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The expansion of the pulmonary rib cage during breath stacking is influenced by age in obese women.

Barcelar Jde M, Aliverti A, Rattes C, Ximenes ME, Campos SL, Brandão DC, Fregonezi G, de Andrade AD - PLoS ONE (2014)

Bottom Line: Age was significantly lower in group 1 than group 2.During breath stacking, inspiratory capacity was significant differences in obese subjects with a smaller expansion of the pulmonary rib cage and a greater expansion of the abdomen compared to controls and also between groups 1 and 2.A significant inverse linear relationship was found between age and inspiratory capacity of the pulmonary rib cage but not of the abdomen.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Fisioterapia, Universidade Federal de Pernambuco, Pernambuco, Brazil.

ABSTRACT

Objective: To analyze in obese women the acute effects of the breath stacking technique on thoraco-abdominal expansion.

Design and methods: Nineteen obese women (BMI ≥ 30 kg/m(2)) were evaluated by anthropometry, spirometry and maximal respiratory muscle pressures and successively analyzed by Opto-Electronic Plethysmography and a Wright respirometer during quiet breathing and breath stacking maneuvers and compared with a group of 15 normal-weighted healthy women. The acute effects of the maneuvers were assessed in terms of total and compartmental chest wall volumes at baseline, end of the breath stacking maneuver and after the maneuver. Obese subjects were successively classified into two groups, accordingly to the response during the maneuver, group 1 = prevalent rib cage or group 2 = abdominal expansion.

Results: Age was significantly lower in group 1 than group 2. When considering the two obese groups, FEV1 was lower and minute ventilation was higher only in group 2 compared to controls group. During breath stacking, inspiratory capacity was significant differences in obese subjects with a smaller expansion of the pulmonary rib cage and a greater expansion of the abdomen compared to controls and also between groups 1 and 2. A significant inverse linear relationship was found between age and inspiratory capacity of the pulmonary rib cage but not of the abdomen.

Conclusions: In obese women the maximal expansion of the rib cage and abdomen is influenced by age and breath stacking maneuver could be a possible therapy for preventing respiratory complications.

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Related in: MedlinePlus

Representative tracings of total chest wall (top traces), pulmonary rib cage (middle traces) and abdominal (bottom traces) volume variations during the different phases of the test: spontaneous quiet breathing before the maneuver, breath stacking maneuver and recovery after the maneuver.P1: baseline period; P2: end of the breath stacking maneuver (Total Lung Capacity, TLC); P3: end of the first expiration after the breath stacking maneuver; P4: period after the maneuver. Tracings in control subjects, not shown, were generally similar to those recorded in group 1.
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pone-0110959-g001: Representative tracings of total chest wall (top traces), pulmonary rib cage (middle traces) and abdominal (bottom traces) volume variations during the different phases of the test: spontaneous quiet breathing before the maneuver, breath stacking maneuver and recovery after the maneuver.P1: baseline period; P2: end of the breath stacking maneuver (Total Lung Capacity, TLC); P3: end of the first expiration after the breath stacking maneuver; P4: period after the maneuver. Tracings in control subjects, not shown, were generally similar to those recorded in group 1.

Mentions: OEP (BTS Engineering, Milano, Italy) was used to assess thoraco-abdominal volumes and breathing pattern. According to the protocol, 89 reflective markers (diameter 5 or 10 mm) were used, fixed on the skin by hypoallergenic adhesive tape along seven horizontal rows (arranged circumferentially between the level of the clavicles and the anterior superior iliac spines) and five vertical columns (anteriorly and posteriorly), plus two additional columns in the midaxillary lines. Seven additional markers were placed to provide better detail in the anterior and posterior regions [22], [23]. OEP data were captured by eight cameras, four positioned anteriorly and four posteriorly with respect to the subject. After markers' positioning and a period of adaptation to the experimental conditions, all subjects were asked not to speak or move during the recording and analyzed while sitting on a rigid bed with both feet on the floor, knees and hips at about 90 degrees and the hands on the hips. OEP data were then recorded during a test composed by a) period of about 60 sec of spontaneous quiet breathing (QB) at rest, followed by b) a breath stacking maneuver and c) another period of QB during the recovery from the maneuver. During the breath stacking maneuver, a silicone face mask (Newmed, São Paulo, Brasil) was applied to the subject. A Wright MARK 8 respirometer (British Oxygen Company, London, England) attached to a connection on the mask allowed inspiration but not expiration. The other connection present on the mask was kept occluded. Before measurements, the subjects were instructed to voluntarily inspire during breath stacking, starting from FRC and gradually fill the lungs until reaching TLC over a period of about 20 seconds (Fig. 1). The termination of the maneuver was determined by observing no changes of inspired volume in the respirometer. After termination of the maneuver, the mask was promptly removed by the researcher, allowing the subject to freely inspire and expire again. In each subject, tests were repeated three times, with an interval of at least two minutes in between. For each test, the researcher took note of the inspired lung volume as measured by the Wright respirometer.


The expansion of the pulmonary rib cage during breath stacking is influenced by age in obese women.

