 16(1), 55-60.
Becklake, M. R., Goldman, H. I., & McGregor, M. (1954). The effects of pneumoperitoneum on lung function in pulmonary emphysema. Thorax, 9(3), 222-225.
Bendstrup, K. E., Ingenmann, J. I., & Holm, S. (1997). Out-patient rehabilitation improves activities of daily living, quality of life and exerice tolerance in chronic obstructive pulmonary disease. European Respiratory Journal, 10(12), 2801-2806.
Baratz, D. M., Westbrook, P. R., Shah, P. K., & Mohsenifar, Z. (1992). Effect of nasal continuous positive airway pressure on cardiac output and oxygen delivery in patients with congestive heart failure. Chest, 102(5), 1397-1401.
Bernard, S., Whittom, F., LeBlanc, P., Jobin, J., Belleau, R., Berube, C., Carrier, G., & Maltais, F. (1999). Aerobic and strength training in patients with chronic obstructive pulmonary disease. American Journal of Respiratory & Critical Care Medicine, 159(3), 896-900.
Bernstein, M. L., Despars, J. A., Singh, N. P., Avalos, K., Stansbury, D. W., & Light, R. W. (1994). Reanalysis of the 12-minute walk in patients with chronic obstructive pulmonary disease. Chest, 105(1), 163-167.
Berry, M. J., Adair, N. E., Sevensky, K. S., Quinby, A., & Lever, H. M. (1996). Inspiratory muscle training and whole- body reconditioning in chronic obstructive pulmonary disease. American Journal of respiratory & Critical Care Medicine, 153(6 Pt 1), 1812-1816.
Bohannon, R. W. (1990). Hand- held compared with isokinetic dynamometry for measurement of ststic knee extension torque. Clinical Physics & Physiological Measurement, 11(3), 217-222.
Butland, R. J., Pang, J., Gross, E. R., Woodcock, A. A., & Geddes, D. M. (1982). Two-, six-, and 12-minute walking tests in respiratory disease. British Medical Journal, 284(6329), 1607-1608.
Boueri, F. M., Bucher-Bartelson, B. L., Glenn, K. A., & Make, B. J. (2001). Quality of life measured with a generic instrument (short from-36) improves following pulmonary rehabilitation in patients wit h COPD. Chest, 11(1), 77-84.
Carter, R., Holiday, D. B., Stocks, J., Grothues, C., & Tiep, B. (2003). Predicting oxygen uptake for men and women with moderate to severe chronic obstructive pulmonary disease. Archives of Physical Medicine & Rehabilitation, 84(8), 1158-1164.
Campbell, E. J., & Friend, J. (1955). Action of breathing exercise in pulmonary emphysema. Lancet, 268(6859), 325-329.
Celli, B.R. (1998). Pulmonary rehabilitation and lung volume reduction surgery in the treatment of patients with chronic obstructive pulmonary disease. Monaldi Archives for Chest Disease, 53(4), 471-479.
Celli, B. R. (1998). Pulmonary rehabilitation for COPD: A pratical approach for improving ventilatory conditioning. Postgraduate Medicine, 103(4), 159-176.
Celli, B. R., Cote, C. G.., Marin, J. M., Casanova, C., Oca, M. M., Mendez, R.A., Plata, V. P., & Cabral, H. J. ( 2004). The Body- Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity Index, in Chronic Obstrucyive Pulmonary Disease. The new England journal of medicine, 350(10), 1005-1012.
Clark, C. J., Cochrane, L. M., Mackay, E., & Paton, B. (2000). Skeletal muscle strength and endurance in patients with mild COPD and the effects of weight training. European Respiratory Journal, 15(1), 92- 97.
Cooper, K. H. (1968). A means of assessingmaximal oxygen intake. JAMA, 203(3), 201-204.
Couser, Ji. Jr., Martinez, F. J., & Celli, B. R. (1993). Pulmonary rehabilitation that includes arm exercise reduces metabolic and ventilatory requirements for simple arm elevation. Chest, 103(1), 37-41.
Curtis, J. R., Deyo, R. A., & Hudson, L. D. (1994). Health- related quality of life among patients with chronic obstructive pulmonary disease. Throax. 49(2), 162-170.
Dean, E., & Ross, J. (1992). Discordance between cardiopulmonary physiology and physical therapy. Toward a rational basis for practice. Chest, 101(6), 1694-1698.
Delgado, H. R., Braun, S. R., Skatrud, J. B., Reddan, W. G., & Pegelow, D. F. (1982). Chest wall and abdominal motion during exercise in patients with chronic obstructive pulmonary disease. American Review of Respiratory Disease, 126(2), 200-205.
Dries, D. (1997). Weaning from mechanical ventilation. Journal of Trauma Injury Infection and Critical Care, 43(2), 372–384.
