Table 1 Classification of degree of activity modified based on The Judgment Standard of ADL Independency (Ministry of Health and Welfare)

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2 Table 1 Classification of degree of activity modified based on The Judgment Standard of ADL Independency (Ministry of Health and Welfare)

3 Table 2 Degree of activity and characteristics of 163 people Ht : height, FEV : FEVI0%, PFR : PEFR, V25 : V25/Ht, UC : upper chest, LC : lower chest, F/E : flexion/extension *: p<0.05, **: p<

4 Fig. 1 Degree of activity and values of measurement SD : standard deviation, U : upper, L : lower, Flex/Ext : flexion/extension 621

5 Table 4 Correlation coefficient of % VC (163 people) Fig. 2 Restrictive and obstructive abnormality Restr : restricitve (%VC<80% ), Obstr : obstructive (FEV~.o% <70%) CC : correlation coefficient, P : partial Det : determination 622

restricitve (%VC<80% ), Obstr : obstructive (FEV~.

6 Table 5 Degree of activity and characteristics of 85 people nerve : central nervous system disorder, ortho : orthopaedic disorder

7 Table 6 Degree of activity and ADL I : independent, PD: partly dependent, TD : totally dependent

8 Fig. 3 Degree of activity and the time frame Stand : standing/sitting, Walk : walking/shopping, Hobby : hobby and housekeeping (*) : o'clock (* *) : hours

9 Table 7 Significant difference of 85 people Table 8 Correlation (85 people) coefficient of % VC Ht : height, Stand : standing/sitting, Walk : walking/shopping, Hobby : hobby and housekeeping * : p<0.05, ** : p<0,01 CC : correlation coefficient, P : partial Det : determination

Walk : walking/shopping, Hobby : hobby and housekeeping * : p<0.

10 3) Devito E and Grassino AE: Respiratory muscle fatigue. In The Thorax, Part C, 2nd ed., (Ed by Roussos C) pp , Marcel Dekker Inc., New York, Basel, } Hahn A, Bach JR, Delaubier A, et al : Clinical implications of maximal respiratory pressure determinations for individuals with Duchenne muscular dystrophy. Arch Phys Med Rehabil 78 : 1-6, ) Grimby G, Elgef ors B and Oxhoj H : Ventilatory levels and chest wall mechanics during exercise in obstructive lung disease. Scand J Respir Dis 54 : 45-52, ) Lissoni A, Aliverti A, Molteni F, et al: Spinal muscular atrophy- Kinematic breathing analysis-. Am J Phys Med Rehabil 75 : , 1996.

Arch Phys Med Rehabil 78 : 1-6, 1997. 9) Grimby G, Elgef ors B and Oxhoj H : Ventilatory levels and chest wall mechanics during exercise in obstructive lung disease.

11 THE INFLUENCE OF LOW ACTIVITY LEVEL ON VENTILATORY FUNCTION -In Case of Subjects Without Respiratory Disease- Tadashi MIZOROGI Department of Rehabilitation Medicine, Showa University School of Medicine (Director : Prof. Yoshiaki MORI) Masahiro YOSHIIKE Ryokuseikai Hospital, Dept of Rehabilitation Abstract - This paper discusses the influence of the degree of activity on ventilatory function. The subjects were 163 people from 65 to 99 years of age (mean 77.7±8.2yrs) with no respiratory disease. The degree of activity was designated in accordance with The Judgement Standard of ADL Dependency (the Ministry of Health and Welfare), and was divided into 6 levels : N (normal), J1 (goes out by bus or train), J2 (goes out in the neighborhood), Al (needs help for outdoor activities), A2 (needs help for indoor activities), B (spends a long time in bed). %VC, FEV10%, PEFR, VSHt, MEP, MIP, chest girth, ROM of thoracic spine were measured. ADL and the time frame of daily life was also analyzed for 85 of the subjects. %VC, PEFR, MEP, MIP, chest girth and ROM of spine significantly decreased with a lowering of activity level. Chest girth significantly decreased in J1, and %VC also decreased in J2. The rate of restrictive ventilatory disorder (%VC<80%) increased according to the activity level : 0 % in N and J1, 42% in J2, 61% in A1, and over 90% in A2 and B. Because of the characteristics of the subjects, it was thought that these changes were due to the disuse syndrome. There was no significant change in FEVLO% and Vn/Ht with the change of the degree of activity. Moreover, no certain tendency was found in obstructive ventilatory change. Factors which contributed a great deal to an increase of %VC were the degree of activity, lower chest girth, MIP, the duration of hobby or housekeeping and the duration of upright position. Conversely, factors which contributed less to the amount of %VC were age, FEVI.o%, MEP and time of getting up or going to bed. These factors mean that restrictive changes of the ventilatory system occur at a very early stage of activity decline despite independent ADL or absence of respiratory disorder. Physical therapy and activation of daily life are needed. Key words : activity level, ventilation, MIP, chest girth, time frame

Yoshiaki MORI) Masahiro YOSHIIKE Ryokuseikai Hospital, Dept of Rehabilitation Abstract - This paper discusses the influence of the degree of activity on ventilatory function.

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