title: Reduced Chest and Abdominal Wall Mobility and Their Relationship to Lung Function, Respiratory Muscle Strength, and Exercise Tolerance in Subjects With COPD.
abstract: BACKGROUND
  Advanced air-flow limitation in patients with COPD leads to a reduction in vital capacity, respiratory muscle strength, and exercise capacity. However, its impact on chest and abdominal wall mobility is unknown. This study aimed to ascertain the prevalence of patients with COPD with reduced chest and abdominal wall mobility and to investigate the effect of reduced chest and abdominal wall mobility on pulmonary function, respiratory muscle strength, and exercise capacity.
  
  
  METHODS
  In 51 elderly male subjects with COPD, chest and abdominal wall mobility, FVC, FEV1, FEV1/FVC, maximal inspiratory pressure (PImax), maximal expiratory pressure (PEmax), and the 6-min walk distance (6MWD) were assessed. Chest and abdominal wall mobility were measured using the breathing movement scale (0-8) at the 3 regions (upper chest, lower chest, and abdomen). Reduced mobility was defined as a value lower than the lower limit of the normal scale. The unpaired t test, Mann-Whitney test, and multiple regression analysis were performed.
  
  
  RESULTS
  The percentages of subjects with reduced mobility were 78% for the upper chest, 76% for the lower chest, and 53% for the abdomen. The subjects with reduced mobility had significantly low FVC, FEV1, and 6MWD in each region and significantly low FEV1/FVC, PImax, and PEmaxin the abdominal region compared with those with nonreduced mobility. FVC and 6MWD were independently associated with the scale values in each region and with the abdominal scale value, respectively.
  
  
  CONCLUSIONS
  The majority of subjects with COPD had reduced chest and abdominal wall mobility, which was independently associated with FVC. Even though abdominal wall mobility was relatively preserved compared with chest wall mobility, it was also independently associated with 6MWD.
authors: Department of Physical Therapy, School of Health Sciences at Fukuoka, International University of Health and Welfare, Okawa-shi, Fukuoka, Japan hkaneko@iuhw.ac.jp.
authors: Hideo
authors: H
authors: Kaneko
authors: Choseido-Watanabe Clinic, Karatsu-shi, Saga, Japan.
authors: Shuichi
authors: S
authors: Shiranita
authors: Department of Physical Therapy, School of Health Sciences, Kyoto Tachibana University, Kyoto-shi, Kyoto, Japan.
authors: Jun
authors: J
authors: Horie
authors: Department of Respiratory Medicine, Takagi Hospital, Okawa-shi, Fukuoka, Japan.
authors: Shinichiro
authors: S
authors: Hayashi
mesh_terms: D034861:Abdominal Wall / Q000503:physiopathology*; D000368:Aged; D000369:Aged, 80 and over; D017079:Exercise Tolerance / Q000502:physiology*; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D009068:Movement; D053580:Muscle Strength / Q000502:physiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D015656:Respiratory Mechanics / Q000502:physiology; D012132:Respiratory Muscles / Q000503:physiopathology*; D035441:Thoracic Wall / Q000503:physiopathology*; D014797:Vital Capacity / Q000502:physiology; D000070857:Walk Test
keywords: COPD; abdominal wall; exercise tolerance; pulmonary function; respiratory mechanics; thoracic wall