Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India.
Centre for Physiotherapy and Rehabilitation Sciences, Jamia Millia Islamia, New Delhi, India.
Braz J Phys Ther. 2020 Jul-Aug;24(4):325-332. doi: 10.1016/j.bjpt.2019.05.002. Epub 2019 May 24.
Few studies have demonstrated postural abnormalities in patients with chronic obstructive pulmonary disease - when compared with healthy individuals. However, none of these studies have compared postural abnormalities in different phenotypes of chronic obstructive pulmonary disease.
To compare the thoracic posture between two phenotypes of chronic obstructive pulmonary disease (emphysema and chronic bronchitis) with healthy individuals.
Forty individuals with chronic obstructive pulmonary disease (20 with chronic bronchitis, 67±3.5 years, 20 with emphysema, 67.7±4 years) and 20 age-matched healthy individuals (67.3±3.9 years) underwent postural assessment which was performed using photogrammetric measurements of head protraction, shoulder protraction, thoracic kyphosis angle, coronal shoulder angle, and scapular elevation.
Significant differences were found amongst the groups in protraction of head (emphysema vs. chronic bronchitis, mean difference=7.63°, 95% confidence interval [CI]=2.10, 13.15°; emphysema vs. healthy, 7.91°, 95% CI=2.38, 13.43°), protraction of shoulder (emphysema vs. healthy, 13.69°, 95% CI=6.96, 20.43°; chronic bronchitis vs. healthy, 8.11°, 95% CI=1.38, 14.85°), thoracic kyphosis (emphysema vs. healthy, -11.59°, 95% CI=-17.26, -5.92°; chronic bronchitis vs. healthy, -6.75°, 95% CI=-12.41, -1.08°), coronal shoulder angle (emphysema vs. chronic bronchitis, 1.01°, 95% CI=.22, 1.80°; emphysema vs. healthy, 1.59°, 95% CI=.80, 2.38°) and scapular elevation (emphysema vs. chronic bronchitis, =.74cm, 95% CI=.34, 1.15cm; emphysema vs. healthy, .99cm, 95% CI=.59, 1.40cm).
People with emphysema show greater degree of postural malalignments in terms of head and shoulder protraction, thoracic kyphosis, symmetry of shoulders and scapular elevation than patients with chronic bronchitis and age-matched healthy individuals. These observations emphasize the importance of postural assessment in individuals with chronic obstructive pulmonary disease, particularly if they are emphysematous.
与健康个体相比，很少有研究表明慢性阻塞性肺疾病患者存在姿势异常。然而，这些研究均未比较慢性阻塞性肺疾病不同表型之间的姿势异常。
比较两种慢性阻塞性肺疾病表型（肺气肿和慢性支气管炎）与健康个体之间的胸壁姿势。
40 名慢性阻塞性肺疾病患者（慢性支气管炎 20 名，67±3.5 岁；肺气肿 20 名，67.7±4 岁）和 20 名年龄匹配的健康个体（67.3±3.9 岁）接受了姿势评估，使用头部前伸、肩部前伸、胸曲角度、冠状肩角和肩胛骨抬高的摄影测量法进行评估。
在头部前伸（肺气肿与慢性支气管炎，平均差异=7.63°，95%置信区间[CI]=2.10，13.15°；肺气肿与健康个体，7.91°，95%CI=2.38，13.43°）、肩部前伸（肺气肿与健康个体，13.69°，95%CI=6.96，20.43°；慢性支气管炎与健康个体，8.11°，95%CI=1.38，14.85°）、胸曲（肺气肿与健康个体，-11.59°，95%CI=-17.26，-5.92°；慢性支气管炎与健康个体，-6.75°，95%CI=-12.41，-1.08°）、冠状肩角（肺气肿与慢性支气管炎，1.01°，95%CI=0.22，1.80°；肺气肿与健康个体，1.59°，95%CI=0.80，2.38°）和肩胛骨抬高（肺气肿与慢性支气管炎，0.74cm，95%CI=0.34，1.15cm；肺气肿与健康个体，0.99cm，95%CI=0.59，1.40cm）方面，各组之间存在显著差异。
与慢性支气管炎和年龄匹配的健康个体相比，肺气肿患者在头部和肩部前伸、胸曲、肩部对称和肩胛骨抬高方面表现出更大程度的姿势异常。这些观察结果强调了对慢性阻塞性肺疾病患者进行姿势评估的重要性，特别是对于肺气肿患者。
