It is important to find the effective position for cough and sputum clearance in respiratory physical therapy. The purpose of this study was to compare the changes in peak expiratory flow (PEF), forced expiratory volume in 1 second (FEV1), and peak cough flow (PCF) related to functional level and measurement position in patients with Duchenne muscular dystrophy. Twenty one subjects were classified into three functional levels, and measurements was undertaken in three different measurement positions (upright sitting, 45˚ reclining and supine). Vitalograph PEF/FEV DIARY was used to measure PEF and FEV1, and Ferraris Pocket Peak was used to measure PCF. Mixed two-way analysis of variance and Bonferroni post-hoc test were used for statistical analysis. The results of the study were as follows: 1) Significant main effects for measurement position were found. 2) PEF was the highest in upright sitting, followed by 45˚ reclining, and supine in order. 3)FEV1 in upright sitting and 45˚ reclining were significantly greater compared with that in supine. 4) PCF in upright sitting and 45˚ reclining were significantly greater compared with that in supine. 5) No significant main effects for functional level were found in PEF, FEV1, and PCF. 6) No significant functional level by measurement position interactions were found in PEF, FEV1, and PCF. Therefore, it is concluded that upright sitting and 45˚ degree reclining positions are recommended for effective cough and sputum clearance.

The aim of this study was to investigate the effect of abdominal drawing-in maneuver (ADIM) on peak exploratory flow (PEF), forced exploratory volume in 1 second (FEV1), and low back pain during forced expiration. Twenty-two subjects (14 subjects in experimental group, 8 subjects in control group) participated in this study. The stabilizer was used for ADIM training for five consecutive days. Vitalograph PEF/FEV1 DIARY and visual analogue scale (VAS) were used to determine forced expiratory pulmonary function and low back pain, respectively. Independent t-test and analysis of covariance were used for statistical analysis with a significance level of .05. The findings of this study were as follows: 1) There were no significant differences of ADIM effect on PEF and FEV1 between experimental group and control group. 2) There was a significant pain reduction in experimental group with ADIM. 3) PEF and FEV1 increased significantly in the fifth day compared with the first day pre-exercise baseline. Therefore, it is concluded that ADIM was effective in improving PEF and FEV1, and reducing VAS during forced expiration in patients with chronic low back pain.