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Träfflista för sökning "AMNE:(MEDICAL AND HEALTH SCIENCES Health Sciences Physiotherapy) srt2:(1995-2009);pers:(Westerdahl Elisabeth 1964)"

Sökning: AMNE:(MEDICAL AND HEALTH SCIENCES Health Sciences Physiotherapy) > (1995-2009) > Westerdahl Elisabeth 1964

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1.
  • Westerdahl, Elisabeth, 1964- (författare)
  • Effects of Deep Breathing Exercises after Coronary Artery Bypass Surgery
  • 2004
  • Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
    • Deep breathing exercises are widely used in the postoperative care to prevent or reduce pulmonary complications, but no scientific evidence for the efficacy has been found after coronary artery bypass grafting (CABG) surgery. The aim of the thesis was to describe postoperative pulmonary function and to evaluate the efficacy of deep breathing exercises performed with or without a blow bottle device for positive expiratory pressure (PEP) 10 cmH2O or an inspiratory resistance-positive expiratory pressure (IR-PEP) mask with an inspiratory pressure of -5 cmH2O and an expiratory pressure of +10 to +15 cmH2O. Patients undergoing CABG were instructed to perform 30 slow deep breaths hourly during daytime for the first four postoperative days. Patient management was similar in the groups, except for the different breathing techniques. Measurements were performed preoperatively, on the fourth postoperative day and four months after surgery. The immediate effect of the deep breathing exercises was examined on the second postoperative day. Pulmonary function was assessed by spirometry, diffusion capacity for carbon monoxide and arterial blood gases. Atelectasis was determined by chest roentgenograms or spiral computed tomography (CT). Lung volumes were markedly reduced on the fourth postoperative day. Four months after surgery the pulmonary function was still significantly reduced. On the second and fourth postoperative day all patients had atelectasis visible on CT. A single session of deep breathing exercises performed with or without a mechanical device caused a significant reduction in atelectasis and an improvement in oxygenation. No major differences between deep breathing performed with or without a blow bottle or IR-PEP-device were found, except for a lesser decrease in total lung capacity in the blow bottle group on the fourth postoperative day. Patients who performed deep breathing exercises after CABG had significantly smaller atelectasis and better pulmonary function on the fourth postoperative day compared to a control group who performed no exercises.
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2.
  • Fagevik Olsén, Monika, 1964, et al. (författare)
  • Positive Expiratory Pressure in Patients with Chronic Obstructive Pulmonary Disease - A Systematic Review.
  • 2009
  • Ingår i: Respiration; international review of thoracic diseases. - : S. Karger AG. - 1423-0356 .- 0025-7931. ; 77:1, s. 110-18
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Breathing exercises against a resistance during expiration are often used as treatment for patients with chronic obstructive pulmonary disease (COPD). Controversy still exists regarding the clinical application and efficacy. Objectives: The aim of this systematic review was to determine the effects of chest physiotherapy techniques with positive expiratory pressure (PEP) for the prevention and treatment of pulmonary impairment in adults with COPD. Methods: The review was conducted on randomised, controlled clinical trials in which breathing exercises with positive expiratory pressure were compared with other chest physical therapy techniques or with no treatment, in adult patients with COPD. A computer-assisted literature search of available databases from 1970 to January 2008 was performed. Two reviewers extracted data independently and assessed the trials systematically with an instrument for measuring methodological quality. Results: In total, 11 trials met the inclusion criteria, of which 5 reached an adequate level of internal validity. Several kinds of PEP techniques with a diversity of intensities and durations of treatment have been evaluated with different outcome measures and follow-up periods. Benefits of PEP were found in isolated outcome measures in separate studies with a follow-up period <1 month. Concerning long-term effects, the results are contradictory. Conclusion: Prior to widespread prescription of long-term PEP treatment, more research is required to establish the benefit of the technique in patients with COPD.
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3.
