[Purpose] The purpose of this study was to clarify the impact of postural changes during
tidal breathing on the configuration and motion of chest-wall in order to further
breathing motion evaluation. [Subjects and Methods] Chest-wall configuration
and motion in the supine, right lateral, and sitting positions were measured using
optoelectronic plethysmography in 15 healthy adult men. [Results] The anteroposterior
diameters of the chest wall were significantly lower in the supine position for the
pulmonary and abdominal rib cages, whereas the mediolateral diameters in the lateral
position were lowest for the abdominal rib cage. Regarding chest-wall motion, both
craniocaudal and anteroposterior motions of the anterior surface of the pulmonary and
abdominal rib cages were significantly greater in the sitting position. Regarding motion
of the left lateral abdominal rib cage, lateral motion was greatest in the lateral
position. [Conclusion] Chest-wall configuration and motion changed according to posture in
healthy men, particularly in the pulmonary and abdominal rib cages.
BACKGROUND: Assessment of the degree of air-flow obstruction is important for determining the treatment strategy in COPD patients. However, in some elderly COPD patients, measuring FVC is impossible because of cognitive dysfunction or severe dyspnea. In such patients a simple test of airways obstruction requiring only a short run of tidal breathing would be useful. We studied whether the spontaneous expiratory flow-volume (SEFV) curve pattern reflects the degree of airflow obstruction in elderly COPD patients. METHODS: In 34 elderly subjects (mean ؎ SD age 80 ؎ 7 y) with stable COPD (percent-of-predicted FEV 1 39.0 ؎ 18.5%), and 12 age-matched healthy subjects, we measured FVC and recorded flow-volume curves during quiet breathing. We studied the SEFV curve patterns (concavity/convexity), spirometry results, breathing patterns, and demographics. The SEFV curve concavity/convexity prediction accuracy was examined by calculating the receiver operating characteristic curves, cutoff values, area under the curve, sensitivity, and specificity. RESULTS: Fourteen subjects with COPD had a concave SEFV curve. All the healthy subjects had convex SEFV curves. The COPD subjects who had concave SEFV curves often had very severe airway obstruction. The percent-of-predicted FEV 1 % (32.4%) was the most powerful SEFV curve concavity predictor (area under the curve 0.92, 95% CI 0.83-1.00), and had the highest sensitivity (0.93) and specificity (0.88). CONCLUSIONS: Concavity of the SEFV curve obtained during tidal breathing may be a useful test for determining the presence of very severe obstruction in elderly patients unable to perform a satisfactory FVC maneuver.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.