title: Influence of posture on the ventilatory pattern and the thoraco-abdominal kinematics of patients with chronic obstructive pulmonary disease (COPD).
abstract: 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).
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Physical Therapy, Cardiorespiratory Physical Therapy Laboratory , Federal University of Pernambuco, Av. Jornalista Anibal Fernandes, s/n, Cidade Universitária, Recife , Brazil.
authors.forename: Ana Gabriela L
authors.initials: AG
authors.lastname: Cavalcanti
authors.forename: Catarina S F Rattes
authors.initials: CS
authors.lastname: Lima
authors.forename: Rafaela Barros
authors.initials: RB
authors.lastname: de Sá
authors.forename: Cyda M A
authors.initials: CM
authors.lastname: Reinaux
authors.forename: Donato S
authors.initials: DS
authors.lastname: Braz Júnior
authors.forename: Andrei L S
authors.initials: AL
authors.lastname: Teixeira
authors.forename: Arméle Dornelas
authors.initials: AD
authors.lastname: de Andrade
authors.forename: Patrícia E M
authors.initials: PE
authors.lastname: Marinho
mesh_terms: D000009:Abdominal Muscles / Q000503:physiopathology*; D000368:Aged; D001696:Biomechanical Phenomena; D003430:Cross-Sectional Studies; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010991:Plethysmography; D011187:Posture; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology*; D012123:Pulmonary Ventilation; D015656:Respiratory Mechanics; D012132:Respiratory Muscles / Q000503:physiopathology*; D012720:Severity of Illness Index; D016683:Supine Position; D035441:Thoracic Wall / Q000503:physiopathology*; D013997:Time Factors; D014797:Vital Capacity
keywords: COPD; opto-electronic plethysmo-graphy; thoraco-abdominal movement