Dugan, D., walker, R., & Monroe, D. A. (1995). The effect of a 9-week program of aerobic and upper body execise on the maximal voluntary ventilation of chronic obstructive pulmonary disease. Journal of Cardiopulmonary rehabilitation, 15(2), 130-133.
Emery, C. F., Leatherman, N. E., Burker, E. J., & MacIntyre, N. R. (1991). Psychological outcomes of a pulmonary rehabilitation program. Chest, 100(3), 613-617.
Emery, C. F., Schein, R. L., Hauck, E. R., & MacIntyre, N. R. (1998). Psychological and cognitive outcomes of a randomized trial of exercise among patients with chronic obstructive pulmonary disease. Health Psychology, 17(3), 232-240.
Epstein, S. K., Celli, B. R., Martinez, F. J., Couser, Ji. Jr., Roa, J., Pollock, M., & Benditt, J. O. (1997). Arm training reduces the VO2 and VE cost unsupported arm exercise and elevation in chronic obstructive pulmonary disease. Journal of Cardiopulmonary Rehabilitation, 17(3), 171-177.
Esteban, F., Frutos, M. J., Tobin, I., Alia, J. F., Solsona, I., Valverdu, R., Fernandez, M., De La Cal, S., Benito, R., Thomas, D., Carriedo, S., Macias, J., & Blanco. (1995). A comparison of four methods of weaning patients from mechanical ventilation. New England Journal of Medicine, 332( 9), 345–350.
Faling, L. J. (1986). Pulmonary rehabilitation – physical modalities. Clinics in Chest Medicine, 7(4), 599-618.
Finnerty, J. P., Keeping, I., & Bullough, I. (2001). The Effectiveness of Outpatient Pulmonary rehabilitation in Chronic Lung Disease. Chest, 119(6), 1705-1710.
Foglio, K., Bianchi, L., & Ambrosino, N. (2001). Is It Really Useful To Repeat outpateint Pulmonary Rehabilitation Program in Patients With Chronic Airway Obstruction? Chest, 119(1), 1696-1704.
Gayard, P., Becker, M., & Bergofsky, E. H. (1968). The effect of abdominal weights on iaphragmatic position and excursion in man. Clinical Science, 35(3), 589-601.
Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease. NHLB/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) workshop report. www.goldcopd.com. Data last updated: September 2005. Data last accessed: December 15, 2006.
Goldstein, R. S., Gort, E. H., Stubbing, D., Avendano, M. A., & Guyatt, G. H. (1994). Randomised controlled trial of respiratory rehabilitation. Lancet, 344(8934), 1394-1397.
Green, R. H., Singh, S. J., Williams, J., & Morgan, M. D. (2001). A randomised controlled trial of four weeks versus seven weeks of pulmonary rehabilitation in chronic obstructive pulmonary disease. Thorax, 56(2), 143-145.
Griffiths, T. L., Burr, M. l., & Campbell, I. A. (2000). Results at 1 year of outpatient multidisciplinary pulmonary rehabilitation: a randomized controlled trial. Lancet. 355(9201), 362-368.
Groenewegen, K. H., Schols, A. M., & Wouters, E. F. (2003). Mortality and mortality-related factors after hospitalization for acute exacerbation of COPD. Chest, 124(2), 459-469.
Guyatt, G. H., Thompson, P. J., Berman, L. B., Sullivan, M. J., Townsend, M., Jones, N. L., & Pugsley, S. O. (1985). How should we measure function in patients with chronic heart and lung disease? Journal of Chronic Diseases, 38(6), 517-524.
Hajiro, T., Nishimura, K., Tsukino, M., Ikeda, A., Koyama, H., & Izumi, T. (1998). Analysis of clinical methods used to evaluate dyspnea in patients with chronic obstructive pulmonary disease. American Journal of Respiratory & Critical Care Medicine, 158(4), 1185- 1189.
Hui, K. P., & Hewitt, A. B. (2003). A simple pulmonary rehabilitation program improves health outcomes and reduces hospital utilization in patient with COPD. Chest, 124(1), 94-97.
Jones, P. W., Quirk, F. H., Baveystock, C. M., & Littlejohns, P. A. (1992). A Self-complete Measure of Health Status for Chronic Airflow Limitation. The St George’s respiratory questionnaire. American Review of Respiratory Disease, 145(6), 1321-1327.
Jones, P. W., Quirk, F. H., Baveystock, C. M. (1991). The St George’s respiratory questionnaire. Respiratory Medicine, 85(Supplement B), 25-31.
Kapella, M. C., Larson, J. L., Patel, M. K., Covey, M. K., & Berry, J. K. (2006). Subjective fatigue, influencing variables, and consequences in chronic obstructive pulmonary disease. Nursing Research, 55(1), 10-17.
