Inspiratory pressure load training management device and system

Abstract

Provided is a training management device for expiratory pressure load to alleviate tachypnea in COPD patients and improve exercise ability and physical mobility. The device is a training management device for users with COPD. The device includes an expiratory information input unit for inputting expiratory information related to the ratio T EX of the inhalation or exhalation time to one breath time during maximum exercise obtained by performing an exercise load cardiopulmonary function examination (CPET) on the user, and the ratio T RE of the inhalation or exhalation time to one breath time at rest obtained by the examination, and a user determination unit that calculates the difference between T EX and T RE to determine whether there is expiratory prolongation during exercise in the user, a menu presentation unit that presents a menu for expiratory pressure load training based on the maximum expiratory pressure value for a user with expiratory prolongation during exercise, and a training result presentation unit that inputs expiratory information and information related to exercise ability after a predetermined number of expiratory pressure load trainings, determines whether there is an improvement effect on the exercise ability of the target user, and presents the training result.

Description

Technical Field

[0001] The present invention relates to a technology for managing expiratory pressure load training that helps improve rapid and shallow breathing in patients with Chronic Obstructive Pulmonary Disease (COPD). Background Art

[0002] COPD is a lifestyle disease caused by long-term exposure to harmful substances such as cigarette smoke, resulting in persistent inflammation of the lungs and a decline in respiratory function. According to the statistics of the World Health Organization (WHO) in 2018, COPD ranks third among the causes of global death, and 65 million people worldwide suffer from moderate or severe COPD. According to the NICE study (published in 2001), an epidemiological research report conducted by Mr. Fukuchi et al. of the School of Medicine, Juntendo University, approximately 5.3 million people in Japan suffer from COPD. Recently, with the soaring social security subsidies and national medical expenses, medical, economic, and social countermeasures for COPD have become a top priority. Improving the shortness of breath, which is the most frequent complaint among COPD patients, is an urgent task. Without reducing rapid and shallow breathing, it is impossible to improve exercise ability and physical activity.

[0003] β2-agonists and anticholinergics are the mainstream long-acting inhaled drugs known to be prescribed for relieving COPD symptoms. Currently, in addition to many other drugs, non-drug therapies such as respiratory rehabilitation can also be used, but the fact is that there is still no treatment strategy for COPD. In order to improve rapid and shallow breathing, appropriate measures need to be taken based on an understanding of the diverse pathophysiology of COPD.

[0004] In view of the aging society, the inventor believes that it is more necessary to provide opportunities for respiratory rehabilitation training, nutritional therapy, and exercises such as walking that cannot be provided in daily medical care. The inventor is a professional doctor in the respiratory system and has many opportunities to contact COPD patients. The actual experience of COPD patients is that "when they are tired from exercise, it is easier to exhale deeply rather than breathe with their mouths closed, and there are such moments of ease." For the inventor, it is difficult to understand based on the traditional medical knowledge that recommends closed-mouth breathing, which motivates the search for a method to improve shortness of breath.

[0005] The present inventor has intensively studied the relationship between the exercise ability of COPD patients, the timing of inhalation and exhalation, and the balance of respiratory muscles. As a result, it has been found that in a breathing pattern in which exhalation is prolonged and the respiratory rate cannot be increased (hereinafter also referred to as the "slow and shallow pattern" in this text), the expiratory muscle strength is insufficient and the exercise ability decreases. Previously, there has been no report on the usefulness of expiratory muscle training (EMT) for actual COPD patients. The present inventor believes that if the expiratory muscle strength is increased through EMT and sufficient exhalation is achieved, sufficient inhalation can be brought about, thereby promoting the improvement of shortness of breath or exercise ability (Non-Patent Document 1).

[0006] On the other hand, in a breathing pattern in which there is no prolonged exhalation and the respiratory rate is high (hereinafter also referred to as the "rapid and shallow pattern" in this text), although the exercise ability is maintained, shortness of breath occurs once breathing becomes frequent. In recent years, the effectiveness of inspiratory muscle training (IMT) has attracted increasing attention, but the effects are not always constant. The present inventor believes that in the case of a breathing pattern of the rapid and shallow pattern, if sufficient inhalation is achieved through IMT, it may promote the improvement of shortness of breath (the same as Non-Patent Document 1).

