Department of Physiotherapy, and Activity and Human Movement Study Center (CEMAH), School of Allied Health Technologies, Polytechnic Institute of Porto, Rua Dr. António Bernardino de Almeida 400, 4200-072 Porto, Portugal; Faculty of Sport, CIFI2D, and Porto Biomechanics Laboratory (LABIOMEP), University of Porto, Rua Dr. Plácido Costa 91, 4200-450 Porto, Portugal.
Physiotherapist, Private Practice, Portugal.
Hum Mov Sci. 2018 Oct;61:167-176. doi: 10.1016/j.humov.2018.07.011. Epub 2018 Aug 11.
Despite the reported benefits of postures involving leaning the trunk forward with arm support for relieving dyspnea, how those postures influence the mechanics of breathing remains unclear. In response, the aim of the study reported here was to evaluate how posture (i.e., standing and sitting) and leaning the trunk forward with arm support affect the activity of accessory respiratory muscles and thoracoabdominal movement in healthy individuals. Thirty-five volunteers (15 males and 20 females) aged 18-29 years breathed with the same rhythm in standing and sitting positions while upright and while leaning the trunk forward with arm support. Surface electromyography was performed to assess the activity of accessory inspiratory (i.e., during inspiration) and abdominal (i.e., during inspiration and expiration) muscles, and a motion capture system was used to assess thoracoabdominal movement. Results revealed that upper trapezius activity was significantly lower in forward-leaning postures than in upright ones (P = 005; η = 0.311), although the activity of the sternocleidomastoideus and scalenus (P < 0.001; η = 0.427-0.529), along with the anterior-to-posterior movement of the upper ribcage (P < 0.001; η = 0.546), were significantly greater in forward-leaning postures than in upright ones. The activity of the external oblique and transversus abdominis/internal oblique was significantly lower in sitting than in standing postures (P < 0.050; η = 0.206-0.641), and though the activity of the transversus abdominis/internal oblique was significantly lower in forward-leaning than in upright postures (P ≤ 0.001; η = 0.330-0.541), a significantly greater anterior-to-posterior movement of the abdomen was observed (P < 0.001; η = 0.662). However, the magnitude of the lower ribcage's medial-to-lateral movement was significantly lower in forward-leaning than in upright postures (P = 0.039; η = 0.149). Leaning the trunk forward with arm support not only increased the use of accessory inspiratory muscles but also decreased the use of the transversus abdominis/internal oblique, which improved thoracoabdominal movement.
尽管有研究报道称,采用前倾躯干并辅以手臂支撑的姿势可以缓解呼吸困难,但这些姿势如何影响呼吸力学仍不清楚。有鉴于此,本研究旨在评估直立和前倾躯干并辅以手臂支撑这两种姿势如何影响健康个体辅助呼吸肌的活动和胸腹部运动。35 名志愿者(15 名男性,20 名女性)年龄 18-29 岁,在直立和前倾躯干并辅以手臂支撑这两种姿势下以相同的节奏呼吸。采用表面肌电图评估辅助吸气肌(吸气时)和腹部肌(吸气和呼气时)的活动,采用运动捕捉系统评估胸腹部运动。结果显示,与直立姿势相比,前倾姿势时斜方肌上部的活动显著降低(P=0.05;η=0.311),但胸锁乳突肌和斜角肌的活动(P<0.001;η=0.427-0.529)以及上肋骨的前后运动(P<0.001;η=0.546)在前倾姿势时显著大于直立姿势。与直立姿势相比,坐姿时腹外斜肌和腹横肌/腹内斜肌的活动显著降低(P<0.05;η=0.206-0.641),虽然前倾姿势时腹横肌/腹内斜肌的活动显著低于直立姿势(P≤0.001;η=0.330-0.541),但观察到腹部的前后运动显著增大(P<0.001;η=0.662)。然而,前倾姿势时下肋骨的内外侧运动幅度显著小于直立姿势(P=0.039;η=0.149)。前倾躯干并辅以手臂支撑不仅增加了辅助吸气肌的使用,还降低了腹横肌/腹内斜肌的使用,从而改善了胸腹部运动。