Abstract
ObjectiveTo analyze in obese women the acute effects of the breath stacking technique on thoraco-abdominal expansion.Design and MethodsNineteen 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.ResultsAge 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.ConclusionsIn 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.
Highlights
Obesity even without associated diseases can induce changes in the respiratory system, impacting on strength and endurance of the respiratory muscles [1,2,3], pulmonary gas exchange [4], [5], lung volumes [6], [7] and exercise tolerance [8]
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 between groups 1 and 2
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
Summary
Obesity even without associated diseases can induce changes in the respiratory system, impacting on strength and endurance of the respiratory muscles [1,2,3], pulmonary gas exchange [4], [5], lung volumes [6], [7] and exercise tolerance [8]. The breath stacking technique, developed by Marini et al [16], consists in using a mask equipped with a one way valve preventing either expiration or inspiration and facilitating either lung expansion from Functional Residual Capacity (FRC) to Total Lung Capacity (TLC) or lung emptying from FRC to Residual Volume (RV). This technique was originally designed to estimate the subcomponents of vital capacity, namely inspiratory capacity (IC) and expiratory reserve volume (ERV), in poorly or not cooperative patients. Breath stacking proved to be able to improve lung expansion [16], [17], and it appears to be an interesting therapeutic tool for reversing atelectasis in obese patients, who show reduced FRC and ERV and hypoventilation of lung bases, due to the accumulation of fat in the chest and abdomen
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