Assessment of muscle shortening and static posture in children with persistent asthma

Abstract

Asthmatic patients experience an increase in airway resistance that overburdens both respiratory and non-respiratory muscles. The objective of the present study was to determine whether children with persistent asthma present muscle shortening and postural changes. The 60 boys evaluated, aged 7-12 (pubertal ages up to Tanner stage G2) were divided into three age- and BMI-matched groups of equal number: CON (no history of asthma or allergy); MPA (mild persistent asthma); SPA (severe persistent asthma). Pulmonary function, muscle shortening and static posture were evaluated. The SPA group presented higher protraction of the head and shoulder compared with the CON group [9.5 (6.0-12.0) degrees vs 5.5 (0.0-12.0) degrees, P < 0.05; 0.89 (0.80-0.94) anterior/posterior ratio vs 0.94 (0.87-1.1) anterior/posterior ratio, P < 0.01)]. Severe asthmatic patients also presented shortening of arm flexor and posterior muscle of the thigh compared with the CON group [18.0 (10.0-24.0) degrees vs 12.0 (6.0-16.0) degrees, P < 0.05; and 16.5 (10.0-38.5) cm vs 8.0 (0.0-21.0) cm, respectively, P < 0.05]. Chest expansion at axillar and xiphoid levels were limited in SPA subjects compared with CON subjects [3.7 (1.5-6.5) cm vs 5.5 (2.0-8.0) cm and 4.7 (1.5-6.5) vs 6.0 (3.5-8.0) cm, respectively, P < 0.01]. SPA subjects also presented a higher incidence of lumbar spine straightening compared with CON and MPA subjects. Moderate asthmatic subjects presented intermediate values compared with severe and control subjects in five out nine evaluated outcomes. Our data suggest that severe asthmatic children present postural adaptations and muscle shortening that seem to be related to disease severity.

Heliox and Forward-Leaning Posture Improve the Efficacy of Nebulized Bronchodilator in Acute Asthma: A Randomized Trial

“…8,9 Studies of postures and their relationship to that mechanical disadvantage 10,11 suggest that the influence of posture is mainly on the position of the diaphragm, increasing the tension in muscles such as the abdominals and the effect gravity has on them. 10 We studied the effect of forward-leaning posture and heliox as adjuncts to bronchodilator administration in patients with acute asthma crisis in our emergency department.…”

Review of different anthropometric and nutritional measurements in children with bronchial asthma

“…The height of the child with BA is impacted by several factors: the age at diagnosis, duration and the severity of the disease, recurrent respiratory infections, chest deformity, muscle shortening and postural adaptations, hypoxemia, the impaired pulmonary function, enhanced metabolic demands of the increased work of breathing and allergic processes and corticosteroid treatment [19,26,48].…”

Alterações posturais e função pulmonar de crianças respiradoras bucais

“…These changes tend to progress with the passing of the years, as per observed in our results: with an increase in age, posture adaptations intensify in order to make up for the drop in vital capacity, causing a progressive increase in head projection and neck lordosis (Table 1). Numerous studies have assessed the association between respiratory dysfunction and posture changes in other clinical situations; nonetheless, in such papers muscle-skeletal changes and posture balance changes are seen as consequence of the additional stress employed during normal ventilation 15,16,17 . The results from our study bring about an important contribution as they show changes to the respiratory function arising from posture changes.…”