the check of pulmonary function is used to estimate an individual s fitness and athletes 
 performance1 , 2 .
spirometry is a generally used method for evaluating pulmonary 
 function in the same way that blood pressure provides important information about general 
 cardiovascular health1,2,3 .
meanwhile , sports injury of 
 the chest is closely related to maintenance of athletes performance and health1 , 4 . in 
 particular ,
chest injuries such as rib stress fracture and thoracic chance fracture are 
 directly or indirectly associated with swimmer , rodeo athlete , wrestler , and rower5,6,7,8 . 

therefore , respiratory physiotherapy is an important method in patients with respiratory 
 dysfunction by sports injury1 , 2 .
regular exercise may increase the strength and endurance of 
 breathing and blood circulation11 . 

respiratory rehabilitation from exercise training , along 
 with a wide range of education and behavior change interventions , can be used to improve the 
 physical and mental state of the people . on the other hand , respiratory function
can be 
 damaged when the strength of respiratory muscles decreases with comorbidity and loss of 
 mobility14 .
taekwondo is devised to 
 improve the quality of spirit and life through the training of body and mind .
the poomsae is the style of conduct that expresses mental and physical refinements directly 
 or indirectly , as well as the principles of offense and defense resulting from the 
 cultivation of the taekwondo spirit and techniques16 .
the poomsae is a series of movements for offense and defense 
 techniques that can be practiced and trained , even without the presence of an instructor , in 
 accordance with fixed patterns .
taekwondo combines agility , strength , speed , balance , 
 flexibility , coordination , and stamina , which are all important attributes required for a 
 taekwondo athlete to be able to execute the highly demanding kicking combinations17 , 18 .
although a measure of the 
 respiratory of taekwondo was performed in the previous study , there was no respirogram 
 analysis .
therefore , the purpose of the present study is to analyze and compare the 
 respiratory function of taekwondo poomsae athletes and nonathletes .
the present study consisted of thirteen taekwondo poomsae athletes and ninety - five 
 nonathletes .
one hundred 
 and eight volunteers who had no abnormal physical or psychological conditions provided 
 written informed consent to participation in this study1 .
participants were asked to complete a questionnaire via individual 
 in - depth interviews , which took 30 minutes per person1 , 2 .
the criteria for the 
 inclusion of participants in the study were as follows : ( 1 ) 1922  years of age , ( 2 ) male , 
 ( 3 ) history of respiratory disease , ( 4 ) experience of stress during exercise , ( 5 ) 
 psychological factors , ( 6 ) history of injuries , and ( 7 ) primary technology used . before 
 measurement , all participants rested for 30 minutes1 , 
 2 , 4 .
we measured chest and abdominal circumference at rest , inspiratory , 
 and expiratory conditions .
chest circumference was measured from axillary height , and 
 abdominal circumference was measured from navel height .
thigh circumference was measured at 1/3 the height below the 
 straight line that connects the patella center from anterior superior iliac spine ( asis ) , 
 the calf circumference was measured at 1/3 the height above and below the straight line 
 connecting the lateral malleolus at the fibular head1 .
spirometric parameters , including forced vital capacity 
 ( fvc ) , forced expiratory volume in 1 second ( fev1 ) , fev1/fvc , peak expiratory flow ( pef ) , 
 peak inspiratory flow ( pif ) , slow vital capacity ( svc ) , inspiratory reserve volume ( irv ) , 
 expiratory reserve volume ( erv ) , tidal volume ( tv ) , maximum voluntary ventilation ( mvv ) , 
 minute or expired ventilation ( mv ) , and respiratory rate ( rr ) were recorded and analyzed by 
 methods of resting breathing and forced breathing .
measurement was focused on the fvc graph , 
 which was divided into the expiratory area ( exa ) and the inspiratory area ( insa)1,2,3 .
analogously , 
 the insa was divided into c and d sections based on the pif .
each a , b , c , and d section was 
 further subdivided to four areas ( fig .