  • Westerdahl, Elisabeth, 1964-, et al. (författare)
  • Pulmonary function 4 months after coronary artery bypass graft surgery
  • 2003
  • Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 97:4, s. 317-322
  • Tidskriftsartikel (refereegranskat)abstract
    • The objective of this study was to describe the pulmonary function and pain 4 months after coronary artery bypass graft surgery. Twenty-five male patients performed pulmonary function tests before surgery, on the 4th postoperative day and 4 months after surgery. A severe reduction in pulmonary function was present after surgery. Four months postoperatively, the patients still showed a significant decrease (6-13% of preoperative values) in vital capacity (P<0.001), inspiratory capacity (P<0.001), forced expiratory volume in 1 s (P<0.001) peak expiratory flow rate (P<0.001), functional residual capacity (P=0.05) total lung capacity (P<0.001) and single-breath carbon monoxide diffusing capacity (P<0.01). Residual volume and single-breath carbon monoxide diffusing capacity per litre of alveolar volume had returned to the preoperative level. Four months postoperatively, the median values for sternotomy pain while taking a deep breath was 0.2 and while coughing 0.3 on a 10 cm visual analogue pain scale. In conclusion, a significant restrictive pulmonary impairment persisting up to 4 months into the postoperative period was found after CABG. Measured levels of pain were low and could not explain the impairment.
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4.
  • Westerdahl, Elisabeth, 1964-, et al. (författare)
  • The immediate effects of deep breathing exercises on atelectasis and oxygenation after cardiac surgery
  • 2003
  • Ingår i: Scandinavian Cardiovascular Journal. - : Informa UK Limited. - 1401-7431 .- 1651-2006. ; 37:6, s. 363-367
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: To investigate the effects of deep breathing performed on the second postoperative day after coronary artery bypass graft surgery.Design: The immediate effects of 30 deep breaths performed without a mechanical device (n = 21), with a blow bottle device (n = 20) and with an inspiratory resistance-positive expiratory pressure mask (n = 20) were studied. Spiral computed tomography and arterial blood gas analyses were performed immediately before and after the intervention.Results: Deep breathing caused a significant decrease in atelectatic area from 12.3 +/- 7.3% to 10.2 +/- 6.7% (p < 0.0001) of total lung area 1 cm above the diaphragm and from 3.9 +/- 3.5% to 3.3 +/- 3.1% (p < 0.05) 5 cm above the diaphragm. No difference between the breathing techniques was found. The aerated lung area increased by 5% (p < 0.001). The PaO (2) increased by 0.2 kPa (p < 0.05), while PaCO (2) was unchanged in the three groups.Conclusion: A significant decrease of atelectatic area, increase in aerated lung area and a small increase in PaO (2) were found after performance of 30 deep breaths. No difference between the three breathing techniques was found.
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5.
  • Westerdahl, Elisabeth, 1964-, et al. (författare)
  • Chest physiotherapy after coronary artery bypass graft surgery : a comparison of three different deep breathing techniques
  • 2001
  • Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 33:2, s. 79-84
  • Tidskriftsartikel (refereegranskat)abstract
    • The effectiveness of three deep breathing techniques was evaluated in 98 male patients after coronary artery bypass graft surgery in a randomized trial. The techniques examined were deep breathing with a blow bottle-device, an inspiratory resistance-positive expiratory pressure mask (IR-PEP) and performed with no mechanical device. Pulmonary function and roentgenological changes were evaluated. Four days post-operatively there were significantly decreased vital capacity, inspiratory capacity, forced expiratory volume in 1 second, functional residual capacity, total lung capacity and single-breath carbon monoxide diffusing capacity in all three groups (p < 0.0001). No major differences between the treatment groups were found, but the impairment in pulmonary function tended to be less marked using the blow bottle technique. The Blow bottle group had significantly less reduction in total lung capacity (p = 0.01) compared to the Deep breathing group, while the IR-PEP group did not significantly differ from the other two groups.
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