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Lopes AL, Sarro KJ, Rodrigues IM, Leite RD, Massaroni C, Amorim PRDS, Cerveri P, Silvatti AP. Breathing Motion Pattern in Cyclists: Role of Inferior against Superior Thorax Compartment. Int J Sports Med 2024; 45:450-457. [PMID: 37967867 PMCID: PMC11208087 DOI: 10.1055/a-2211-9421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 11/15/2023] [Indexed: 11/17/2023]
Abstract
The thoracoabdominal breathing motion pattern is being considered in sports training because of its contribution, along with other physiological adaptations, to overall performance. We examined whether and how experience with cycling training modifies the thoracoabdominal motion patterns. We utilized optoelectronic plethysmography to monitor ten trained male cyclists and compared them to ten physically active male participants performing breathing maneuvers. Cyclists then participated in a self-paced time trial to explore the similarity between that observed during resting breathing. From the 3D coordinates of 32 markers positioned on each participant's trunk, we calculated the percentage of contribution of the superior thorax, inferior thorax, and abdomen and the correlation coefficient among these compartments. During the rest maneuvers, the cyclists showed a thoracoabdominal motion pattern characterized by an increased role of the inferior thorax relative to the superior thorax (26.69±5.88%, 34.93±5.03%; p=0.002, respectively), in contrast to the control group (26.69±5.88%; 25.71±6.04%, p=0.4, respectively). In addition, the inferior thorax showed higher coordination in phase with the abdomen. Furthermore, the results of the time trial test underscored the same pattern found in cyclists breathing at rest, suggesting that the development of a permanent modification in respiratory mechanics may be associated with cycling practice.
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Affiliation(s)
- Ana Luiza Lopes
- Faculdade de Educação Física, Universidade Estadual de Campinas,
Campinas, Brazil
| | - Karine Jacon Sarro
- Faculdade de Educação Física, Universidade Estadual de Campinas,
Campinas, Brazil
| | | | - Richard Diego Leite
- Centro de Educação Física e Desportos , Universidade Federal do
Espirito Santo, Vitória, Brazil
| | - Carlo Massaroni
- Unit of Measurements and Biomedical Instrumentation, Universita Campus
Bio-Medico di Roma, Roma, Italy
| | | | - Pietro Cerveri
- Department of Electronics, Information and Bioengineering, Politecnico
di Milano, Milano, Italy
- Center for Intelligent Technologies in Sleep Medicine, Istituto
Auxologico Italiano Istituto di Ricovero e Cura a Carattere Scientifico, Milano,
Italy
| | - Amanda P. Silvatti
- Departamento de Educação Física, Universidade Federal de Viçosa,
Viçosa, Brazil
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2
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Dempsey JA, Welch JF. Control of Breathing. Semin Respir Crit Care Med 2023; 44:627-649. [PMID: 37494141 DOI: 10.1055/s-0043-1770342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/28/2023]
Abstract
Substantial advances have been made recently into the discovery of fundamental mechanisms underlying the neural control of breathing and even some inroads into translating these findings to treating breathing disorders. Here, we review several of these advances, starting with an appreciation of the importance of V̇A:V̇CO2:PaCO2 relationships, then summarizing our current understanding of the mechanisms and neural pathways for central rhythm generation, chemoreception, exercise hyperpnea, plasticity, and sleep-state effects on ventilatory control. We apply these fundamental principles to consider the pathophysiology of ventilatory control attending hypersensitized chemoreception in select cardiorespiratory diseases, the pathogenesis of sleep-disordered breathing, and the exertional hyperventilation and dyspnea associated with aging and chronic diseases. These examples underscore the critical importance that many ventilatory control issues play in disease pathogenesis, diagnosis, and treatment.
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Affiliation(s)
- Jerome A Dempsey
- John Rankin Laboratory of Pulmonary Medicine, Department of Population Health Sciences, University of Wisconsin, Madison, Wisconsin
| | - Joseph F Welch
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
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3
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Chen X, Dong F, Yin C, Tu J, Zhang D, Guo X. Ultrasonic Imaging Based on Pulsed Airy Beams. IEEE TRANSACTIONS ON ULTRASONICS, FERROELECTRICS, AND FREQUENCY CONTROL 2023; 70:1146-1156. [PMID: 37490370 DOI: 10.1109/tuffc.2023.3298596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
In ultrasonic imaging, high impedance obstacles in tissues may lead to artifacts behind them, making the examination of the target area difficult. Acoustical Airy beams possess the characteristics of self-bending and self-healing within a specific range. They are limited-diffracting when generated from finite aperture sources and are expected to have great potential in medical imaging and therapy. In this article, pulsed Airy (pAiry) beams are employed for ultrasonic imaging at megahertz frequency, and the protocol is demonstrated via both simulations and experiments. First, the generation of pAiry beams using a linear array is simulated, and the pulsed beams inherit some characteristics of continuous wave Airy beams, such as propagating along curved paths and self-healing. In experiments where obstacles are present at the beam paths, the image quality in pAiry-based imaging is superior to that in classical iso-depth imaging. The results demonstrate the feasibility and benefits of ultrasonic imaging based on pAiry beams and provide an important basis for developing imaging techniques employing nondiffracting acoustic beams.
