de Sá Rafaela Barros, Pessoa Maíra Florentino, Cavalcanti Ana Gabriela Leal, Campos Shirley Lima, Amorim César, Dornelas de Andrade Armèle
Department of Physical Therapy, Federal of Pernambuco University, Recife, Pernambuco, Brazil.
City University of São Paulo, São Paulo, Brazil.
Respir Physiol Neurobiol. 2017 Aug;242:1-7. doi: 10.1016/j.resp.2017.03.002. Epub 2017 Mar 10.
This study evaluated the immediate effects of respiratory muscle stretching on chest wall kinematics and electromyographic activity in COPD patients. 28 patients with COPD were randomized into two groups: 14 to the treatment group (TG) and 14 to the control group (CG). The TG underwent a stretching protocol of the rib cage muscles, while the CG remained at rest under similar conditions. After a single session, TG increased the tidal volume of the pulmonary rib cage (Vrcp) (p=0.020) and tidal volume of abdominal rib cage (Vrca) (p=0.043) variations and their percentages in relation to the thoracic wall, Vrcp% (p=0.044) and Vrca% (p=0.022). Also, TG decreased the end-expiratory Vrcp (p=0.013) and the end-inspiratory Vrcp (p=0.011) variations. In addition, there was a reduction in respiratory rate (RR) (p=0.011) and minute volume (MV) (p=0.035), as well as an increase in expiratory time (Te) (p=0.026). There was also an immediate reduction in sternocleidomastoid (p=0.043) and upper trapezium (p=0.034) muscle electrical activity. Then, the study supports the use of stretching to improve COPD chest wall mobility with positive effects on chest wall mechanics, on volume distribution and electromyography.
本研究评估了呼吸肌拉伸对慢性阻塞性肺疾病（COPD）患者胸壁运动学和肌电图活动的即时影响。28例COPD患者被随机分为两组：14例进入治疗组（TG），14例进入对照组（CG）。TG组接受胸廓肌肉拉伸方案，而CG组在相似条件下保持休息状态。单次治疗后，TG组增加了肺胸廓潮气量（Vrcp）（p = 0.020）和腹胸廓潮气量（Vrca）（p = 0.043）的变化及其相对于胸壁的百分比，Vrcp%（p = 0.044）和Vrca%（p = 0.022）。此外，TG组降低了呼气末Vrcp（p = 0.013）和吸气末Vrcp（p = 0.011）的变化。另外，呼吸频率（RR）（p = 0.011）和分钟通气量（MV）（p = 0.035）降低，呼气时间（Te）增加（p = 0.026）。胸锁乳突肌（p = 0.043）和上斜方肌（p = 0.034）的肌肉电活动也立即降低。因此，该研究支持使用拉伸来改善COPD患者的胸壁活动度，对胸壁力学、容积分布和肌电图有积极影响。
