Breathing pattern, thoracoabdominal motion and muscular activity during three breathing exercises

Abstract

The objective of the present study was to evaluate breathing pattern, thoracoabdominal motion and muscular activity during three breathing exercises: diaphragmatic breathing (DB), flow-oriented (Triflo II) incentive spirometry and volume-oriented (Voldyne) incentive spirometry. Seventeen healthy subjects (12 females, 5 males) aged 23 ± 5 years (mean ± SD) were studied. Calibrated respiratory inductive plethysmography was used to measure the following variables during rest (baseline) and breathing exercises: tidal volume (Vt), respiratory frequency (f), rib cage contribution to Vt (RC/Vt), inspiratory duty cycle (Ti/Ttot), and phase angle (PhAng). Sternocleidomastoid muscle activity was assessed by surface electromyography. Statistical analysis was performed by ANOVA and Tukey or Friedman and Wilcoxon tests, with the level of significance set at P < 0.05. Comparisons between baseline and breathing exercise periods showed a significant increase of Vt and PhAng during all exercises, a significant decrease of f during DB and Voldyne, a significant increase of Ti/Ttot during Voldyne, and no significant difference in RC/Vt. Comparisons among exercises revealed higher f and sternocleidomastoid activity during Triflo II (P < 0.05) with respect to DB and Voldyne, without a significant difference in Vt, Ti/Ttot, PhAng, or RC/Vt. Exercises changed the breathing pattern and increased PhAng, a variable of thoracoabdominal asynchrony, compared to baseline. The only difference between DB and Voldyne was a significant increase of Ti/Ttot compared to baseline. Triflo II was associated with higher f values and electromyographic activity of the sternocleidomastoid. In conclusion, DB and Voldyne showed similar results while Triflo II showed disadvantages compared to the other breathing exercises.

Mobilidade diafragmática durante espirometria de incentivo orientada a fluxo e a volume em indivíduos sadios

“…Another study showed that the electromyographic activity of the accessory respiratory muscles is significantly greater during ISFOD than during ISVOD. (10) Our results corroborate the finding that diaphragmatic mobility is greater during ISVOD than during ISFOD.…”

“…Some studies have shown differences between the different types of incentive spirometers in terms of respiratory pattern, thoracoabdominal motion, respiratory effort, and accessory muscle recruitment. (8)(9)(10) In the present study, diaphragmatic mobility was measured via ultrasound during the use of incentive spirometers. Our results showed that diaphragmatic mobility was significantly greater during ISVOD and during DB than during ISFOD.…”

“…(8) Other authors have observed that there is greater abdominal motion, lower accessory respiratory muscle recruitment, and higher tidal volume during the use of ISVOD than during the use of ISFOD. (9,10) In addition to the evaluation parameters mentioned above, diaphragmatic mobility during the use of different types of incentive spirometers has not been quantified in previous studies, and such quantification could contribute to a better understanding of the mechanical effects of the devices and of their indications in clinical practice. Therefore, the primary objective of the present study was to compare diaphragmatic The volume-oriented device was a Voldyne spirometer (Hudson RCI, Temecula, CA, USA) and the flow-oriented device was a Respiron spirometer (Hudson RCI).…”

Effect of Volume-Oriented Versus Flow-Oriented Incentive Spirometry on Chest Wall Volumes, Inspiratory Muscle Activity, and Thoracoabdominal Synchrony in the Elderly

“…In healthy adults, previous studies have reported that VIS induced greater chest wall expansion and abdominal displacement 10,11,19 and lower inspiratory muscle activity 9,11,20 and work of breathing 21,22 than FIS. However, to the best of our knowledge the advice to use incentive spirometry has never been investigated in elderly subjects.…”

“…These maneuvers increase transpulmonary pressure and therefore increase chest-wall volume. 9 Parreira et al 10 and Paisani et al 11 showed that VIS promotes a greater chest wall volume with a larger abdominal contribution than does FIS in healthy adult subjects. In addition, Chang et al (2010) 7 and Parreira et al (2005) 10 suggested that the inspiratory flow, rather than the type of incentive spirometry, determines the breathing pattern and the respiratory muscle activation in this population.…”