Abdominal muscle activity during breathing in different postures in COPD “Stage 0” and healthy subjects

Abstract

This study aims to evaluate the effect of different postures on the abdominal muscle activity during breathing in subjects "at risk" for the development of chronic obstructive pulmonary disease (COPD) and healthy. Twenty-nine volunteers, divided in "At Risk" for COPD (n=16; 47.38±5.08years) and Healthy (n=13; 47.54±6.65years) groups, breathed at the same rhythm in supine, standing, tripod and 4-point-kneeling positions. Surface electromyography was performed to assess the activation intensity of rectus abdominis, external oblique and transversus abdominis/internal oblique (TrA/IO) muscles, during inspiration and expiration. From supine to standing, an increased activation of all abdominal muscles was observed in "At Risk" for COPD group; however, in Healthy group, TrA/IO muscle showed an increased activation. In both groups, the TrA/IO muscle activation in tripod and 4-point kneeling positions was higher than in supine and lower than in standing. Subjects "at risk" for the development of COPD seemed to have a specific recruitment of the superficial layer of ventrolateral abdominal wall for the synchronization of postural function and mechanics of breathing.

Posisi Tripod untuk Menurunkan Sesak Napas pada Pasien PPOK: Literature Review

“…Menyandarkan tubuh ke depan dengan penyangga lengan sambil berdiri atau duduk meningkatkan perekrutan otot-otot aksesori inspirasi yaitu sternocleidomastoideus (SCM) dan scalenus (Sc), yang meningkatkan pergerakan anterior-keposterior interkostalis. (Mesquita Montes et al, 2017). Pada review ini untuk mengetahui bagaimana cara mengatasi sesak napas yang sering dialami oleh pasien PPOK agar pasien dapat memodifikasi pengobatan yang didapat dengan terapi non farmakologi sehingga resiko terjadi kejadian morbiditas dan mortalitas menurun.…”

“…Posisi tripod yaitu posisi dengan lengan menyangga pada paha atau lengan menyangga kepala akan lebih rileks dibandingkan posisi duduk biasa dengan demikian posisi tripod kedepan dapat meningkatkan otot diagfragma dalam pernapasan dan mengurangi tekanan otot abdomen (Kim et al, 2012). (Mesquita Montes et al, 2017). Posisi tripod dengan lengan menekuk kedalam membuat otot assesoris pernapasan lebih efektif di lihat dari maksimal inspirasi.…”

Effects of Pursed Lip Breathing with Arm Ergometry after Chin Support Position in Copd Patients

“…Chronic Obstructive Pulmonary Disease (COPD) is defined as the typically progressive limitation of airflow associated with unusual inflammatory response of the airways and dysfunction of the skeletal muscles. (1)(2)(3) It is clinically a diverse condition affecting status of function, QoL, and reaction to treatment, especially pulmonary rehabilitation. (4) Pursed Lip Breathing (PLB) was observed in COPD subjects as a method initiated by them in order to relieve dyspnea, and it was first recommended by Saege in 1910 as a breathing maneuver.…”

“…The arm support engages pectoralis major and pectoralis minor muscles for improving elevation of ribs. (1)Postures which involve forward trunk leaning with arm support are often believed improve lung function. (9,10) Significance of the Study: Among the previous studies, none has seen the integrated effect of chin support positioning with pursed lip breathing maneuver and arm ergometry in COPD patients on their QoL, level of dyspnea and pulmonary function.…”