[0007]

Non-Patent Document 1

[0008] Technical Problem to be Solved by the Invention

[0009] As described above, the number of COPD patients is increasing. To solve this problem, it is necessary to widely popularize training that is useful for improving the most common shallow and rapid breathing, exercise ability, and physical activity of COPD patients.

[0010] However, the effects of the highly regarded inspiratory muscle training (IMT) are not always constant, and there is no report on the usefulness of expiratory muscle training (EMT) for actual COPD patients.

[0011] In view of the above, in order to relieve the tachypnea of COPD patients, improve exercise ability and physical activity, the object of the present invention is to provide an expiratory pressure load training management device, management system and management method useful for actual COPD patients.

[0012] Method for solving the problem

[0013] The present inventors conducted a clinical trial on the effectiveness of expiratory muscle training (EMT) for COPD patients, and based on the slow and shallow pattern that causes prolonged expiration and the shallow and fast pattern that does not cause prolonged expiration, performed expiratory muscle training (EMT) or inspiratory muscle training (IMT), and evaluated and confirmed their respective usefulness, thereby completing the present invention.

[0014] In order to achieve the above object, the expiratory pressure load training management device of the present invention is a training management device for users with chronic obstructive pulmonary disease (COPD), and includes the following units 1) to 4).

[0015] 1) An expiratory information input unit that inputs the time ratio T of inspiration or expiration with respect to one respiratory cycle during maximum exercise obtained by performing a cardiopulmonary exercise test (CPET) on the user EX and the time ratio T of inspiration or expiration with respect to one respiratory cycle at rest obtained by the examination RE related expiratory information.

[0016] 2) A user determination unit that calculates the difference between T EX and T RE and determines whether there is a user with prolonged expiration during exercise.

[0017] 3) A menu presentation unit that presents an expiratory pressure load training menu based on the maximum expiratory pressure value for users with prolonged expiration during exercise.

[0018] 4) After performing a predetermined number of expiratory pressure load trainings, input the expiratory information in 1) above and information related to exercise ability, determine whether there is an improvement effect on the exercise ability of the target user, and present a training result presentation unit for the training result.

[0019] According to the device configured as described above, for actual COPD patients, it is possible to relieve tachypnea, improve exercise ability and physical activity.

[0020] Here, the exercise load cardiopulmonary function examination (cardiopulmonary exercise test: CPET) is also called CPX examination. During the exercise load test using an exercise load device such as a treadmill or a bicycle ergometer (bicycle), and by using an exhaled gas analysis device to measure the oxygen concentration, carbon dioxide concentration, and ventilation volume in the exhaled gas in real time, an examination is conducted to measure indices such as the maximum oxygen uptake, which is an index of exercise ability. CPET is a useful examination for grasping the respective exercise pathophysiology of patients, and it can also measure the ventilation volume per inhalation and the ventilation volume per exhalation during each breath.

[0021] In addition, if the ratio of the inhalation time to the respiratory time per breath decreases, the exhalation time will be prolonged. As the respiratory information input to the respiratory information input unit, when T EX is the ratio of the inhalation time to the respiratory time per breath during maximum exercise, T RE is also obtained by examining the ratio of the inhalation time to the respiratory time per breath at rest. When T EX is the ratio of the exhalation time to the respiratory time per breath during maximum exercise, T RE is also obtained by examining the ratio of the exhalation time to the respiratory time per breath at rest. That is to say, when using the inhalation time ratio, for both T EX and T RE the inhalation time ratio is used in the same way. When using the exhalation time ratio, for both T EX and T RE the exhalation time ratio is used in the same way. Therefore, for example, when T EX is the ratio of the inhalation time to the respiratory time per breath during maximum exercise, T RE will not be obtained by examining the ratio of the exhalation time to the respiratory time per breath at rest.

[0022] Regarding the user determination unit, the difference between T EX and T RE is calculated. For example, if T EX and T RE are used as the ratio of the inhalation time, the value of T EX -T RE is calculated, and it is determined whether the difference value is negative. A user with a negative value is determined to be a user with prolonged exhalation during exercise. Then, the menu prompt unit provides a menu for expiratory pressure load training to the users determined to have prolonged exhalation during exercise and encourages the implementation of expiratory pressure load training.

