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.
Despite the increase in asynchrony, both breathing exercises were able to improve chest wall volumes without affecting dyspnea. The combination of exercises maintained the benefits but did not reduce the adverse effects of diaphragmatic breathing.
BACKGROUND: The mechanisms underlying breathing exercises have not been fully elucidated. OBJECTIVES: To evaluate the impact of four on breathing exercises (diaphragmatic breathing,
inspiratory sighs, sustained maximal inspiration and intercostal exercise) the on
breathing pattern and thoracoabdominal motion in healthy subjects. METHOD: Fifteen subjects of both sexes, aged 23±1.5 years old and with normal pulmonary
function tests, participated in the study. The subjects were evaluated using the
optoelectronic plethysmography system in a supine position with a trunk
inclination of 45° during quiet breathing and the breathing exercises. The order
of the breathing exercises was randomized. Statistical analysis was performed by
the Friedman test and an ANOVA for repeated measures with one factor (breathing
exercises), followed by preplanned contrasts and Bonferroni correction. A
p<0.005 value was considered significant. RESULTS: All breathing exercises significantly increased the tidal volume of the chest wall
(Vcw) and reduced the respiratory rate (RR) in
comparison to quiet breathing. The diaphragmatic breathing exercise was
responsible for the lowest Vcw, the lowest contribution of the rib
cage, and the highest contribution of the abdomen. The sustained maximal
inspiration exercise promoted greater reduction in RR compared to
the diaphragmatic and intercostal exercises. Inspiratory sighs and intercostal
exercises were responsible for the highest values of minute ventilation.
Thoracoabdominal asynchrony variables increased significantly during diaphragmatic
breathing. CONCLUSIONS: The results showed that the breathing exercises investigated in this study
produced modifications in the breathing pattern (e.g., increase
in tidal volume and decrease in RR) as well as in
thoracoabdominal motion (e.g., increase in abdominal contribution
during diaphragmatic breathing), among others.
Malnutrition is a risk factor for noncommunicable diseases related to ageing, and it can also contribute to musculoskeletal health. This study investigated whether nutritional risk is associated with chronic musculoskeletal pain in community-dwelling older persons. Nutritional risk was assessed by the DETERMINE Checklist. Chronic musculoskeletal pain was defined as the presence of pain in the past six months that did not disappear for at least 30 consecutive days. Multivariate logistic regression including confounding variables was used for the analysis. The sample was comprised of 383 participants (age 75.6 ± SD 6.1); the majority were at moderate-to-high nutritional risk (69%) and approximately one third presented chronic musculoskeletal pain (30%). The nutritional risk score was independently associated with chronic musculoskeletal pain: adding one unit in the risk score produces an 11% increment in the odds of presenting pain (OR 1.109, 95% CI 1.022-1.204). Individuals classified into moderate- or high-risk categories also had substantially higher odds (∼90%) of presenting chronic musculoskeletal pain when compared to those in the low-risk category, although our findings were only marginally significant. This is the first study to demonstrate the association between nutritional risk and chronic musculoskeletal pain above and beyond the contributed effects from relevant confounders.
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