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体位、性别和年龄对健康受试者呼吸模式和胸壁运动的影响。

Influence of posture, sex, and age on breathing pattern and chest wall motion in healthy subjects.

机构信息

Rehabilitation Sciences Program, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil.

Health Science Department, Universidade Federal de Santa Catarina (UFSC), Araranguá, SC, Brazil.

出版信息

Braz J Phys Ther. 2020 May-Jun;24(3):240-248. doi: 10.1016/j.bjpt.2019.02.007. Epub 2019 Mar 1.

Abstract

OBJECTIVE

We evaluated the effects of posture, sex, and age on breathing pattern and chest wall motion during quiet breathing in healthy participants.

METHODS

Eighty-three participants aged 42.72 (SD=21.74) years presenting normal pulmonary function were evaluated by optoelectronic plethysmography in the seated, inclined (with 45° of trunk inclination), and supine positions. This method allowed to assess the chest wall in a three dimensional way considering the chest wall as three compartments: pulmonary rib cage, abdominal rib cage and abdomen.

RESULTS

Posture influenced all variables of breathing pattern and chest wall motion, except respiratory rate and duty cycle. Chest wall tidal volume and minute ventilation were reduced (p<0.05) in both sexes from seated to inclined and from seated to supine positions, mainly in males. Moreover, moving from seated to supine position significantly increased the percentage contribution of the abdomen to the tidal volume in both sexes (p<0.0001). Regarding sex, women showed higher contribution of thoracic compartment compared to men (p=0.008). Aging provided reductions on rib cage contributions to tidal volume that were compensated by increases of abdomen contributions (p<0.0001). In addition, increases in end-inspiratory and end-expiratory volumes over the years were observed.

CONCLUSION

The degree of contribution of chest wall compartments is dependent on posture, sex, and age. Therefore, verticalization increases expansion of pulmonary rib cage as well as horizontalization increases abdominal displacement. Women presented higher thoracic contribution to tidal volume than men. Aging reduces rib cage contributions to tidal volume that were compensated by increases of abdomen contributions.

摘要

目的

我们评估了姿势、性别和年龄对健康参与者静息呼吸时呼吸模式和胸壁运动的影响。

方法

83 名年龄为 42.72(SD=21.74)岁、肺功能正常的参与者接受了坐位、倾斜位(躯干倾斜 45°)和仰卧位的光体积描记法评估。这种方法允许通过将胸壁视为三个腔室:肺肋骨笼、腹部肋骨笼和腹部,从三维角度评估胸壁。

结果

除呼吸频率和占空比外,姿势影响呼吸模式和胸壁运动的所有变量。在男女两性中,从坐位到倾斜位以及从坐位到仰卧位,胸壁潮气量和分钟通气量均降低(p<0.05),主要发生在男性中。此外,从坐位到仰卧位显著增加了男女两性腹部对潮气量的贡献百分比(p<0.0001)。关于性别,女性的胸部分布比男性更高(p=0.008)。衰老导致肋骨笼对潮气量的贡献减少,被腹部贡献的增加所补偿(p<0.0001)。此外,还观察到吸气末和呼气末容积随时间的增加。

结论

胸壁各腔室的贡献程度取决于姿势、性别和年龄。因此,垂直化增加了肺肋骨笼的扩张,而水平化增加了腹部的位移。女性的潮气量比男性有更高的胸部分布。衰老减少了肋骨笼对潮气量的贡献,被腹部贡献的增加所补偿。

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