Sanna A, Bertoli F, Misuri G, Gigliotti F, Iandelli I, Mancini M, Duranti R, Ambrosino N, Scano G
Fondazione Don C. Gnocchi-ONLUS, UOF di Riabilitazione Respiratoria, Centro di S. Maria agli Ulivi, 50020 Pozzolatico (FI), Italy.
J Appl Physiol (1985). 1999 Sep;87(3):938-46. doi: 10.1152/jappl.1999.87.3.938.
We studied chest wall kinematics and respiratory muscle action in five untrained healthy men walking on a motor-driven treadmill at 2 and 4 miles/h with constant grade (0%). The chest wall volume (Vcw), assessed by using the ELITE system, was modeled as the sum of the volumes of the lung-apposed rib cage (Vrc,p), diaphragm-apposed rib cage (Vrc,a), and abdomen (Vab). Esophageal and gastric pressures were measured simultaneously. Velocity of shortening (V(di)) and power [Wdi = diaphragm pressure (Pdi) x V(di)] of the diaphragm were also calculated. During walking, the progressive increase in end-inspiratory Vcw (P < 0.05) resulted from an increase in end-inspiratory Vrc,p and Vrc,a (P < 0.01). The progressive decrease (P < 0.05) in end-expiratory Vcw was entirely due to the decrease in end-expiratory Vab (P < 0.01). The increase in Vrc,a was proportionally slightly greater than the increase in Vrc,p, consistent with minimal rib cage distortion (2.5 +/- 0.2% at 4 miles/h). The Vcw end-inspiratory increase and end-expiratory decrease were accounted for by inspiratory rib cage (RCM,i) and abdominal (ABM) muscle action, respectively. The pressure developed by RCM,i and ABM and Pdi progressively increased (P < 0.05) from rest to the highest workload. The increase in V(di), more than the increase in the change in Pdi, accounted for the increase in Wdi. In conclusion, we found that, in walking healthy humans, the increase in ventilatory demand was met by the recruitment of the inspiratory and expiratory reserve volume. ABM action accounted for the expiratory reserve volume recruitment. We have also shown that the diaphragm acts mainly as a flow generator. The rib cage distortion, although measurable, is minimized by the coordinated action of respiratory muscles.
我们研究了5名未经训练的健康男性在电动跑步机上以2英里/小时和4英里/小时的速度、恒定坡度(0%)行走时的胸壁运动学和呼吸肌活动。使用ELITE系统评估的胸壁容积(Vcw)被建模为与肺相邻的胸廓容积(Vrc,p)、与膈肌相邻的胸廓容积(Vrc,a)和腹部容积(Vab)之和。同时测量食管和胃内压力。还计算了膈肌的缩短速度(V(di))和功率[Wdi = 膈肌压力(Pdi)×V(di)]。行走过程中,吸气末Vcw的逐渐增加(P < 0.05)是由于吸气末Vrc,p和Vrc,a的增加(P < 0.01)。呼气末Vcw的逐渐减少(P < 0.05)完全是由于呼气末Vab的减少(P < 0.01)。Vrc,a的增加略大于Vrc,p的增加,这与胸廓的最小变形一致(在速度为4英里/小时时为2.5±0.2%)。吸气末Vcw的增加和呼气末Vcw的减少分别由吸气胸廓肌(RCM,i)和腹部肌(ABM)的活动引起。RCM,i和ABM产生的压力以及Pdi从静息状态到最高负荷时逐渐增加(P < 0.05)。V(di)的增加比Pdi变化的增加更多,这解释了Wdi的增加。总之,我们发现,在健康人行走时,通气需求的增加通过动用吸气和呼气储备容积来满足。ABM的活动导致呼气储备容积的动用。我们还表明,膈肌主要起气流发生器的作用。尽管胸廓变形可测量,但呼吸肌的协同作用使其最小化。