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Wichum F, Wiede C, Seidl K. Depth-Based Measurement of Respiratory Volumes: A Review. SENSORS (BASEL, SWITZERLAND) 2022; 22:9680. [PMID: 36560048 PMCID: PMC9785978 DOI: 10.3390/s22249680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/25/2022] [Accepted: 12/04/2022] [Indexed: 06/17/2023]
Abstract
Depth-based plethysmography (DPG) for the measurement of respiratory parameters is a mobile and cost-effective alternative to spirometry and body plethysmography. In addition, natural breathing can be measured without a mouthpiece, and breathing mechanics can be visualized. This paper aims at showing further improvements for DPG by analyzing recent developments regarding the individual components of a DPG measurement. Starting from the advantages and application scenarios, measurement scenarios and recording devices, selection algorithms and location of a region of interest (ROI) on the upper body, signal processing steps, models for error minimization with a reference measurement device, and final evaluation procedures are presented and discussed. It is shown that ROI selection has an impact on signal quality. Adaptive methods and dynamic referencing of body points to select the ROI can allow more accurate placement and thus lead to better signal quality. Multiple different ROIs can be used to assess breathing mechanics and distinguish patient groups. Signal acquisition can be performed quickly using arithmetic calculations and is not inferior to complex 3D reconstruction algorithms. It is shown that linear models provide a good approximation of the signal. However, further dependencies, such as personal characteristics, may lead to non-linear models in the future. Finally, it is pointed out to focus developments with respect to single-camera systems and to focus on independence from an individual calibration in the evaluation.
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Affiliation(s)
| | | | - Karsten Seidl
- Fraunhofer IMS, 47057 Duisburg, Germany
- Department of Electronic Components and Circuits, University of Duisburg-Essen, 47047 Duisburg, Germany
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Traser L, Schwab C, Burk F, Özen AC, Bock M, Richter B, Echternach M. Differences of respiratory kinematics in female and male singers - A comparative study using dynamic magnetic resonance imaging. Front Psychol 2022; 13:844032. [PMID: 36544443 PMCID: PMC9760878 DOI: 10.3389/fpsyg.2022.844032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Breath control is an important factor for singing voice production, but pedagogic descriptions of how a beneficial movement pattern should be performed vary widely and the underlying physiological processes are not understood in detail. Differences in respiratory movements during singing might be related to the sex of the singer. To study sex-related differences in respiratory kinematics during phonation, 12 singers (six male and six female) trained in the Western classical singing tradition were imaged with dynamic magnetic resonance imaging. Singers were asked to sustain phonation at five different pitches and loudness conditions, and cross-sectional images of the lung were acquired. In each dynamic image frame the distances between anatomical landmarks were measured to quantify the movements of the respiratory apparatus. No major difference between male and female singers was found for the general respiratory kinematics of the thorax and the diaphragm during sustained phonation. However when compared to sole breathing, male singers significantly increased their thoracic movements for singing. This behavior could not be observed in female singers. The presented data support the hypothesis that professional singers follow sex-specific breathing strategies. This finding may be important in a pedagogical context where the biological sex of singer and student differ and should be further investigated in a larger cohort.
