Tomich G M, França D C, Diório A C M, Britto R R, Sampaio R F, Parreira V F
Departamento de Fisioterapia, Escola de Educação Física, Fisioterapia e Terapia Ocupacional, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
Braz J Med Biol Res. 2007 Oct;40(10):1409-17. doi: 10.1590/s0100-879x2006005000165. Epub 2007 Aug 14.
The objective of the present study was to evaluate breathing pattern, thoracoabdominal motion and muscular activity during three breathing exercises: diaphragmatic breathing (DB), flow-oriented (Triflo II) incentive spirometry and volume-oriented (Voldyne) incentive spirometry. Seventeen healthy subjects (12 females, 5 males) aged 23 +/- 5 years (mean +/- SD) were studied. Calibrated respiratory inductive plethysmography was used to measure the following variables during rest (baseline) and breathing exercises: tidal volume (Vt), respiratory frequency (f), rib cage contribution to Vt (RC/Vt), inspiratory duty cycle (Ti/Ttot), and phase angle (PhAng). Sternocleidomastoid muscle activity was assessed by surface electromyography. Statistical analysis was performed by ANOVA and Tukey or Friedman and Wilcoxon tests, with the level of significance set at P < 0.05. Comparisons between baseline and breathing exercise periods showed a significant increase of Vt and PhAng during all exercises, a significant decrease of f during DB and Voldyne, a significant increase of Ti/Ttot during Voldyne, and no significant difference in RC/Vt. Comparisons among exercises revealed higher f and sternocleidomastoid activity during Triflo II (P < 0.05) with respect to DB and Voldyne, without a significant difference in Vt, Ti/Ttot, PhAng, or RC/Vt. Exercises changed the breathing pattern and increased PhAng, a variable of thoracoabdominal asynchrony, compared to baseline. The only difference between DB and Voldyne was a significant increase of Ti/Ttot compared to baseline. Triflo II was associated with higher f values and electromyographic activity of the sternocleidomastoid. In conclusion, DB and Voldyne showed similar results while Triflo II showed disadvantages compared to the other breathing exercises.
本研究的目的是评估三种呼吸练习过程中的呼吸模式、胸腹运动和肌肉活动：膈肌呼吸（DB）、流量导向型（Triflo II）激励肺活量测定法和容量导向型（Voldyne）激励肺活量测定法。研究了17名年龄为23±5岁（平均±标准差）的健康受试者（12名女性，5名男性）。使用校准后的呼吸感应体积描记法在静息（基线）和呼吸练习期间测量以下变量：潮气量（Vt）、呼吸频率（f）、胸廓对Vt的贡献（RC/Vt）、吸气占空比（Ti/Ttot）和相位角（PhAng）。通过表面肌电图评估胸锁乳突肌的活动。采用方差分析和Tukey检验或Friedman检验和Wilcoxon检验进行统计分析，显著性水平设定为P<0.05。基线期和呼吸练习期之间的比较显示，所有练习期间Vt和PhAng均显著增加，DB和Voldyne期间f显著降低，Voldyne期间Ti/Ttot显著增加，RC/Vt无显著差异。练习之间的比较显示，与DB和Voldyne相比，Triflo II期间f和胸锁乳突肌活动更高（P<0.05），Vt、Ti/Ttot、PhAng或RC/Vt无显著差异。与基线相比，练习改变了呼吸模式并增加了PhAng（胸腹不同步的一个变量）。DB和Voldyne之间的唯一差异是与基线相比Ti/Ttot显著增加。Triflo II与更高的f值和胸锁乳突肌的肌电活动相关。总之，DB和Voldyne显示出相似的结果，而与其他呼吸练习相比，Triflo II显示出劣势。