[0023] In addition, regarding the user determination unit, the difference between T EX and T RE is calculated. For example, when T EX and T REWhen used as a ratio of the inhalation time, T is calculated. EX -T RE The value is calculated, and it is determined whether the difference value is positive. A user with a positive value is determined to be a user who does not have an extended exhalation during exercise. Then, the menu prompt unit provides a menu for inspiratory pressure load training to the user determined to not have an extended exhalation during exercise and encourages the implementation of inspiratory pressure load training.

[0024] In the expiratory pressure load training management device of the present invention, the expiratory pressure load training preferably uses an expiratory pressure load device with a one-way valve. The expiratory pressure load device has a function of opening the valve when the set pressure is reached and allowing exhaled air to flow in, thereby increasing the expiratory pressure.

[0025] Regarding the expiratory pressure load device, for example, EMST150 (manufactured by Aspire Products LLC) can be used. Currently, EMST150 is not sold in Japan and is only sold overseas.

[0026] The set pressure in the above-mentioned expiratory pressure load device can be set within a low-pressure setting range of 30 cmH2O or less, and training can start with an expiratory pressure load of 20 - 30% of the user's maximum expiratory pressure and gradually increase. As far as the present inventors know, existing expiratory pressure load devices cannot set the most appropriate pressure for COPD patients in Japan at least. In the case of EMST150, there is no low-pressure setting function of 30 cmH2O or less. In order to implement respiratory muscle training for expiratory pressure load training according to the pathophysiology for each user, a device that can be set at 30 cmH2O or less is preferred. In addition, by starting training with an expiratory pressure load of 20 - 30% of the user's maximum expiratory pressure, it is possible to minimize the aggravation of muscle pain or shallow breathing caused by respiratory muscle fatigue due to training.

[0027] Regarding expiratory pressure load training, even for the elderly, since it can be easily carried out at home and trained with a load pressure suitable for each individual user, it can minimize the aggravation of muscle pain or shallow breathing caused by respiratory muscle fatigue due to training, and does not impose an excessive burden on the user, enabling it to be continued.

[0028] In the expiratory pressure load training management device of the present invention, when the difference result calculated in the user determination unit is that there is no extended exhalation during exercise, a menu for inspiratory pressure load training is presented in the menu prompt unit.

[0029] Thus, targeted respiratory pressure load training for selecting EMT and IMT according to pathophysiology can be achieved.

[0030] The training menu in the menu presentation unit of the expiratory pressure load training management device of the present invention is preferably confirmed and approved by a respiratory specialist. The expiratory pressure load training participated by a respiratory specialist can provide a suitable training menu for users based on medical knowledge. Depending on the situation, when performing expiratory pressure load training, by using chest X-ray images, it is possible to confirm the flattening of the diaphragm and the possibility of ineffective ventilation due to insufficient exhalation causing air to block the lungs. The training frequency can be adjusted and the pressure can be set. In addition, in combination with the training, edible oils and the like can be used for the user as nutritional therapy.

[0031] Next, the expiratory pressure load training management system of the present invention will be described.

[0032] Regarding the expiratory pressure load training management system of the present invention, it is composed of the above-mentioned expiratory pressure load training management device of the present invention connected to a user terminal and a management server via a network. The user terminal and the management server share the functions of the expiratory pressure load training management device and are respectively connected via the network. Many users input information related to their expiratory information and exercise ability via their own user terminals, and a customized expiratory pressure load training menu is presented to them. Then, after inputting the expiratory information after training, the training results are presented.

[0033] Hereinafter, the functions of the user terminal and the management server will be described.

[0034] The user terminal has the following units 1a) to 1e).

[0035] 1a) An expiratory information input unit including the maximum expiratory pressure.

[0036] 1b) A sending unit that sends the input expiratory information to the management server.

[0037] 1c) A menu presentation unit that presents the expiratory pressure load training menu received from the management server.

[0038] 1d) A sending unit that inputs the expiratory information and information related to exercise ability after a predetermined number of expiratory pressure load trainings and sends them to the management server.

[0039] 1e) A training result presentation unit that presents the training results received from the management server.

[0040] The management server has the following units 2a) to 2d).

[0041] 2a) A receiving unit that receives the expiratory information from the user terminal.

