The effect of posture on asynchronous chest wall movement in COPD

The effect of posture on asynchronous chest wall movement in COPD

Autor Priori, Rita Google Scholar
Aliverti, Andrea Google Scholar
Albuquerque, Andre L. Autor UNIFESP Google Scholar
Quaranta, Marco Google Scholar
Albert, Paul Google Scholar
Calverley, Peter M. A. Google Scholar
Instituição Politecn Milan
Universidade Federal de São Paulo (UNIFESP)
Univ Liverpool
Resumo Priori R, Aliverti A, Albuquerque AL, Quaranta M, Albert P, Calverley PM. the effect of posture on asynchronous chest wall movement in COPD. J Appl Physiol 114: 1066-1075, 2013. First published February 14, 2013; doi:10.1152/japplphysiol.00414.2012.-Chronic obstructive pulmonary disease (COPD) patients often show asynchronous movement of the lower rib cage during spontaneous quiet breathing and exercise. We speculated that varying body position from seated to supine would influence rib cage asynchrony by changing the configuration of the respiratory muscles. Twenty-three severe COPD patients (forced expiratory volume in 1 s = 32.5 +/- 7.0% predicted) and 12 healthy age-matched controls were studied. Measurements of the phase shift between upper and lower rib cage and between upper rib cage and abdomen were performed with opto-electronic plethysmography during quiet breathing in the seated and supine position. Changes in diaphragm zone of apposition were measured by ultrasounds. Control subjects showed no compartmental asynchronous movement, whether seated or supine. in 13 COPD patients, rib cage asynchrony was noticed in the seated posture. This asynchrony disappeared in the supine posture. in COPD, upper rib cage and abdomen were synchronous when seated, but a strong asynchrony was found in supine. the relationships between changes in diaphragm zone of apposition and volume variations of chest wall compartments supported these findings. Rib cage paradox was noticed in approximately one-half of the COPD patients while seated, but was not related to impaired diaphragm motion. in the supine posture, the rib cage paradox disappeared, suggesting that, in this posture, diaphragm mechanics improves. in conclusion, changing body position induces important differences in the chest wall behavior in COPD patients.
Palavra-chave chronic obstructive pulmonary disease
chest wall asynchrony
body posture
diaphragm movement
Idioma Inglês
Data de publicação 2013-04-01
Publicado em Journal of Applied Physiology. Bethesda: Amer Physiological Soc, v. 114, n. 8, p. 1066-1075, 2013.
ISSN 8750-7587 (Sherpa/Romeo, fator de impacto)
Publicador Amer Physiological Soc
Extensão 1066-1075
Fonte http://dx.doi.org/10.1152/japplphysiol.00414.2012
Direito de acesso Acesso aberto Open Access
Tipo Artigo
Web of Science WOS:000317714000013
Endereço permanente http://repositorio.unifesp.br/handle/11600/36124

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