1.differences in fvc and respirogram phase between the tkdp athletes and 
 nonathletes . area and slope of the fvc and respiratory parameters were determined , as described in 
 the subjects and methods section .
fvc : forced vital capacity ; as13 : first , second , 
 and third slopes of the a area ; bs13 : first , second , and third slopes of the b area ; 
 cs13 : first , second , and third slopes of the c area ; ds13 : first , second , and third 
 slopes of the d area ; exa : expiratory area ; insa : inspiratory area ; tkdp athletes : 
 taekwondo poomsae athletes ) . from left to right , the connections between each of the divided points of the a 
 area were designated as the first slope ( as1 ) , the second slope ( as2 ) , and the third slope 
 ( as3 ) . correspondingly , from left to right , the first , second , and third slopes defining the 
 b area were designated bs1 , bs2 , and bs3 , respectively ; the first , second , and third slopes 
 defining the c area were designated cs1 , cs2 , and cs3 , respectively ; and the first , second , 
 and third slopes defining the d area were designated ds1 , ds2 , and ds3 , respectively ( fig .
1a)1,2,3 . 
 after creating these subdivisions , the tangent and angle of each point were measured .
the 
 angle of each point and the respiratory area of the fvc were each measured in triplicate at 
 each measurement time , and the mean values were calculated1 , 2 .
the significance level was set to =0.05 , and all data are presented as the mean  standard 
 error ( se ) of the measurements .
the protocol for this study was approved by the 
 committee of ethics in research of yongin university in accordance with the terms of 
 resolution 5 - 1 - 20 .
differences in fvc and respirogram phase between the tkdp athletes and 
 nonathletes . area and slope of the fvc and respiratory parameters were determined , as described in 
 the subjects and methods section .
fvc : forced vital capacity ; as13 : first , second , 
 and third slopes of the a area ; bs13 : first , second , and third slopes of the b area ; 
 cs13 : first , second , and third slopes of the c area ; ds13 : first , second , and third 
 slopes of the d area ; exa : expiratory area ; insa : inspiratory area ; tkdp athletes : 
 taekwondo poomsae athletes
table 1table 1.general characteristics of the participantsnonathletestkdp athletesage ( yrs)24.9  2.820.6  0.9height ( cm)/weight ( kg)174.1  4.7/75.9  10.1171.9  5.5/65.5  7.4bmi ( kg / m)24.9  2.822.2  1.9career ( yrs)-9.5  3.0training frequency-1/day ( 5/week)training time-1.8  0.2 h / day ( 9.0  1.0 h / week)aerobic exercise-1.0  0.1 h / day ( 5.0  0.5 h / week)anaerobic exercise-0.6  0.1 h / day ( 3.0  0.5 h / week)ches cir ( cm)rest96.1  6.392.9  5.1exp / insp94.0  6.5/100.3  6.191.4  5.0/97.7  5.4der / dir1.6  1.4/3.3  2.21.6  1.4/4.7  1.2abd cir ( cm)rest86.8  7.580.3  5.5exp / insp84.5  8.0/89.4  7.975.8  5.6/82.6  5.8der / dir2.1  2.0/2.2  1.84.6  2.1/2.3
2.4/53.9  2.4calf cir ( cm)above 1/3 rt / lt39.5  1.2/39.8  1.339.0  1.6/38.7  1.9below 1/3 rt / lt25.9  1.8/26.1  1.524.0  1.8/523.5 
tkdp athletes : taekwondo poomsae athletes ; 
 bmi : body mass index ; ches cir : chest circumference ; abd cir : abdominal circumference ; 
 thigh cir : thigh circumference ; calf cir : calf circumference ; exp : expiration ; insp : 
 inspiration ; der : differences between expiration and rest ; dir : differences between 
 inspiration and rest ; rt : right ; lt : left . * significantly different from nonathletes , 
 p<0.05 shows the general characteristics of the taekwondo poomsae athletes compared 
 with those of the nonathletes .