[0042] 2b) A user determination unit that determines whether there is a user with an extended exhalation during exercise based on the result of calculating the difference of the received expiratory information.

[0043] 2c) A menu creation unit that creates a menu for expiratory pressure load training and sends it to the user terminal.

[0044] 2d) A training result generation unit that receives expiratory information and information related to exercise ability after a predetermined number of expiratory pressure load trainings from the user terminal, determines whether there is an improvement effect on the exercise ability of the user, generates a training result, and sends it to the user terminal.

[0045] The user terminal is preferably set in the home of a patient user, a training facility, or a medical clinic facility. Expiratory pressure load training can be simply carried out at home even by the elderly, or can be carried out in a gym. Therefore, the user terminal is set inside the user's residence, training facility, or medical clinic facility, and the management server that actually creates the training menu is centrally managed.

[0046] Next, the expiratory pressure load training management method of the present invention will be described.

[0047] The expiratory pressure load training management method of the present invention is a training management method for users with COPD, including the following steps a) to d).

[0048] a) An expiratory information input step of inputting the time ratio T of inhalation or exhalation to one breath time during maximum exercise of the user obtained by CPET EX and the time ratio T of inhalation or exhalation to one breath time at rest obtained by CPET RE related expiratory information.

[0049] b) A user determination step of calculating the difference between T EX and T RE to determine whether the user has an extended exhalation during exercise.

[0050] c) A menu presentation step of presenting a menu for expiratory pressure load training based on the maximum expiratory pressure to users with an extended exhalation during exercise.

[0051] d) A training result presentation step of inputting the expiratory information in a) above and information related to exercise ability after a predetermined number of expiratory pressure load trainings, determining whether there is an improvement effect on the exercise ability of the user, and presenting the training result.

[0052] In the expiratory pressure load training management method of the present invention, expiratory pressure load training uses an expiratory pressure load device with a one-way valve. When the expiratory pressure load device reaches the set pressure, the valve opens and exhaled air flows in. Here, the set pressure can be set within a low pressure setting range of 30 cmH2O or less, and training can start from an expiratory pressure load of 20-30% of the user's maximum expiratory pressure and gradually increase. In addition, when the result of the above difference calculated in the user determination step is that there is no expiratory prolongation during exercise, a menu for inspiratory pressure load training is presented in the menu presentation step. The training menu in the menu presentation step is preferably content confirmed and approved by a respiratory expert.

[0053] Next, the management program for the expiratory pressure load training of the present invention will be described.

[0054] The expiratory pressure load training management program of the present invention is a program for causing a computer to execute all unit functions provided in the user terminal in the above expiratory pressure load training management system.

[0055] From another perspective, the expiratory pressure load training management program of the present invention is a program for causing a computer to execute all unit functions provided in the management server in the above expiratory pressure load training management system.

[0056] From another perspective, the expiratory pressure load training management program of the present invention is a program for causing a computer to execute the expiratory information input step, user determination step, menu presentation step, and training result presentation step in the above expiratory pressure load training management method.

[0057] Advantages of the Invention

[0058] According to the present invention, for actual COPD patients, it has the effects of alleviating tachypnea, improving exercise ability and physical activity. Brief Description of the Drawings

[0059]

Figure 1

[0060]

Figure 2

[0061]

Figure 3

[0062]

Figure 4

[0063]

Figure 5

[0064]

Figure 6

[0065]

Figure 7

[0066]

Figure 8

[0067]

Figure 9

[0068] Hereinafter, an example of the implementation manner of the present invention will be described in detail with reference to the accompanying drawings. In addition, the scope of the present invention is not limited to the following examples or illustrated examples, and there may be other changes and modifications.

