Source: Annual Congress 2010 - Exercise training: new groups, new methods and outcomes
Disease area: Airway diseases

Abstract

Background Breathing assistance(BA) is a technique of chest manual physiotherapies, which reduces expiratory effort and increases the expiratory volume. In this study, we studied the changes in tidal ventilatory volume with BA in healthy subjects to verify the direct effects. Methods Thirty healthy male subjects (38.2±18.7yr,170.7±6.3cm,65.8±8.1kg,VC 3.9±0.7L) were studied. Ventilation was measured using a standard spirometric device. Following the breathing at rest, BA was performed at upper and lower thorax with sitting (Uur, Lur) or supine (Usp, Lsp) position by one trained physiotherapist. To estimate mobility of the thorax, the difference of the circumference from full-inspiration to -expiration (ΔC) at the nipple level with sitting position was measured. The flexibility of the thorax (Flex) accessed by physiotherapist was rated with an original 5 points scale. Results During BA, Vt in Uur and Lur were significantly increased from 0.50±0.20 to 1.40±0.32 L(p<0.001) and to 1.55±0.34 L(p<0.001), respectively. Similarly, Vt in Usp and Lsp were from 0.50±0.10 L to 1.35±0.31 L(p<0.001) and to 1.31±0.37 L(p<0.001), respectively. End-inspiratory volume (EIV) shift to the inspiratory side was the greater in the supine position than in sitting one (p<0.05). The mean ΔC was 6.30±1.20 cm, and significantly correlated with ΔVt in all BA (p<0.01). Flex significantly correlated with lower thorax (Lsp, Lur)(p<0.05), and upper one (Uur, Usp)(p<0.01). The extent of EIV shift was not significantly related to Flex and ΔC. However, the shift of EIV had significant correlation with BMI(p<0.001). Conclusion BA could increase Vt by, in average, 30-40% of VC. Mobility and flexibility may be related to the extent of the increase in Vt.

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Y. Sano, K. Tsuji, H. Kurosawa (Tokyo, Saitama, Sendai, Japan). Can chest physiotherapies directly help to increase ventilation ?. Eur Respir J 2010; 36: Suppl. 54, 4878

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