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Affiliation(s)
- Louisa Traser
- Institute of Musicians’ Medicine, Faculty of Medicine, Medical Center – University of Freiburg, Freiburg, Germany,Faculty of Medicine, University of Freiburg, Freiburg, Germany,*Correspondence: Louisa Traser,
| | - Carmen Schwab
- Faculty of Medicine, University of Freiburg, Freiburg, Germany,Department of Prosthetic Dentistry, Center for Dental Medicine, Faculty of Medicine, Medical Center – University of Freiburg, Freiburg, Germany
| | - Fabian Burk
- Institute of Musicians’ Medicine, Faculty of Medicine, Medical Center – University of Freiburg, Freiburg, Germany,Department of Phoniatrics and Pediatric Audiology, University Medical Center Münster, Münster, Germany
| | - Ali Caglar Özen
- Faculty of Medicine, University of Freiburg, Freiburg, Germany,Department of Radiology, Medical Physics, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Michael Bock
- Faculty of Medicine, University of Freiburg, Freiburg, Germany,Department of Radiology, Medical Physics, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Bernhard Richter
- Institute of Musicians’ Medicine, Faculty of Medicine, Medical Center – University of Freiburg, Freiburg, Germany,Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Matthias Echternach
- Division of Phoniatrics and Pediatric Audiology, Department of Otorhinolaryngology, Munich University Hospital (LMU), Munich, Germany
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LoMauro A, Colli A, Colombo L, Aliverti A. Breathing patterns recognition: A functional data analysis approach. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 217:106670. [PMID: 35172250 DOI: 10.1016/j.cmpb.2022.106670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/27/2022] [Accepted: 01/27/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE The ongoing pandemic proved fundamental is to assess a subject's respiratory functionality and breathing pattern measurement during quiet breathing is feasible in almost all patients, even those uncooperative. Breathing pattern consists of tidal volume and respiratory rate in an individual assessed by data tracks of lung or chest wall volume over time. State-of-art analysis of these data requires operator-dependent choices such as individuation of local minima in the track, elimination of anomalous breaths and individuation of breath clusters corresponding to different breathing patterns. METHODS A semi-automatic, robust and reproducible procedure was proposed to pre-process and analyse respiratory tracks, based on Functional Data Analysis (FDA) techniques, to identify representative breath curve and the corresponding breathing patterns. This was achieved through three steps: 1) breath separation through precise localization of the minima of the volume trace; 2) functional outlier breaths detection according to time-duration, magnitude and shape; 3) breath clustering to identify different pattern of interest, through K-medoids with Alignment. The method was firstly validated on simulated tracks and then applied to real data in conditions of clinical interest: operational volume change, exercise, mechanical ventilation, paradoxical breathing and age. RESULTS The total error in the accuracy of minima detection and in was less than 5%; with the artificial outliers being almost completely removed with an accuracy of 99%. During incremental exercise and independently on the bike resistance level, five clusters were identified (quiet breathing; recovery phase; onset of exercise; maximal and intermediate levels of exercise). During mechanical ventilation, the procedure was able to separate the non-ventilated from the ventilatory-supported breathing and to identify the worsening of paradoxical breathing due to the disease progression and the breathing pattern changes in healthy subjects due to age. CONCLUSIONS We proposed a robust validated automatic breathing patterns identification algorithm that extracted representative curves that could be implemented in clinical practice for objective comparison of the breathing patterns within and between subjects. In all case studies the identified patterns proved to be coherent with the clinical conditions and the physiopathology of the subjects, therefore enforcing the potential clinical translational value of the method.
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Affiliation(s)
- A LoMauro
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, P.zza L. da Vinci 32; 20133 Milano, Italy.
| | - A Colli
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, P.zza L. da Vinci 32; 20133 Milano, Italy
| | - L Colombo
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, P.zza L. da Vinci 32; 20133 Milano, Italy
| | - A Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, P.zza L. da Vinci 32; 20133 Milano, Italy
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Hedge ET, Hughson RL, Dominelli PB. Repeatability and reproducibility of changes in thoracoabdominal compartmental volumes and breathing pattern during low-, moderate- and heavy-intensity exercise. Eur J Appl Physiol 2022; 122:1217-1229. [DOI: 10.1007/s00421-022-04917-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 02/15/2022] [Indexed: 11/03/2022]
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8
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Effect of chest mobilization on intercostal muscle stiffness. Curr Res Physiol 2022; 5:429-435. [DOI: 10.1016/j.crphys.2022.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 11/30/2022] Open