[0069]

Example 1

[0070] (Expiratory pressure load training management device)

[0071] Figure 1 The functional block diagram of the expiratory pressure load training management device of Example 1 is shown. As Figure 1 shown, the expiratory pressure load training management device 1 includes an expiratory information input unit 11, a user determination unit 12, a menu presentation unit 13, and a training result presentation unit 14. The expiratory information input unit 11 is a unit that inputs the time ratio T of inspiration or expiration of one breath at maximum exercise obtained through a cardiopulmonary exercise test (CPET) on the user EX , and the expiratory information related to the time ratio T of inspiration or expiration of one breath at rest obtained through the test RE . The user determination unit 12 determines whether the user has an extended expiration during exercise by calculating the difference between T EX and T RE . The menu presentation unit 13 presents a menu of expiratory pressure load training based on the maximum expiratory pressure value to the user determined to have an extended expiration during exercise by calculating the difference result. In addition, the training result presentation unit 14 is a unit that inputs the expiratory information after a predetermined number of trainings and the information related to the exercise ability, discriminates whether there is an improvement effect on the exercise ability of the user, and presents the training result.

[0072] Figure 2 The processing flow chart of the expiratory pressure load training management method is shown. As Figure 2As shown, first, the input is the time ratio T of inhalation or exhalation relative to one breath time during maximum exercise obtained by performing a cardiopulmonary exercise test (CPET) on the user EX and the time ratio T of inhalation or exhalation relative to one breath time at rest obtained by the examination RE related exhalation information (step S01: exhalation information input step). Then, calculate the difference between T EX and T RE to determine whether the user has an extended exhalation during exercise (step S02: user determination step).

[0073] Based on the calculated difference result, for the user determined to have an extended exhalation during exercise, a menu of expiratory pressure load training is presented based on the maximum expiratory pressure value (step S03: menu presentation step). Input the exhalation information and the information related to exercise ability after a predetermined number of trainings, determine whether there is an improvement effect on the exercise ability of the user, and present the training result (step S04: training result presentation step).

[0074] Based on the calculated difference result, for the user determined not to have an extended exhalation during exercise, a menu of inspiratory pressure load training is presented based on the maximum expiratory pressure value (step S05: menu presentation step). Input the exhalation information and the information related to exercise ability after a predetermined number of trainings, determine whether there is an improvement effect on the exercise ability of the user, and present the training result (step S06: training result presentation step).

[0075]

Example 2

[0076] (Expiratory Pressure Load Training Management System)

[0077] Figure 3 Schematically shows the functional block diagram of the expiratory pressure load training management system. As Figure 3 shown, the expiratory pressure load training management system 100 is composed of a user terminal 2 and a management server 3. The user terminal is provided with an exhalation information input unit 11, a menu presentation unit 13, a training result presentation unit 14, a sending unit 17a and a receiving unit 18a. The management server is provided with a user determination unit 12, a menu creation unit 15, a training result generation unit 16, a sending unit 17b and a receiving unit 18b.

[0078] The exhalation information input to the exhalation information input unit of the user terminal 2 is sent to the management server 3 by the sending unit 17a and received by the receiving unit 18b provided on the management server 3. The user determination unit 12 calculates the differential result based on the received exhalation information and determines whether the user has an extended exhalation. The menu creation unit 15 creates a menu for expiratory pressure load training or inspiratory pressure load training according to the maximum expiratory pressure value and sends it through the sending unit 17b. The sent menu information is received by the receiving unit 18a provided on the user terminal 2. The menu presentation unit 13 provided on the user terminal 2 presents the menu for expiratory pressure load training received from the management server 3.

[0079] The user terminal 2 inputs the exhalation information after a predetermined number of trainings and the information related to the exercise ability through the sending unit 17a and sends it to the management server 3. The management server 3 receives the exhalation information and the information related to the exercise ability from the user terminal 2 through the receiving unit 18b. The management server 3 determines whether there is an improvement effect on the exercise ability of the user based on the exhalation information after a predetermined number of trainings and the information related to the exercise ability through the training result generation unit 16, then generates a training result and sends it to the user terminal 2 through the sending unit 17b, and receives it through the receiving unit 18a provided on the user terminal 2. The user terminal 2 presents the training result received from the management server 3 through the training result presentation unit 14.

[0080] Figure 4 Schematically shows the configuration diagram of the expiratory pressure load training management system. As Figure 4 shown, the expiratory pressure load training management system 100 is composed of a smart phone 2a, a personal computer 2b and a management server 3, and the smart phone 2a, the personal computer 2b and the management server 3 are connected through the Internet 5. Here, although only the smart phone 2a and the personal computer 2b are shown as the user terminal 2, in fact, more user terminals 2 can be connected. The types of the user terminal 2 are not limited to smart phones or personal computers, and for example, they can also be tablet terminals or wearable terminals.

