Graduate Program in Advanced Neurology Physical Therapy, Rocky Mountain University of Health Professions, Provo, Utah, USA.
J Appl Physiol (1985). 2013 Aug 15;115(4):483-90. doi: 10.1152/japplphysiol.01226.2012. Epub 2013 Jun 13.
Maintenance of upright posture involves complex neuromotor processes that include control of thoracic and abdominal pressures. Control of airflow by glottal structures is a primary determinant of thoracic pressure and may have a role in control of postural stability. This study aimed to investigate the effect of modulation of airway control on upright postural stability during postural perturbations. Standing balance was gently perturbed in the sagittal plane during 7 breathing/voicing tasks that ranged from completely closed (breath-hold), to partially opened (voicing) or completely open (sigh) glottal conditions in 11 healthy adults. Dependent measures were peak amplitude of displacement of the thorax and center of pressure (CoP). When the glottis was completely open during sigh, thoracic displacement in response to the perturbation was greater than in all other conditions, regardless of direction of perturbation (post hoc, all P < 0.002). The absolute amplitude of CoP displacement was greater with backward perturbation (main effect, Direction P = 0.001) and was greater at both extremes of glottal modulation (glottis closed and completely open) than when the glottis was partially opened during counting out loud (post hoc, all P < 0.04). These results show that airway modulation affects postural control during upright perturbations. The thorax was more stable when the glottis was engaged than when it was required to remain open, whereas control of CoP displacement appeared more optimal during the natural dynamic mid-range airway modulation of voicing. These data suggest that glottal control influences balance, and that glottal control strategies may be an important consideration for patients with breathing and/or balance disorders.
维持直立姿势涉及复杂的神经运动过程，包括对胸腹部压力的控制。声门结构对气流的控制是胸压的主要决定因素，并且可能在姿势稳定性的控制中发挥作用。本研究旨在探讨气道控制调节对姿势干扰下直立姿势稳定性的影响。在 11 名健康成年人中，在矢状面轻轻干扰站立平衡，在 7 种呼吸/发声任务中，声门条件从完全关闭（屏气）、部分打开（发声）到完全打开（叹气）。依赖测量指标为胸廓和中心点（CoP）的位移峰值幅度。当声门在叹气时完全打开时，与干扰相比，胸廓的位移大于所有其他条件，无论干扰的方向如何（事后，所有 P <0.002）。向后干扰时 CoP 位移的绝对幅度更大（主要效果，方向 P = 0.001），并且在声门调制的两个极端（声门关闭和完全打开）时比在大声数数时声门部分打开时更大（事后，所有 P <0.04）。这些结果表明气道调节会影响直立干扰期间的姿势控制。声门参与时，胸廓比需要保持打开时更稳定，而 CoP 位移的控制在发声时的自然动态中程气道调节期间似乎更优化。这些数据表明声门控制会影响平衡，并且声门控制策略可能是呼吸和/或平衡障碍患者的重要考虑因素。