chest , abdominal , thigh , and calf circumferences in 
 nonathletes and tkdp athletes were compared .
all measured values for nonathletes were 
 larger , most significantly in the case of abdominal circumference ( table 1 ) .
spirometry parameters in the tkdp athletes group were 
 higher than in the nonathletes ( table 
 2table 2.differences in respiratory function between the nonathletes and tkdp 
 athletesvariablenonathletestkdp athletesfvc ( l)4.9  0.54.6  0.6fev1.0 ( l)4.1  0.44.1  0.5fev1.0/fvc ( % ) 84.1  6.189.7  6.5pef ( l / s)/pif ( l / s)9.2  1.4/6.4  1.210.1  1.1/7.9  1.6svc ( l)4.8  0.64.7  0.6erv ( l)/irv ( l)1.5  0.4/2.4  0.61.5  0.4/2.3  0.6tv ( l)0.7  0.31.0  0.5mvv ( l / min)161.5  30.5168.8  28.7rr ( l / min)/tv ( l / min)94.5  17.9/1.7  0.4120.9  18.2/1.4  0.3mv ( l / min)12.8  6.017.8  7.5rr ( l / min)/tv ( l / min)27.1  6.8/0.5  0.324.2  5.7/0.7 
tkdp athletes : taekwondo poomsae athletes ; 
 fvc : forced vital capacity ; fev1.0 : forced expiratory volume in one second ; 
 fev1.0/fvc : fev1.0/fvc ratio , pef : peak expiratory flow ; pif : peak inspiratory flow ; 
 svc : slow vital capacity ; irv : inspiratory reserve volume ; erv : expiratory reserve 
 volume ; tv : tidal volume ; mvv : maximum voluntary ventilation ; mv : minute ventilation ; 
 rr : respiratory rate . * significantly different from nonathletes , p<0.05 ) .
in particular , the fev1.0/fvc ratio showed significant differences between 
 the two groups of participants ( table 2 ) . in 
 respirogram phasic analysis ,
the inspiratory area of forced vital capacity were 
 significantly increased in the tkdp athletes compared with the nonathletes ( fig .
1b , table 
 3table 3.differences in respirogram phases of forced vital capacity between the 
 nonathletes and tkdp athletesvariablenonathletestkdp athletesafvcexa22,309.6  4,630.220,017.8  4,096.8insa23,728.6  6,598.025,184.5  3,470.4total46,038.3  9,559.745,202.3  5,958.4sfvcas1/as2/as310.3  3.1/5.6  2.4/1.9  1.012.4  2.8/7.7  1.5/2.7  
 1.6bs1/bs2/bs31.4  0.8/1.4  0.6/1.4  0.51.5  0.7/1.4  0.5/1.2  0.3cs1/cs2/cs32.7  1.7/0.5  4.4/0.5  0.43.5  3.0/1.3  1.1/0.7  0.5ds1/ds2/ds30.3  0.3/0.7  0.5/1.7  1.10.4  0.5/0.9  0.5/2.5  0.8all data are presented as the mean  se .
tkdp athletes , taekwondo poomsae athletes ; 
 afvc : area of forced vital capacity ; exa : expiratory area ; insa : inspiratory area ; 
 total , total area ; sfvc : slope of forced vital capacity ; as1 : first slope of the a 
 area ; as2 : second slope of the a area ; as3 : third slope of the a area ; bs1 : first 
 slope of the b area ; bs2 : second slope of the b area ; bs3 : third slope of the b area ; 
 cs1 : first slope of the c area ; cs2 : second slope of the c area ; cs3
: third slope of 
 the c area ; ds1 : first slope of the d area ; ds2 : second slope of the d area ; ds3 : 
 third slope of the d area .
the slopes of the forced vital capacity for tkdp athletes at slopes 1 , 2 , 
 and 3 of the a area were significantly higher than in the nonathletes ( fig .