[0081] In the exercise load cardiopulmonary function examination device 4, although not shown, there are provided an exercise load device, an exhaled gas analysis device, etc., which can measure the oxygen concentration, carbon dioxide concentration and ventilation volume in the exhalation during exercise in real time, and can perform the determination examination of indexes such as the maximum oxygen uptake that can be used as an exercise ability index.

[0082] In this embodiment, the exercise load cardiopulmonary function examination device 4 and the smart phone 2a communicate through the wireless communication unit 6a, and the exercise load cardiopulmonary function examination device 4 and the personal computer 2b communicate through the wired communication tool 6b. However, the communication method is not limited to this. For example, the exercise load cardiopulmonary function examination device 4 and the smart phone 2a can also communicate through the wired communication tool 6b, and the exercise load cardiopulmonary function examination device 4 and the personal computer 2b can communicate through the wireless communication tool 6a.

[0083] In addition, the wireless communication tool 6a or the wired communication tool 6b may not be used. For example, it is also possible to confirm the values displayed on the display (not shown) provided on the exercise load cardiopulmonary function examination device 4 and then input them into the smart phone 2a or the personal computer 2b.

[0084]

Embodiment 3

[0085] The results of confirming the usefulness of the expiratory pressure load training management device of the present invention for 7 subject users of expiratory pressure load training and 9 subject users of inspiratory pressure load training will be described. Figure 5 (1) shows the ratio T of the inspiratory time to one breath obtained by CPET before the expiratory pressure training intervention, at maximum exercise. EX and the ratio T at rest. RE The difference T. In addition, Figure 5 (2) shows the expiratory residue volume (inspiratory V T in - expiratory V T ex) obtained by CPET before the expiratory pressure training intervention. Here, Figure 9 The "Ti / Ttot" shown in (1) is the ratio of the inspiratory time to one breath. Figure 9 The "V T in - V T ex" shown in (2) is the expiratory residue volume.

[0086] As Figure 5 shown in (1), users with an extended exhalation during exercise, that is, those with a negative difference T (at maximum exercise - at rest) (T - lower group), are subjects for expiratory pressure load training. On the other hand, patients with no extended exhalation, that is, those with a positive difference T (at maximum exercise - at rest) (T - increasing group), are subjects for inspiratory pressure load training.

[0087] As Figure 5 shown in (2), in the CPET performed by the subjects for expiratory pressure load training before the training intervention, the expiratory residue volume at maximum exercise, that is, the difference between the inspiratory volume per breath and the expiratory volume per breath (inspiratory V T in - expiratory V TeX) is significantly more than the inspiratory pressure load training subjects. That is, the expiratory pressure load training subjects (T low group) cannot completely exhale air during each breath, and air remains in the lungs, which is the cause of shallow and rapid breathing. Thus, it can be seen that how to exhale air is very important in this group. Therefore, if the expiratory pressure load training subjects (T low group) are subjected to expiratory pressure load training to obtain sufficient exhalation and thereby improve expiratory prolongation, it may be possible to improve exercise ability. On the other hand, since the inspiratory pressure load training subjects (T increase group) have the ability to exhale the air accumulated in the lungs during exercise, it is considered that even if the inspiratory ability is improved and the inspiratory volume is increased, the burden on exhalation is less. If sufficient ventilation volume is obtained through inspiratory pressure load training, it may be possible to improve exercise ability.

[0088] Figure 6 and Figure 7 Shows the evaluation results of the continuous exercise time under a stable load by continuously applying a certain load after 3 months of actual training. Figure 6 Are the improvement results of continuous exercise after expiratory pressure load training evaluated under a stable load (n = 7), Figure 7 Are the improvement results of continuous exercise after inspiratory pressure load training evaluated under a stable load (n = 9).

[0089] Figure 6 The improvement results of continuous exercise after the expiratory pressure load training shown. The average exercise time before training was 454 seconds (standard deviation 211 seconds), and the average exercise time after training was 764 seconds (standard deviation 313 seconds), confirming a significant improvement in continuous exercise time. In addition, Figure 7 The improvement results of continuous exercise after the inspiratory pressure load training shown. The average exercise time before training was 458 seconds (standard deviation 203 seconds), and the average exercise time after training was 799 seconds (standard deviation 495 seconds), which also confirmed a significant improvement in continuous exercise time. In particular, for the users who received expiratory pressure load training, although many users have already introduced sufficient inhalation drug treatment and many users have received respiratory rehabilitation training so far, significant improvement has been achieved, which is an interesting result.

