Physiotherapy Department, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.
J Electromyogr Kinesiol. 2012 Dec;22(6):961-7. doi: 10.1016/j.jelekin.2012.05.001. Epub 2012 Jun 6.
Breathing exercises (BE), incentive spirometry and positioning are considered treatment modalities to achieve lung re-expansion. This study evaluated the influence of incentive spirometry and forward leaning on inspired tidal volumes (V(T)) and electromyographic activity of inspiratory muscles during BE. Four modalities of exercises were investigated: deep breathing, spirometry using both flow and volume-oriented devices, and volume-oriented spirometry after modified verbal instruction. Twelve healthy subjects aged 22.7 ± 2.1 years were studied. Surface electromyography activity of diaphragm, external intercostals, sternocleidomastoid and scalenes was recorded. Comparisons among the three types of exercises, without considering spirometry after modified instruction, showed that electromyographic activity and V(T) were lower during volume-oriented spirometry (p = 0.000, p = 0.054, respectively). Forward leaning resulted in a lower V(T) when compared to upright sitting (p = 0.000), but electromyographic activity was not different (p = 0.606). Inspired V(T) and electromyographic activity were higher during volume-oriented spirometry performed after modified instruction when compared with the flow-oriented device (p = 0.027, p = 0.052, respectively). In conclusion BE using volume-oriented spirometry before modified instruction resulted in a lower work of breathing as a result of a lower V(T) and was not a consequence of the device type used. Forward leaning might not be assumed by healthy subjects during situations of augmented respiratory demand.
呼吸练习(BE)、激励式肺活量计和体位被认为是实现肺复张的治疗方法。本研究评估了激励式肺活量计和前倾位对 BE 期间吸气潮气量(V(T))和吸气肌肌电图活动的影响。研究了四种运动方式:深呼吸、使用流量和容量导向装置的肺活量计测量、以及经改良口头指令后的容量导向式肺活量计测量。研究对象为 12 名年龄为 22.7 ± 2.1 岁的健康受试者。记录了膈肌、肋间外肌、胸锁乳突肌和斜角肌的表面肌电图活动。在不考虑改良指令后的肺活量计测量的情况下,三种运动方式之间的比较显示,在容量导向式肺活量计测量期间,肌电图活动和 V(T)较低(p = 0.000,p = 0.054)。与直立坐姿相比,前倾位导致 V(T)降低(p = 0.000),但肌电图活动无差异(p = 0.606)。与流量导向装置相比,改良指令后进行的容量导向式肺活量计测量时,吸气 V(T)和肌电图活动更高(p = 0.027,p = 0.052)。总之,在改良指令前进行的容量导向式肺活量计测量的 BE 导致较低的呼吸功,这不是由于设备类型所致,而是由于较低的 V(T)所致。在呼吸需求增加的情况下,健康受试者可能不会采取前倾位。