Kaneko Hideo, Shiranita Shuichi, Horie Jun, Hayashi Shinichiro
Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Okawa-shi, Fukuoka, Japan
Choseido-Watanabe Clinic, Karatsu-shi, Saga, Japan.
Respir Care. 2016 Nov;61(11):1472-1480. doi: 10.4187/respcare.04742. Epub 2016 Oct 18.
Advanced air-flow limitation in patients with COPD leads to a reduction in vital capacity, respiratory muscle strength, and exercise capacity. However, its impact on chest and abdominal wall mobility is unknown. This study aimed to ascertain the prevalence of patients with COPD with reduced chest and abdominal wall mobility and to investigate the effect of reduced chest and abdominal wall mobility on pulmonary function, respiratory muscle strength, and exercise capacity.
In 51 elderly male subjects with COPD, chest and abdominal wall mobility, FVC, FEV, FEV/FVC, maximal inspiratory pressure (P), maximal expiratory pressure (P), and the 6-min walk distance (6MWD) were assessed. Chest and abdominal wall mobility were measured using the breathing movement scale (0-8) at the 3 regions (upper chest, lower chest, and abdomen). Reduced mobility was defined as a value lower than the lower limit of the normal scale. The unpaired t test, Mann-Whitney test, and multiple regression analysis were performed.
The percentages of subjects with reduced mobility were 78% for the upper chest, 76% for the lower chest, and 53% for the abdomen. The subjects with reduced mobility had significantly low FVC, FEV, and 6MWD in each region and significantly low FEV/FVC, P, and P in the abdominal region compared with those with nonreduced mobility. FVC and 6MWD were independently associated with the scale values in each region and with the abdominal scale value, respectively.
The majority of subjects with COPD had reduced chest and abdominal wall mobility, which was independently associated with FVC. Even though abdominal wall mobility was relatively preserved compared with chest wall mobility, it was also independently associated with 6MWD.
慢性阻塞性肺疾病（COPD）患者的严重气流受限会导致肺活量、呼吸肌力量和运动能力下降。然而，其对胸壁和腹壁活动度的影响尚不清楚。本研究旨在确定胸壁和腹壁活动度降低的COPD患者的患病率，并研究胸壁和腹壁活动度降低对肺功能、呼吸肌力量和运动能力的影响。
对51名老年男性COPD患者进行胸壁和腹壁活动度、用力肺活量（FVC）、第一秒用力呼气容积（FEV）、FEV/FVC、最大吸气压（P）、最大呼气压（P）和6分钟步行距离（6MWD）评估。使用呼吸运动量表（0 - 8分）在3个区域（上胸部、下胸部和腹部）测量胸壁和腹壁活动度。活动度降低定义为低于正常量表下限的值。进行了非配对t检验、曼-惠特尼检验和多元回归分析。
上胸部活动度降低的受试者比例为78%，下胸部为76%，腹部为53%。与活动度未降低的受试者相比，活动度降低的受试者在每个区域的FVC、FEV和6MWD均显著降低，在腹部区域的FEV/FVC、P和P也显著降低。FVC和6MWD分别与每个区域的量表值以及腹部量表值独立相关。
大多数COPD患者的胸壁和腹壁活动度降低，且与FVC独立相关。尽管与胸壁活动度相比，腹壁活动度相对保留，但它也与6MWD独立相关。