[0090]

Example 4

[0091] (Case of actual COPD patients: Exercise time and shallow and rapid breathing were improved by expiratory pressure load training)

[0092] The case of actual COPD patients will be described. The patient is a 64-year-old male, 174 cm tall and 69 kg in weight, with no past medical history (such as asthma, etc.).

[0093] Regarding the medical history, as a patient with COPD, the patient was treated with three inhaled medications, namely a long-acting anticholinergic, a long-acting β-agonist, and an inhaled corticosteroid. However, due to shortness of breath during exercise, the patient could walk a maximum of about 200 meters on flat ground. Even with non-pharmacological therapies such as respiratory rehabilitation training, the effect was insufficient. Therefore, the patient participated in a clinical study that included expiratory pressure load training. In the evaluation before the respiratory pressure load training, with the above three inhaled medications, the patient's lung function showed a significant decline. The patient was diagnosed with a forced expiratory volume in 1 second (FEV1) of 0.89 L and a %FEV1 of 26.9%, and the stage of COPD was grade IV: very severe (the stage classification is divided into four types: I - IV). In addition, during exercise, the patient participated in a clinical study to determine whether to perform expiratory and inspiratory pressure load training based on the degree of expiratory prolongation. Through CPET with a dynamometer, the proportion of inspiratory time to one breath time during exercise was confirmed. As the exercise progressed, the proportion of inspiratory time decreased (expiratory time prolonged). Therefore, it can be inferred that insufficient exhalation is related to shallow and rapid breathing, and an expiratory pressure load training menu was presented.

[0094] The chest X-ray examination results showed that the diaphragm was flattened. It is possible that due to insufficient exhalation, air is blocked in the lungs, leading to an ineffective ventilation state.

[0095] The presented expiratory pressure load training is as follows.

[0096] Perform 30 times of expiratory pressure load training twice a day (in the morning and evening). For the first time, start from 20% of the maximum expiratory pressure and increase by 5% every two weeks. The goal is to reach 50% within three months. This case reached the 50% goal and completed the training.

[0097] The results are as follows. In the pulmonary function test, after three months of expiratory pressure load training, there was a slight improvement as shown in Table 1 below. In addition, in Table 1, FEV1 represents the forced expiratory volume in 1 second, and VC represents the vital capacity.

[0098]

Table 1

[0099] Lung function Before training After 3 months of training <![CDATA[FEV1, (L)]]> 0.89 0.93 <![CDATA[% FEV1, (%)]]> 26.9 28.1 VC, (L) 3.65 3.81

[0100] The load method of evaluating by increasing the load by 10 watts every two minutes, that is, the incremental load CPET. After the expiratory load training, by increasing the one-breath ventilation volume of exhalation, the minute ventilation volume increased. As a result, the oxygen uptake increased and the exercise ability was improved. When applying a steady-state load with 70% of the load obtained through incremental load, interestingly, there was a significant extension of the exercise time (refer to Table 2 below and Figure 8 ).

[0101] As Figure 8As shown, after expiratory pressure load training, although the tidal volume of one exhalation under a stable load decreased, and the tidal volume of one inhalation - tidal volume of one exhalation decreased. That is to say, sufficient breathing could be performed, and the ratio T of the inhalation time to the breathing time of one breath did not decrease during exercise, that is, the exhalation time did not extend, and the exercise ended. The results showed that the slope of the Borg dyspnea index, which represents the degree of shallow and rapid breathing during exercise, became slow, and the exercise time was extended by about 9 minutes, achieving amazing results. In addition, the Borg dyspnea index is divided into 0 - 10 levels, representing the degree of shallow and rapid breathing, and the maximum oxygen uptake representing exercise ability is calculated using the minute ventilation volume. Here, the minute ventilation volume is calculated based on the product of the tidal volume and the respiratory rate.