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Kipp S, Leahy MG, Hanna JA, Sheel AW. Partitioning the work of breathing during running and cycling using optoelectronic plethysmography. J Appl Physiol (1985) 2021; 130:1460-1469. [PMID: 33703946 DOI: 10.1152/japplphysiol.00945.2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Work of breathing ([Formula: see text]) derived from a single lung volume and pleural pressure is limited and does not fully characterize the mechanical work done by the respiratory musculature. It has long been known that abdominal activation increases with increasing exercise intensity, yet the mechanical work done by these muscles is not reflected in [Formula: see text]. Using optoelectronic plethysmography (OEP), we sought to show first that the volumes obtained from OEP (VCW) were comparable to volumes obtained from flow integration (Vt) during cycling and running, and second, to show that partitioned volume from OEP could be utilized to quantify the mechanical work done by the rib cage ([Formula: see text]RC) and abdomen ([Formula: see text]AB) during exercise. We fit 11 subjects (6 males/5 females) with reflective markers and balloon catheters. Subjects completed an incremental ramp cycling test to exhaustion and a series of submaximal running trials. We found good agreement between VCW versus Vt during cycling (bias = 0.002; P > 0.05) and running (bias = 0.016; P > 0.05). From rest to maximal exercise,[Formula: see text]AB increased by 84% (range: 30%-99%; [Formula: see text]AB: 1 ± 1 J/min to 61 ± 52 J/min). The relative contribution of the abdomen increased from 17 ± 9% at rest to 26 ± 16% during maximal exercise. Our study highlights and provides a quantitative measure of the role of the abdominal muscles during exercise. Incorporating the work done by the abdomen allows for a greater understanding of the mechanical tasks required by the respiratory muscles and could provide further insight into how the respiratory system functions during disease and injury.NEW & NOTEWORTHY We demonstrated that optoelectronic plethysmography (OEP) is a reliable tool to determine ventilatory volume changes during cycling and running, without restricting natural upper arm movements. Second, using OEP volumes coupled with pressure-derived measures, we calculated the work done by the rib cage and abdomen, respectively, during exercise. Collectively, our findings indicate that pulmonary mechanics can be accurately quantified using OEP, and abdominal work performed during ventilation contributes substantially to the overall work of the respiratory musculature.
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Affiliation(s)
- Shalaya Kipp
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Michael G Leahy
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jacob A Hanna
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
| | - A William Sheel
- School of Kinesiology, University of British Columbia, Vancouver, British Columbia, Canada
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Manifield J, Chynkiamis N, Alexiou C, Megaritis D, Hume E, Barry G, Vogiatzis I. Acute thoracoabdominal and hemodynamic responses to tapered flow resistive loading in healthy adults. Respir Physiol Neurobiol 2021; 286:103617. [PMID: 33454351 DOI: 10.1016/j.resp.2021.103617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/22/2020] [Accepted: 01/01/2021] [Indexed: 11/17/2022]
Abstract
We investigated the acute physiological responses of tapered flow resistive loading (TFRL) at 30, 50 and 70 % maximal inspiratory pressure (PImax) in 12 healthy adults to determine an optimal resistive load. Increased end-inspiratory rib cage and decreased end-expiratory abdominal volumes equally contributed to the expansion of thoracoabdominal tidal volume (captured by optoelectronic plethysmography). A significant decrease in end-expiratory thoracoabdominal volume was observed from 30 to 50 % PImax, from 30 to 70 % PImax, and from 50 to 70 % PImax. Cardiac output (recorded by cardio-impedance) increased from rest by 30 % across the three loading trials. Borg dyspnoea increased from 2.36 ± 0.20 at 30 % PImax, to 3.45 ± 0.21 at 50 % PImax, and 4.91 ± 0.25 at 70 % PImax. End-tidal CO2 decreased from rest during 30, 50 and 70 %PImax (26.23 ± 0.59, 25.87 ± 1.02 and 24.30 ± 0.82 mmHg, respectively). Optimal intensity for TFRL is at 50 % PImax to maximise global respiratory muscle and cardiovascular loading whilst minimising hyperventilation and breathlessness.
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Affiliation(s)
- James Manifield
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK.
| | - Nikolaos Chynkiamis
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
| | - Charikleia Alexiou
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
| | - Dimitrios Megaritis
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
| | - Emily Hume
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
| | - Gill Barry
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
| | - Ioannis Vogiatzis
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle Upon Tyne, NE1 8ST, UK
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Siam AI, El-Bahnasawy NA, El Banby GM, Abou Elazm A, Abd El-Samie FE. Efficient video-based breathing pattern and respiration rate monitoring for remote health monitoring. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2020; 37:C118-C124. [PMID: 33175740 DOI: 10.1364/josaa.399284] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 07/25/2020] [Indexed: 06/11/2023]
Abstract
A contact-free inexpensive measurement system with an algorithm based on the integral form of video frames is proposed to estimate the respiration rate from an extracted respiration pattern. The proposed algorithm is applied and tested on 28 videos of sleeping-simulated positions, and the results are compared with the manual visual inspection values. With linear regression, the determination coefficient (R2) is 0.961, which demonstrates high agreement with reference measurements. In addition, the Bland-Altman plot shows that almost all data points are within the 95% limits of agreement. Moreover, the time complexity of the proposed algorithm, which involves taking just a single point value of the integral image, is lower than that of traditional methods that circulate over a large number of points. In other words, the proposed algorithm achieves O(1) fixed-time complexity compared to O(N2) for traditional methods. The average speed of processing is enhanced by about 17.4%.
