Burgos Jesús, Barrios Carlos, Mariscal Gonzalo, Lorente Alejandro, Lorente Rafael
Division of Pediatric Orthopedics, Hospital Ramon y Cajal, Madrid, Spain.
Institute for Research on Musculoskeletal Disorders, Valencia Catholic University, Valencia, Spain.
Front Med (Lausanne). 2021 Aug 30;8:699357. doi: 10.3389/fmed.2021.699357. eCollection 2021.
To analyse the range of motion of the thoracic spine by radiographically measuring changes in the sagittal profile of different thoracic segments during maximal inspiration and exhalation. The starting hypothesis was that forced deep breathing requires an active, but non-uniform widening of the lordotic-kyphotic range of motion of the different thoracic segments. Cross-sectional study. Participants were 40 healthy volunteers aged 21-60. Conventional anteroposterior and functional sagittal chest radiographs were performed during maximal inspiration and exhalation. The range of motion of each spinal thoracic functional segment, global T1-T12 motion, and the sagittal displacement of the thoracic column during breathing were measured. Considering the different type of ribs and their attachment the spine and sternum, thoracic segments were grouped in T1-T7, T7-T10, and T10-T12. The displacement of the thoracic spine with respect to the sternum and manubrium was also recorded. The mean difference from inspiration to exhalation in the T1-T12 physiologic kyphosis was 15.9° ± 4.6°, reflecting the flexibility of the thoracic spine during deep breathing (30.2%). The range of motion was wider in the caudal hemicurve than in the cranial hemicurve, indicating more flexibility of the caudal component of the thoracic kyphosis. A wide range of motion from inspiration to exhalation was found at T7-T10, responsible for 73% of T1-T12 sagittal movement. When the sample was stratified according to age ranges (20-30, 30-45, and 45-60 yr.), none of the measurements for inspiration or exhalation showed statistically significant differences. Only changes at this level showed a positive correlation with changes in the global thoracic kyphosis ( = 0.794, <0.001). The range of motion of the thoracic spine plays a relevant role in respiration dynamics. Maximal inspiration appears to be highly dependent on the angular movements of the T7-T10 segment.
通过影像学测量不同胸椎节段在最大吸气和呼气时矢状面轮廓的变化，以分析胸椎的活动范围。初始假设是，用力深呼吸需要不同胸椎节段的前凸-后凸活动范围进行主动但不均匀的扩大。横断面研究。参与者为40名年龄在21至60岁之间的健康志愿者。在最大吸气和呼气时进行常规前后位和功能性矢状位胸部X线摄影。测量每个胸椎功能节段的活动范围、T1-T12整体活动度以及呼吸时胸椎柱的矢状位移。考虑到肋骨的不同类型及其与脊柱和胸骨的附着情况，将胸椎节段分为T1-T7、T7-T10和T10-T12组。还记录了胸椎相对于胸骨和胸骨柄的位移。T1-T12生理性后凸从吸气到呼气的平均差异为15.9°±4.6°，反映了深呼吸时胸椎的灵活性（30.2%）。尾侧半曲线的活动范围比头侧半曲线更宽，表明胸椎后凸的尾侧部分更灵活。在T7-T10发现从吸气到呼气的活动范围很广，占T1-T12矢状运动的73%。当样本按年龄范围（20-30岁、30-45岁和45-60岁）分层时，吸气或呼气的任何测量值均未显示出统计学上的显著差异。只有该水平的变化与整体胸椎后凸的变化呈正相关（r = 0.794，P <0.001）。胸椎的活动范围在呼吸动力学中起相关作用。最大吸气似乎高度依赖于T7-T10节段的角运动。
