Lunardi Adriana Claudia, Marques da Silva Cibele Cristine Berto, Rodrigues Mendes Felipe Augusto, Marques Amelia Pasqual, Stelmach Rafael, Fernandes Carvalho Celso Ricardo
Department of Physical Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil.
J Asthma. 2011 Feb;48(1):105-10. doi: 10.3109/02770903.2010.520229. Epub 2010 Dec 29.
The mechanical alterations related to the overload of respiratory muscles observed in adults with persistent asthma might lead to the development of chronic alterations in posture, musculoskeletal dysfunction and pain; however, these changes remain poorly understood.
This study aimed to assess postural alignment, muscle shortening and chronic pain in adults with persistent asthma.
This cross-sectional and controlled study enrolled 30 patients with mild (n = 17) and severe (n = 13) persistent asthma. Fifteen non-asthmatic volunteers were also assessed. Asthma was classified by the Global Initiative for Asthma (GINA) guidelines. Postural alignment and muscle shortening were evaluated by head and shoulder positions, chest wall mobility, and posterior (trunk and lower limb) muscle flexibility. In addition, the measures used were previously tested for their reproducibility. Pain complaints were also assessed.
In comparison with non-asthmatic subjects, patients with mild or severe persistent asthma held their head and shoulders more forward and had lower chest wall expansion, decreased shoulder internal rotation, and decreased thoracic spine flexibility. Chronic lower thoracic, cervical, and shoulder pain was significantly increased in patients with mild or severe asthma compared with non-asthmatic subjects (p < 0.05).
Adults with persistent asthma have musculoskeletal dysfunction and chronic pain that is independent of the severity of their disease but that might be related to their age at the onset of disease symptoms.
在持续性哮喘成年患者中观察到的与呼吸肌负荷过重相关的机械性改变,可能会导致姿势的慢性改变、肌肉骨骼功能障碍和疼痛;然而,这些变化仍未得到充分理解。
本研究旨在评估持续性哮喘成年患者的姿势对齐、肌肉缩短和慢性疼痛情况。
这项横断面对照研究纳入了30例轻度(n = 17)和重度(n = 13)持续性哮喘患者。还评估了15名非哮喘志愿者。哮喘根据全球哮喘防治创议(GINA)指南进行分类。通过头部和肩部位置、胸壁活动度以及后部(躯干和下肢)肌肉柔韧性来评估姿势对齐和肌肉缩短情况。此外,所采用的测量方法之前已测试过其可重复性。还评估了疼痛主诉。
与非哮喘受试者相比,轻度或重度持续性哮喘患者的头部和肩部向前的程度更大,胸壁扩张度更低,肩部内旋减少,胸椎柔韧性降低。与非哮喘受试者相比,轻度或重度哮喘患者的慢性下胸部、颈部和肩部疼痛明显增加(p < 0.05)。
持续性哮喘成年患者存在肌肉骨骼功能障碍和慢性疼痛,这与疾病严重程度无关,但可能与疾病症状出现时的年龄有关。