, chest circumference was significantly correlated with slope 1 of the a 
 area of the forced vital capacity ( table 
 4table 4.correlation coefficients of the circumference and forced vital capacityvariablechest circumferenceabdominal circumferencerestexpinspderdirrestexpinspderdirafvcexa0.0530.0350.0350.1220.0850.0200.0190.0450.0000.177insa0.0910.0940.0660.0170.1190.0110.0140.0030.0160.055total0.0360.0470.0280.0730.0390.0020.0000.0210.0110.126sfvcas10.2390.2360.2400.0270.0030.0410.0060.0390.1590.008as20.1540.1500.1710.0360.0700.0240.0030.0080.1210.104as30.0130.0320.0220.1250.0370.0880.0860.1000.0150.099bs10.0060.0090.0120.0230.0290.0200.0250.0190.0250.008bs20.0860.0690.0620.1120.1140.0220.0300.0080.0450.086bs30.0470.0770.0040.1980.1990.0400.0290.0450.0420.040cs10.0260.0230.0160.0220.0470.0690.0710.0920.0250.168cs20.0390.0160.0290.1530.0470.0820.0970.0890.0880.059cs30.1460.1180.1360.1950.0540.1980.2020.1830.0640.070ds10.0840.0790.0830.0330.0060.0420.0300.0300.0490.077ds20.0850.0690.0840.1110.0080.0070.0240.0160.1470.156ds30.0760.0600.0790.1090.0110.0380.0660.0600.1450.159afvc : area of forced vital capacity ; sfvc : slope of forced vital capacity ; exp : 
 expiration condition ; insp : inspiration condition ; der : differences between expiration 
 and rest ; dir : differences between inspiration and rest ; as13 : first , second , and 
 third slopes of the a area ; bs13 : first , second , and third slopes of the b area ; 
 cs13 : first , second , and third slopes of the c area ; ds13 : first , second , and third 
 slopes of the d area .
tkdp athletes : taekwondo poomsae athletes ; 
 bmi : body mass index ; ches cir : chest circumference ; abd cir : abdominal circumference ; 
 thigh cir : thigh circumference ; calf cir : calf circumference ; exp : expiration ; insp : 
 inspiration ; der : differences between expiration and rest ; dir : differences between 
 inspiration and rest ; rt : right ; lt : left .
* significantly different from nonathletes , 
 p<0.05 all data are presented as the mean  se .
tkdp athletes : taekwondo poomsae athletes ; 
 fvc : forced vital capacity ; fev1.0 : forced expiratory volume in one second ; 
 fev1.0/fvc : fev1.0/fvc ratio , pef : peak expiratory flow ; pif : peak inspiratory flow ; 
 svc : slow vital capacity ; irv : inspiratory reserve volume ; erv : expiratory reserve 
 volume ; tv : tidal volume ; mvv : maximum voluntary ventilation ; mv : minute ventilation ; 
 rr : respiratory rate . * significantly different from nonathletes , p<0.05 all data are presented as the mean  se .
tkdp athletes , taekwondo poomsae athletes ; 
 afvc : area of forced vital capacity ; exa : expiratory area ; insa : inspiratory area ; 
 total , total area ; sfvc : slope of forced vital capacity ; as1 : first slope of the a 
 area ; as2 : second slope of the a area ; as3 : third slope of the a area ; bs1 : first 
 slope of the b area ;
bs2 : second slope of the b area ; bs3 : third slope of the b area ; 
 cs1 : first slope of the c area ; cs2 : second slope of the c area ; cs3 : third slope of 
 the c area ; ds1 : first slope of the d area ; ds2 : second slope of the d area ; ds3 : 
 third slope of the d area .
