Jacqueline de Melo Barcelar

Chest wall regional volumes in obese women

Excess body fat, particularly in the abdominal region, is responsible for respiratory system alterations. To study if and how both lung function and thoraco-abdominal volume variations during quiet breathing are altered in obese women and to determine if different obesity patterns in women have an influence on lung and chest wall function, 30 obese women (BMI ≥ 40 kg/m(2)) with both central and peripheral obesity were studied by spirometry and opto-electronic plethysmography during quiet breathing and compared with normoweight women. Compared to controls, obese were characterized by lung restriction and higher minute ventilation at rest. Pulmonary rib cage tidal volume variations were significantly lower and abdominal volume variations higher in obese women. No differences were found between central and peripheral obese women. In conclusion, in obese women, independently if obesity is central or peripheral, both lung function and thoraco-abdominal pattern during spontaneous breathing are strongly altered. The amount of fat in the abdominal compartment, and not the peripheral, alters the respiratory system.

Influence of different levels of immersion in water on the pulmonary function and respiratory muscle pressure in healthy individuals: observational study.

BACKGROUND AND PURPOSE Immersion in water, with the head above the water line, causes acute physiological changes in the pulmonary and cardiovascular systems. The aim of this study was to evaluate the acute physiological responses to immersion on lung volumes and respiratory muscle strength at different depths. METHODS A cross-sectional study was conducted in 28 healthy individuals (21.75 ± 1.99 years; 13 men and 15 women). Anthropometric and spirometric data as well as respiratory muscle strength were evaluated. Evaluations were carried out on dry land (DL) and in a pool at three different levels of immersion: iliac crests (IC), xiphoid appendix of the sternum (XA) and clavicles (CL). The order of evaluation for spirometry and maximal inspiratory and expiratory pressures between DL and the different levels of immersion was randomized. The ANOVA test for repeated measures with post hoc Tukey was applied to compare the variables. RESULTS Vital capacity exhibited lower values at the CL level compared with DL, XA and IC (p < 0.01). The most significant change in forced expiratory volume in the first second (FEV(1)) occurred under immersion at CL and XA levels. No differences in maximal expiratory pressure were found in the comparisons between the different levels of immersion and DL (p = 0.19). There was nevertheless a decrease in maximum inspiratory pressure with immersion at the CL level (91 ± 23 cmH(2)O) compared with DL (105 ± 29 cmH(2)O), XA (99 ± 24 cmH(2)O) and IC (101 ± 25 cmH(2)O) values (p < 0.01). CONCLUSION The results suggest that immersion at the level of the clavicles and xiphoid appendix alters lung function and respiratory muscle strength when compared with the values measured out of the water and immersed at the IC level in healthy individuals, demonstrating the influence of hydrostatic pressure on the respiratory system.

The expansion of the pulmonary rib cage during breath stacking is influenced by age in obese women

Objective To analyze in obese women the acute effects of the breath stacking technique on thoraco-abdominal expansion. Design and Methods Nineteen obese women (BMI≥30 kg/m2) were evaluated by anthropometry, spirometry and maximal respiratory muscle pressures and successively analyzed by Opto-Electronic Plethysmography and a Wright respirometer during quiet breathing and breath stacking maneuvers and compared with a group of 15 normal-weighted healthy women. The acute effects of the maneuvers were assessed in terms of total and compartmental chest wall volumes at baseline, end of the breath stacking maneuver and after the maneuver. Obese subjects were successively classified into two groups, accordingly to the response during the maneuver, group 1 = prevalent rib cage or group 2 = abdominal expansion. Results Age was significantly lower in group 1 than group 2. When considering the two obese groups, FEV1 was lower and minute ventilation was higher only in group 2 compared to controls group. During breath stacking, inspiratory capacity was significant differences in obese subjects with a smaller expansion of the pulmonary rib cage and a greater expansion of the abdomen compared to controls and also between groups 1 and 2. A significant inverse linear relationship was found between age and inspiratory capacity of the pulmonary rib cage but not of the abdomen. Conclusions In obese women the maximal expansion of the rib cage and abdomen is influenced by age and breath stacking maneuver could be a possible therapy for preventing respiratory complications.

Vibrating Platform Training Improves Respiratory Muscle Strength, Quality of Life, and Inspiratory Capacity in the Elderly Adults: A Randomized Controlled Trial

Background Aging affects respiratory strength that could cause reduction in functional capacity and quality of life, playing a fundamental role in healthy aging and survival. To prevent these declines, the whole body vibration (WBV) has been proposed to increase strength and functional capacity. The aim of the study was to evaluate the effects of WBV on respiratory muscle strength, thoracoabdominal ventilation, and quality of life in the elderly adults. Methods This study was a controlled, randomized double-blind clinical trial. The study included 28 elderly adults randomized into three groups: Resistance (n = 9), WBV (n = 9), or WBV + resistance exercises (n = 10), performing training, sham, or double training for 3 months, twice per week. The variables of the study were as follows: maximal inspiratory and expiratory pressures (MIP and MEP), distribution of thoracoabdominal volumes variation in optoelectronic plethysmography (pulmonary rib cage-VRCp, abdominal rib cage-VRCa, and abdomen-VAB), and quality of life. Results After training, WBV and WBV + resistance groups increased MIP and MEP (p < .001). During inspiratory capacity maneuver, WBV groups had incremental increases in chest wall total volume (p < .001), showing a rise in pulmonary rib cage (p = .03) and abdominal rib cage (p = .04). Furthermore, WBV groups improved SF-36 scores in functional capacity, physical aspects, energy, pain, and general heath domains. Conclusions The WBV is a training that could improve respiratory muscle strength and quality of life and promote different ventilatory strategies in chest wall and thoracoabdominal compartments in healthy elderly adults.