[0102]

Table 2

[0103] During maximum exercise Before training After training Tachypnea, Borg dyspnea index 8 7 Maximal oxygen uptake, ml / min 632 725 Minute ventilation, L / min 28.5 31.1 Tidal volume per breath, ml 1132 1193 Respiratory rate, / min 25 26

[0104] Industrial applicability

[0105] The present invention is useful for an expiratory pressure load training management device.

[0106] Explanation of symbols in the figure

[0107] 1 Expiratory pressure load training management device

[0108] 2 User terminal

[0109] 2a Smart phone

[0110] 2b PC personal computer

[0111] 3 Management service

[0112] 4 Exercise load cardiopulmonary function examination device

[0113] 5 Internet

[0114] 6a Wireless communication tool

[0115] 6b Wired communication tool

[0116] 11 Expiratory information input unit

[0117] 12 User determination unit

[0118] 13 Menu presentation unit

[0119] 14 Training result presentation unit

[0120] 15 Menu creation unit

[0121] 16 Training result generation unit

[0122] 17a, 17b transmitting units

[0123] 18a, 18b receiving units

Claims

1. An expiratory pressure load training management device, which is a training management device for users suffering from chronic obstructive pulmonary disease (COPD), is characterized in that including The exhalation information input unit inputs the time ratio T of inhalation relative to one breathing time during maximum exercise obtained by performing cardiopulmonary function test CPET on the user. EX , and the time ratio T of inspiration relative to one breathing time in a resting state obtained by the above examination RE Input relevant information; and A user determination unit calculates T based on the information input by the exhalation information input unit EX and T RE of the difference T EX -T RE , and determines users for whom the difference is negative and who have an extended exhalation during exercise, and users for whom the difference is positive and who do not have an extended exhalation during exercise; and a menu presentation unit that presents an expiratory pressure load training menu based on the maximum expiratory pressure value for a user with an extended exhalation during exercise, and presents an inspiratory pressure load training menu for a user determined to have no extended exhalation during exercise; and a training result presentation unit that inputs the information and the maximum oxygen uptake after a predetermined number of the trainings, determines whether there is an improvement effect on the exercise ability of the target user, and presents the training result.

2. The expiratory pressure load training management device according to claim 1, is characterized in that For the expiratory pressure load training, an expiratory pressure load device with a one-way valve is used, and the valve opens and exhaled air flows in when the set pressure is reached.

3. The expiratory pressure load training management device according to claim 2, is characterized in that The set pressure is set within a set range of 30 cmH2O or less, and the training starts with an expiratory pressure load of 20 - 30% of the user's maximum expiratory pressure value and gradually increases.

4. The expiratory pressure load training management device according to claim 1, is characterized in that The menu in the menu presentation unit is a menu confirmed and approved by a respiratory specialist doctor.

5. An expiratory pressure load training management system is composed of the expiratory pressure load training management device according to claim 1 connected to a user terminal and a management server via a network, wherein: The user terminal is equipped with The expiratory information input unit, and A sending unit that sends the input information to the management server, and A menu presentation unit that presents the menu of the expiratory pressure load training or the inspiratory pressure load training received from the management server, and A sending unit that inputs the information after the training for a predetermined number of times and the maximum oxygen uptake and sends them to the management server, and A training result presentation unit that presents the training result received from the management server; The management server is equipped with A receiving unit that receives the information and the maximum oxygen uptake from the user terminal, and A user determination unit that calculates the differential result based on the received information and determines users with a negative differential and expiratory prolongation during exercise, and users with a positive differential and no expiratory prolongation during exercise, and A menu creation unit that creates the menu of the expiratory pressure load training or the inspiratory pressure load training and sends it to the user terminal, and A training result generation unit that receives the information and the maximum oxygen uptake after the training has been performed a predetermined number of times from a user terminal, determines whether there is an improvement effect on the maximum oxygen uptake of the user, generates a training result, and sends it to the user terminal.

6. The expiratory pressure load training management system according to claim 5, characterized in that The user terminal is set in any one of the patient user's home, a training facility, or a medical clinic facility.

7. A storage medium for recording a program that causes a computer to execute all unit functions of the user terminal in the expiratory pressure load training management system according to claim 5.

8. A storage medium for recording a program that causes a computer to execute all unit functions of the management server in the expiratory pressure load training management system according to claim 5.

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