Koch, S. M., Fogarty, S., Signorino, C., Parmley, L., & Mehlhorn, U. (1996). Effect of passive range of motion on intracranial pressure in neurosurgical patients. J Crit Care, 11(4), 176-179.
Lake, F. R., Henderson, K., Briffa, T., Openshaw, J. & Musk, A.W. (1990). Upper-limbs and lower-limbs exercise training in patients with chronic airflow obstruction. Chest, 97(5), 1077-1082.
Leung, A. S., Chan, K. K., Sykes, K., & Chan, K. S. (2006). Reliability, validity, and responsiveness of a 2-min walk test to assess exercise capacity of COPD patients. Chest, 130(1), 119-125.
Livingstone, J. L., Gillespie, M. (1935). The value of breathing exercise in asthma. Lancet. 2, 705-708.
MacIntyre, N. R. (2006). Muscle dysfunction associated with chronic obstructive pulmonary disease. Respiratory Care, 51(8), 840-847.
Mahler, D. A. (1998). Pulmonary rehabilitation. Chest, 113(4), 263s- 267s.
Maltais, F., LeBlanc, P., Simard, C., Jobin, J., Berube, C., Bruneau, J., Carrier, L., & Belleau, R. (1996). Skeletal muscle adaptation to endurance training in patients with chronic obstructive pulmonary disease. American Journal of Respiratory & Critical Care Medicine, 154(2 Pt 1), 442-447.
Man, W. D., Polkey, M. I., Donaldson, N., Gray, B. J., & Moxham, J. (2004). Community pulmonary rehabilitation after hospitalization for acute exercebation of chronic obstructive pulmonary disease: randomized controlled study. BMJ, 329(7476), 1209-1220.
May, L. A., Burnham, R. S., & Steadward, R. D. (1997). Assessment of isokinetic and hand-held dynamometer measures of shoulder rotator strength among individuals with spinal cord injury. Archives of Physical Medicine & Rehabilitation, 78(3), 251-255.
McNeill, R. S., & McKenzie, J. M. (1955). An assessment of the value of berating exercise in chronic bronchitis and asthema. Thorax, 10(3), 250-252.
Miller, W. F. (1954). A physiologic evaluation of the effects of diaphragmatic breathing training in patients with chronic pulmonary emphysema. Am.J.Med, 17(4), 471-477.
Mueller, R. E., Petty, T. L., & Filley, G. F. (1970). Ventilator and arterial blood gas changes induce by pursed lips breathing. Journal of Applied Physiology, 28(6), 784-789.
Murphy, N., Bell, C., & Costello, R. W. (2005). Extending a home from hospital care programme for COPD exacerbation to include pulmonary rehabilitation. Respiratory Medicine, 99(10), 1297-1302.
Nici, L. et al. (2006). American Thoracic Society /European Respiratory Society Statement on Pulmonary Rehabilitation. American Journal of Respiratory & Critical Care Medicine, 173(12), 1390-1423.
O’Donnell, D. E., McGuire, M., Samis, L., & Webb, K. A. (1995). The impact of exercise reconditioning on breathlessness in severe chronic airflow limitation. Am Respir Crit Care Med, 152(6 Pt 1). 2005- 2013.
Paratz, J. D., & Burns Y. N. (1993). The effect of respiratory physiotherapy on intracranial pressure, mean arterial pressure, cerebral perfusion pressure and end tidal carbon dioxide in ventilated neurosurgical patients. Physiother Theory Pract, 9, 3-11.
Pauwels, R. A., Buist, A. S., Calerley, P. M., Jenkins, C. R., & Hurd, S. S. (2001). Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO GlobalInitiative for Chronic Obstruction Lung Disease (GOLD) Workshop summary. American Journal of respiratory and critical care medicine, 163(5), 1256-1276.
Puhan, M. A., Scharplatz, M., Troosters, T., & Steurer, J. (2005). Respiratory rehabilitation after acute exacerbation of COPD may reduce risk for readmission and mortality: a systematic review. Respiratory Research, 6(1), 54-65.
Reardon, J., Casaburi, R., Morgan, M., Nici, L., & Rochester, C. (2005). Pulmonary rehabilitation for COPD. Respiratory Medicine, 99 (Suppl B), 19s-27s.
Redelmeier, D. A., Bayoumi, A. M., Goldstein, R., & Guyatt, G. (1997). Interpreting small differences in functional status: the six minute walk test in chronic lung disease patients. American Journal of Respiratory Critical Care Medicine, 155(4), 1278-1282.
Ries, A. L., Bauldoff, G. S., Casaburi, R., Mahler, D. A., Rochester, C. L., & Herrerias, C. (2007). Pulmonary rehabilitation. Chest, 131(5), supplement, 4s-42s.