* significantly different from nonathletes , p<0.05 afvc : area of forced vital capacity ; sfvc : slope of forced vital capacity ; exp : 
 expiration condition ; insp : inspiration condition ; der : differences between expiration 
 and rest ; dir : differences between inspiration and rest ; as13 : first , second , and 
 third slopes of the a area ; bs13 : first , second , and third slopes of the b area ; 
 cs13 : first , second , and third slopes of the c area ; ds13 : first , second , and third 
 slopes of the d area .
respiratory physiotherapy is an important way to improve respiratory function in patients 
 including taekwondo players with respiratory dysfunction caused by genetically determined 
 neuropathy , obstructive pulmonary disease , asthma , rib fracture , and others1,2,3 , 8 . 

this function is impacted by items unrelated to level of physical activity , including weight 
 and height19 . however , in the present 
 study , circumference of the chest and abdomen are also greater for nonathletes than tkdp 
 athletes . in particular ,
abdominal circumference is significantly greater because tkdp 
 athletes tend to be slim19 . for tkdp 
 athletes
, there was a larger number of pixel of insa on the fvc graph than there were for 
 nonathletes .
furthermore , in the previous study , the height and weight were observed to 
 influence the spirometry results20 .
we 
 know via our data that the weight was smaller for tkdp athletes than for the nonathletes . in 
 addition , the values for as1 , as2 , and as3 appear to be significantly greater for tkdp 
 athletes .
these results can be expected because of the larger number of certain muscle 
 fibers in tkdp athletes as compared to nonathletes . although the tkdp athletes physiques 
 were small compared to those of the nonathletes , the values in the 
a area were larger for 
 the athletes because a higher proportion of type ii muscle fibers .
therefore , a sudden increase in the  a area of the first 
 expiratory graph of tkdp athletes is to be expected as a result of the type ii muscle 
 fibers influence .
the development of type ii muscle fibers in tkdp athletes is believed to 
 be related to their training and exercise , and therefore can be expected to be associated 
 with the fev1.0/fvc ratio .
the fev1.0/fvc ratio shows the forced expiratory volume of air 
 per second as a percentage of the forced vital capacity , which means it is22 .
the importance of fev1.0 is that 
 respiratory symptoms and impaired lung function are indicated by reduction in fev1.0 .
these 
 symptoms , in turn , are well - described predictors of coronary artery disease , ventricular 
 arrhythmias , and cardiovascular mortality23 , 24 . statistical significance appeared in the 
 differences between the fev1.0/fvc values for tkdp athletes and nonathletes .
therefore , the 
 respirogram analysis in our study revealed not only the respiration capacity of tkdp 
 athletes as compared to nonathletes , but also the type of the muscle - fiber development that 
 can be expected . however , further systematic and scientific studies in the area of healthy 
 science and sports physiotherapy are needed25 , 26 .
 [ purpose ] respiratory physiotherapy is an effective approach to improving lung function 
 in patient , including athletes with respiratory dysfunction caused by sports injury . 
 the 
 purpose of this study was to analyze the differences in the respirograms between taekwondo 
 poomsae athletes and nonathletes according to the respirogram phase . 
 [ subjects and 
 methods ] respiratory measurements for 13 elite taekwondo poomsae athletes were obtained . 
 
 respiratory function was measured using spirometry while the participant was seated . 
 
 [ results ] in respirogram phasic analysis , the inspiratory area of forced vital capacity 
 were significantly increased in the athletes than in the nonathletes . 
 the slopes of the 
 forced vital capacity for athletes at slopes 1 , 2 , and 3 of the a area were significantly 
 higher than those for the nonathletes . 
 in correlation analysis , chest circumference was 
 significantly correlated with slope 1 of the a area of the forced vital capacity . 
 
 [ conclusion ] results indicate that differences in respirogram phasic changes between 
 athletes and nonathletes may contribute to better understanding of respiratory function , 
 which is important to sports physiotherapy research . 
INTRODUCTION
SUBJECTS AND METHODS
RESULTS
DISCUSSION