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首页> 外文期刊>Physiotherapy theory and practice >Influence of posture on the ventilatory pattern and the thoraco-abdominal kinematics of patients with chronic obstructive pulmonary disease (COPD)
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Influence of posture on the ventilatory pattern and the thoraco-abdominal kinematics of patients with chronic obstructive pulmonary disease (COPD)

机译：姿势对慢性阻塞性肺疾病（COPD）患者通气模式和胸腹运动学的影响

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Objective: Evaluate the influence of posture on ventilatory pattern, compartmental distribution of volume of chest wall and thoraco-abdominal kinematics of patients with severe chronic obstructive pulmonary disease (COPD). Design: Cross-sectional study. Methods: Twelve, male patients with severe COPD (Forced Expiratory Volume in the first second (FEV1) = 24.35 ± 4.52%, Forced Vital Capacity% (FVC%) = 60 ± 13.39% and relationship FEV1/FVC = 53.42 ± 14.47). The distribution of the volume of the ribcage [pulmonary rib cage (Rcp), abdominal ribcage (Rca) and abdomen (Ab)] during quiet breathing in a sitting position without back support (SWB), sitting with backrest (SB) and supine position (SUP) was determined using an opto-electronic plethysmograph. Results: The following differences were observed: a greater tidal volume in the SWB position when compared to the SB position (p = 0.01); greater expiratory time in the SUP position in relation to the SWB (p = 0.03) and SB (p = 0.01); and increased abdominal contribution to the tidal volume in the SUP position in relation to the SWB (p < 0.01) and SB (p < 0.001). No difference was found in the thoraco-abdominal synchrony among the positions. Conclusion: Sitting position without back support enhances the activation of respiratory muscles by increasing the tidal volume and supine position seems to favor lung deflation by increasing the expiratory time. It seems appropriate to adopt these positions to optimize the ventilation/perfusion relationship and physiotherapeutic intervention in different clinical conditions.
机译：目的：评估姿势对重度慢性阻塞性肺疾病（COPD）患者的通气模式，胸壁容积的空间分布和胸腹运动的影响。设计：横断面研究。方法：十二名患有严重COPD的男性患者（第一秒强迫呼气量（FEV1）= 24.35±4.52％，强迫肺活量％（FVC％）= 60±13.39％，关系FEV1 / FVC = 53.42±14.47）。安静呼吸时在没有靠背（SWB），有靠背（SB）和仰卧位坐姿的安静呼吸过程中胸腔[肺肋腔（Rcp），腹腔胸腔腔（Rca）和腹部（Ab）]的容积分布（SUP）使用光电体积描记器确定。结果：观察到以下差异：与SB位置相比，SWB位置的潮气量更大（p = 0.01）;相对于SWB（p = 0.03）和SB（p = 0.01），SUP位置的呼气时间更长;相对于SWB（p <0.01）和SB（p <0.001），腹部在SUP位置对潮气量的贡献增加。各部位胸腹同步性无差异。结论：无靠背的坐姿可通过增加潮气量来增强呼吸肌的激活，而仰卧位似乎可通过增加呼气时间来促进肺通气。在不同的临床情况下，采用这些姿势来优化通气/灌注关系和理疗干预似乎是合适的。

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