Ries, A. L., Kaplan, R. M., Limberg, T. M., & Prewitt, L. M. (1995). Effect of pulmonary rehabilitation on physiologic and Psychosocial Outcomes in patients with Chronic Obstructive Pulmonary Diasease. Annals of Internal Medicine, 122( 11), 823-832.
Ries, A. L., & Squier, H. C. (1996). The team concept in pulmonary rehabilitation. In: Fishman A, ed. Pulmonary rehabilitation. New York, NY: Marcel Dekker, 55-65.
Rochester, D. F., & Goldberg, S. K. (1980). Techciques of respiratory physical therapy. American Review of Respiratory Disease, 122(5 Pt 2), 133-146.
Sala E Roca, J., Marrades, R. M., Alonso, J., Gonzalez De Suso, J. M., Moreno, A., Barbera, J. A., Nadal, J., de Jover, L., & Rodriguez- Roisin R. (1999). Effects of endurance training on skeletal muscle bioenergetics in chronic obstructive pulmonary disease. American Journal of Respiratory & Critical Care Medicine, 159(6), 1726- 1734.
Scherer, Y. K., & Schmieder, L. E. (1997). The effect of a pulmonary rehabilitation program on self-efficacy, perception of dyspnea, and physical endurance. Heart & Lung, 26(1), 15-22.
Sharp, J. T., Drutz, W. S., Moisan, T., Foster, J., & Machnach, W. (1980). Postural relief of dyspnea in sever chronic obstructive pulmonary disease emphysema. American Review of Respiratory Disease, 122(2), 201-211.
Sinclair, J. D. (1955). The effect of breathing exercise in pulmonary emphysema. Thorax, 10(3), 246-249.
Stiller, K. (2000). Physiotherapy in intensive care: towards an evidence-based practice. Chest, 118(6), 1801-1813.
Strilbos, J. H., Postma, S. J., van Altena, R. Gimeno, F. & Koeter, G. H. (1996). A comparison between an outpatient hospital- based pulmonary rehabilitation program and a home –care pulmonary rehabilitation program in patients with COPD: a follow- up of 18 months. Chest, 109(2), 366-372.
Swerts, P. M., Kretzers, L. M., Terpstra-Lindeman, E., Verstappen, F. T., & Wouters, E. F. (1990). Exercise reconditioning in the rehabilitation of patients with crhronic obstructive pulmonary disease. Archives of Physical Medicine & Rehabilitation, 71(8), 570-573.
Surburg, P. R., Suomi, R. Poppy, W. K. (1992). Validity and reliability of a Hand-held dynamometer with Two Populations. Arch. Phys. Med. Rehabi, 73(6), 535-539.
Traver, G. A., Mitchell, G. F., & Flodquist-Priestley, G. (1991). Respiratory care a clinical approach. Maryland: An Aspen Pub.
Troosters, T., Gosselink, R., & Decramer, M. (2000). Short-and Long-term Effects of Outpateint Rehabilitation in patients with Chronic Obstructive Pulmonary Disease. American lournal of medicine, 109(3), 207-212.
Wade, O. L., Gilson, J. C. (1951). The effect of posture on diaphragmatic movement and vital capacity in normal subjects with a note on spirometry as an aid in determing radiological chest volumes. Thorax, 6(2), 103-126.
Wang, K. Y., Chiang, C. H., Maa, S. H., Shau, W. Y., & Tarn, Y. H. (2001). Psychometric assessment of the Chinese language version of the St. George’s respiratory questionnaire in Taiwanese patients with bronchial asthma. Journal of the Formosan Medical Association, 100(7), 455-460.
Walke, L. M., Byers, A. L., Tinetti, M. E., Dubin, J. A., McCorkle, R., & Fried, T. R. (2007). Range and severity of symptoms over time among older adults with chronic obstructive pulmonary disease and heart failure. Archives of Internal Medicine, 167(22), 2503-2508.
White, R. J., Rudkin, S. T., Harrison, S. T., Day, K. L.,& Harvey, I. M. (2002). Pulmonary rehabilitation compared with brief advice given for severe chronic obstructive pulmonary disease. Journal of Cardiopulmonary Rehabilitation. 22(5), 338-344.
Wijkstra, P.J., van der Mark, T. W., Kraan, J. Van Altena, R., Koeter, G. H., & Postma, D. S. (1996). Effect of home rehabilitation on physical performance in patients with chronic obstructive pulmonary disease. European Resipratory Journal, 9(1), 104-110.
Zielinski, J., & Bednarek, M. (2003). COPD screening in high-risk groups. American College of Chest physicians, 123(3), 959-960.
ZuWallack, R. L., Haggerty, M. C., Jones, P. (2004). Clinically Meaningful outcomes in Patients With Chronic Obstructive Pulmonary Disease. American journal medicine, 117(12A), 49s-59s.
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