Barcelar Jde M, Aliverti A, Rattes C, Ximenes ME, Campos SL, Brandão DC, Fregonezi G, de Andrade AD - PLoS ONE (2014)

Representative tracings of total chest wall (top traces), pulmonary rib cage (middle traces) and abdominal (bottom traces) volume variations during the different phases of the test: spontaneous quiet breathing before the maneuver, breath stacking maneuver and recovery after the maneuver.P1: baseline period; P2: end of the breath stacking maneuver (Total Lung Capacity, TLC); P3: end of the first expiration after the breath stacking maneuver; P4: period after the maneuver. Tracings in control subjects, not shown, were generally similar to those recorded in group 1.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4220958&req=5

pone-0110959-g001: Representative tracings of total chest wall (top traces), pulmonary rib cage (middle traces) and abdominal (bottom traces) volume variations during the different phases of the test: spontaneous quiet breathing before the maneuver, breath stacking maneuver and recovery after the maneuver.P1: baseline period; P2: end of the breath stacking maneuver (Total Lung Capacity, TLC); P3: end of the first expiration after the breath stacking maneuver; P4: period after the maneuver. Tracings in control subjects, not shown, were generally similar to those recorded in group 1.
Mentions: OEP (BTS Engineering, Milano, Italy) was used to assess thoraco-abdominal volumes and breathing pattern. According to the protocol, 89 reflective markers (diameter 5 or 10 mm) were used, fixed on the skin by hypoallergenic adhesive tape along seven horizontal rows (arranged circumferentially between the level of the clavicles and the anterior superior iliac spines) and five vertical columns (anteriorly and posteriorly), plus two additional columns in the midaxillary lines. Seven additional markers were placed to provide better detail in the anterior and posterior regions [22], [23]. OEP data were captured by eight cameras, four positioned anteriorly and four posteriorly with respect to the subject. After markers' positioning and a period of adaptation to the experimental conditions, all subjects were asked not to speak or move during the recording and analyzed while sitting on a rigid bed with both feet on the floor, knees and hips at about 90 degrees and the hands on the hips. OEP data were then recorded during a test composed by a) period of about 60 sec of spontaneous quiet breathing (QB) at rest, followed by b) a breath stacking maneuver and c) another period of QB during the recovery from the maneuver. During the breath stacking maneuver, a silicone face mask (Newmed, São Paulo, Brasil) was applied to the subject. A Wright MARK 8 respirometer (British Oxygen Company, London, England) attached to a connection on the mask allowed inspiration but not expiration. The other connection present on the mask was kept occluded. Before measurements, the subjects were instructed to voluntarily inspire during breath stacking, starting from FRC and gradually fill the lungs until reaching TLC over a period of about 20 seconds (Fig. 1). The termination of the maneuver was determined by observing no changes of inspired volume in the respirometer. After termination of the maneuver, the mask was promptly removed by the researcher, allowing the subject to freely inspire and expire again. In each subject, tests were repeated three times, with an interval of at least two minutes in between. For each test, the researcher took note of the inspired lung volume as measured by the Wright respirometer.

Bottom Line: Age was significantly lower in group 1 than group 2.During breath stacking, inspiratory capacity was significant differences in obese subjects with a smaller expansion of the pulmonary rib cage and a greater expansion of the abdomen compared to controls and also between groups 1 and 2.A significant inverse linear relationship was found between age and inspiratory capacity of the pulmonary rib cage but not of the abdomen.

View Article: PubMed Central - PubMed

Affiliation: Departamento de Fisioterapia, Universidade Federal de Pernambuco, Pernambuco, Brazil.

ABSTRACT

Objective: To analyze in obese women the acute effects of the breath stacking technique on thoraco-abdominal expansion.

Design and methods: Nineteen obese women (BMI ≥ 30 kg/m(2)) were evaluated by anthropometry, spirometry and maximal respiratory muscle pressures and successively analyzed by Opto-Electronic Plethysmography and a Wright respirometer during quiet breathing and breath stacking maneuvers and compared with a group of 15 normal-weighted healthy women. The acute effects of the maneuvers were assessed in terms of total and compartmental chest wall volumes at baseline, end of the breath stacking maneuver and after the maneuver. Obese subjects were successively classified into two groups, accordingly to the response during the maneuver, group 1 = prevalent rib cage or group 2 = abdominal expansion.

Results: Age was significantly lower in group 1 than group 2. When considering the two obese groups, FEV1 was lower and minute ventilation was higher only in group 2 compared to controls group. During breath stacking, inspiratory capacity was significant differences in obese subjects with a smaller expansion of the pulmonary rib cage and a greater expansion of the abdomen compared to controls and also between groups 1 and 2. A significant inverse linear relationship was found between age and inspiratory capacity of the pulmonary rib cage but not of the abdomen.

Conclusions: In obese women the maximal expansion of the rib cage and abdomen is influenced by age and breath stacking maneuver could be a possible therapy for preventing respiratory complications.

Show MeSH
Related in: MedlinePlus