PneumoCardioVascular Laboratory-Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH) & Laboratório de Inovação Tecnológica em Reabilitação, Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte (UFRN), Natal, Brazil.
Faculdade de Ciências da Saúde do Trairí (FACISA), Universidade Federal do Rio Grande do Norte (UFRN), Santa Cruz, Brazil.
PLoS One. 2022 Oct 14;17(10):e0275584. doi: 10.1371/journal.pone.0275584. eCollection 2022.
Individuals with Parkinson's disease (PD) present respiratory dysfunctions, mainly due to decreased chest wall expansion, which worsens with the course of the disease. These findings contribute to the restrictive respiratory pattern and the reduction in chest wall volume. According to literature, inspiratory muscle thixotropic conditioning maneuvers may improve lung volumes in these patients. The study aimed to determine the after-effects of respiratory muscle thixotropic maneuvers on breathing patterns and chest wall volumes of PD. A crossover study was performed with twelve patients with PD (8 males; mean age 63.9±8.8 years, FVC%pred 89.7±13.9, FEV1%pred 91.2±15, FEV1/FVC%pred 83.7±5.7). Chest wall volumes were assessed using OEP during thixotropic maneuvers. Increases in EIVCW (mean of 126mL, p = 0.01) and EEVCW (mean of 150mL, p = 0.005) were observed after DITLC (deep inspiration from total lung capacity) due to increases in pulmonary (RCp) and abdominal (RCa) ribcage compartments. Changes in ICoTLC (inspiratory contraction from TLC) led to significant EIVCW (mean of 224mL, p = 0.001) and EEVCW (mean of 229mL, p = 0.02) increases that were mainly observed in the RCp. No significant changes were found when performing DERV (deep expiration from residual volume) and ICoRV (Inspiratory contraction from RV). Positive correlations were also observed between the degree of inspiratory contraction during ICoTLC and EEVRCp (rho = 0.613, p = 0.03) and EIVRCp (rho = 0.697, p = 0.01) changes. Thixotropy conditioning of inspiratory muscles at an inflated chest wall volume increases EIVCW and EEVCW in the ten subsequent breaths in PD patients. These maneuvers are easy to perform, free of equipment, low-cost, and may help patients improve chest wall volumes during rehabilitation.
帕金森病（PD）患者存在呼吸功能障碍，主要是由于胸壁扩张减少，随着疾病的发展而恶化。这些发现导致了限制性呼吸模式和胸壁容积减少。根据文献，吸气肌触变性调理手法可能会改善这些患者的肺容积。本研究旨在确定呼吸肌触变性手法对 PD 患者呼吸模式和胸壁容积的后续影响。对 12 名 PD 患者（8 名男性；平均年龄 63.9±8.8 岁，FVC%pred 89.7±13.9，FEV1%pred 91.2±15，FEV1/FVC%pred 83.7±5.7）进行了交叉研究。使用 OEP 在触变性手法期间评估胸壁容积。由于肺（RCp）和腹部（RCa）肋骨腔室的增加，在 DITLC（从 TCL 进行深度吸气）后观察到 EIVCW（平均增加 126mL，p=0.01）和 EEVCW（平均增加 150mL，p=0.005）的增加。ICoTLC（从 TLC 进行吸气收缩）的变化导致 EIVCW（平均增加 224mL，p=0.001）和 EEVCW（平均增加 229mL，p=0.02）的显著增加，主要观察到 RCP 中。在执行 DERV（从残气量进行深度呼气）和 ICoRV（从 RV 进行吸气收缩）时未发现显著变化。在 ICoTLC 期间吸气收缩的程度与 EEVRCp（rho=0.613，p=0.03）和 EIVRCp（rho=0.697，p=0.01）变化之间也观察到了正相关。在充气胸壁容积下对吸气肌进行触变性调理可增加 PD 患者随后 10 次呼吸中的 EIVCW 和 EEVCW。这些手法易于操作，无需设备，成本低，可帮助患者在康复期间改善胸壁容积。
