Department of Physical Therapy, Faculty of Allied Health Sciences.
Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok.
Medicine (Baltimore). 2020 Dec 18;99(51):e23646. doi: 10.1097/MD.0000000000023646.
This study identified the effects of pursed-lip breathing (PLB), forward trunk lean posture (FTLP), and combined PLB and FTLP on total and compartmental lung volumes, and ventilation in patients with chronic obstructive pulmonary disease (COPD). Sixteen patients with mild to moderate COPD performed 2 breathing patterns of quiet breathing (QB) and PLB during FTLP and upright posture (UP). The total and compartmental lung volumes and ventilation of these 4 tasks (QB-UP, PLB-UP, QB-FTLP, PLB-FTLP) were evaluated using optoelectronic plethysmography. Two-way repeated measures ANOVA was used to identify the effect of PLB, FTLP, and combined strategies on total and compartmental lung volumes and ventilation. End-expiratory lung volume of ribcage compartment was significantly lower in PLB-UP than QB-UP and those with FTLP (P < .05). End-inspiratory lung volume (EILV) and end-inspiratory lung volume of ribcage compartment were significantly greater during PLB-FTLP and PLB-UP than those of QB (P < .05). PLB significantly and positively changed end-expiratory lung volume of abdominal compartment (EELVAB ) end-expiratory lung volume, EILVAB, tidal volume of pulmonary ribcage, tidal volume of abdomen, and ventilation than QB (P < .05). UP significantly increased tidal volume of pulmonary ribcage, tidal volume of abdomen, and ventilation and decreased EELVAB, end-expiratory lung volume, and EILVAB than FTLP (P < .05). In conclusion, combined PLB with UP or FTLP demonstrates a positive change in total and compartmental lung volumes in patients with mild to moderate COPD.
本研究旨在探讨缩唇呼吸(PLB)、前躯干倾斜位(FTLP)和 PLB 与 FTLP 联合对轻中度慢性阻塞性肺疾病(COPD)患者总肺容积和分肺容积及通气的影响。16 例轻中度 COPD 患者在 FTLP 及直立位(UP)下分别行静息呼吸(QB)和 PLB 两种呼吸模式。采用光体积描记法评估这 4 种任务(QB-UP、PLB-UP、QB-FTLP、PLB-FTLP)的总肺容积和分肺容积及通气。采用双因素重复测量方差分析来确定 PLB、FTLP 及联合策略对总肺容积和分肺容积及通气的影响。PLB-UP 时的胸壁肺容积的呼气末肺容积明显低于 QB-UP 和 FTLP(P<0.05)。PLB-FTLP 和 PLB-UP 时的吸气末肺容积(EILV)和胸壁肺容积的吸气末肺容积明显大于 QB(P<0.05)。PLB 较 QB 显著且正性地改变了腹肺容积的呼气末肺容积(EELVAB)、呼气末肺容积、胸肺潮气量、腹肺潮气量和通气(P<0.05)。UP 较 FTLP 显著增加了胸肺潮气量、腹肺潮气量和通气,降低了 EELVAB、呼气末肺容积和 EILVAB(P<0.05)。总之,在轻中度 COPD 患者中,PLB 与 UP 或 FTLP 联合使用可使总肺容积和分肺容积发生积极变化。