Article

OBJECTIVE: Evaluate the influence of posture on ventilatory pattern,
compartmental distribution of volume of chest wall and thoraco-abdominal
kinematics of patients with severe chronic obstructive pulmonary disease (COPD).
DESIGN: Cross-sectional study. METHODS: Twelve, male patients with severe COPD
(Forced Expiratory Volume in the first second (FEV1) = 24.35 +/- 4.52%, Forced
Vital Capacity% (FVC%) = 60 +/- 13.39% and relationship FEV1/FVC = 53.42 +/-
14.47). The distribution of the volume of the ribcage [pulmonary rib cage (Rcp),
abdominal ribcage (Rca) and abdomen (Ab)] during quiet breathing in a sitting
position without back support (SWB), sitting with backrest (SB) and supine
position (SUP) was determined using an opto-electronic plethysmograph. RESULTS:
The following differences were observed: a greater tidal volume in the SWB
position when compared to the SB position (p = 0.01); greater expiratory time in
the SUP position in relation to the SWB (p = 0.03) and SB (p = 0.01); and
increased abdominal contribution to the tidal volume in the SUP position in
relation to the SWB (p < 0.01) and SB (p < 0.001). No difference was found in the
thoraco-abdominal synchrony among the positions. CONCLUSION: Sitting position
without back support enhances the activation of respiratory muscles by increasing
the tidal volume and supine position seems to favor lung deflation by increasing
the expiratory time. It seems appropriate to adopt these positions to optimize
the ventilation/perfusion relationship and physiotherapeutic intervention in
different clinical conditions.

Langue : ANGLAIS