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12
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Welch JF, Kipp S, Sheel AW. Respiratory muscles during exercise: mechanics, energetics, and fatigue. CURRENT OPINION IN PHYSIOLOGY 2019. [DOI: 10.1016/j.cophys.2019.04.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Abstract
Men Are from Mars, Women Are from Venus. John Gray used this provocative title for his book to describe the fundamental psychological differences between the sexes. Many other controlled studies and brain scans demonstrate that men and women are physically and mentally different. The purpose of this physiology masterclass is to illustrate how sex-related differences are present in respiratory function and their possible clinical implications. An overview of sex-related differences in respiratory function and their possible clinical implicationshttp://ow.ly/106m30jqOSW
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Affiliation(s)
- Antonella LoMauro
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
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14
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Lage SM, Britto RR, Brandão DC, Pereira DAG, Andrade ADD, Parreira VF. Can diaphragmatic breathing modify chest wall volumes during inspiratory loaded breathing in patients with heart failure? Braz J Phys Ther 2018; 22:452-458. [PMID: 29752160 DOI: 10.1016/j.bjpt.2018.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2017] [Revised: 03/25/2018] [Accepted: 04/04/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Some inspiratory muscle training protocols for patients with heart failure report the request of diaphragmatic breathing during inspiratory loaded breathing. However, it is unclear whether this condition modifies the chest wall volumes. OBJECTIVE The primary purpose was to evaluate chest wall volumes during inspiratory loaded breathing as well as during inspiratory loaded breathing associated with diaphragmatic breathing in patients with heart failure. METHODS Sixteen men with heart failure functional class I to III, aged 50(SD=7) years were evaluated. Volumes of the pulmonary rib cage, abdominal rib cage and abdomen, as well as other breathing pattern variables, were assessed by optoelectronic plethysmography during quiet breathing, inspiratory loaded breathing, and inspiratory loaded breathing associated with diaphragmatic breathing. RESULTS Chest wall tidal volume significantly increased from quiet breathing 0.53(SD=0.14)L to inspiratory loaded breathing 1.33(SD=0.48)L and to inspiratory loaded breathing associated with diaphragmatic breathing 1.36(SD=0.48)L. A significant volume variation was observed on the three compartments (p<0.05 for all). During inspiratory loaded breathing associated with diaphragmatic breathing, patients showed increased abdominal volume compared to quiet breathing [0.28(SD=0.05) to 0.83(SD=0.47)L, p<0.001]; as well as from inspiratory loaded breathing [0.63(SD=0.23) to 0.83(SD=0.47)L, p=0.044]. No significant changes were observed between the two inspiratory loaded breathing conditions on the percentages of the contribution of each chest wall compartment for the tidal volume, respiratory rate, minute ventilation, and duty cycle. CONCLUSION When inspiratory loaded breathing was associated with diaphragmatic breathing, a higher volume in the abdominal compartment was obtained without significant changes in other breathing pattern variables.
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Affiliation(s)
- Susan Martins Lage
- Universidade Federal de Minas Gerais (UFMG), Rehabilitation Sciences Post Graduation Program, Belo Horizonte, MG, Brazil
| | - Raquel Rodrigues Britto
- Universidade Federal de Minas Gerais (UFMG), Department of Physical Therapy, Belo Horizonte, MG, Brazil
| | - Daniella Cunha Brandão
- Universidade Federal de Pernambuco (UFPE), Department of Physical Therapy, Recife, PE, Brazil
| | | | | | - Verônica Franco Parreira
- Universidade Federal de Minas Gerais (UFMG), Department of Physical Therapy, Belo Horizonte, MG, Brazil.
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Feitosa LADS, de Britto MCA, Aliverti A, Noronha JB, de Andrade AD. Accuracy of optoelectronic plethysmography in childhood exercise-induced asthma. J Asthma 2018; 56:61-68. [PMID: 29360392 DOI: 10.1080/02770903.2018.1424196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To assess the variations of end-expiratory volume of chest wall (EEVcw) measured by optoelectronic plethysmography (OEP) as a diagnostic tool in exercise-induced asthma (EIA) among asthmatic preschool children. METHODS Forty children diagnosed with asthma were included in the study. Spirometry was used as a gold standard test for comparison with OEP. A 10% decline in forced expiratory volume in 1 second was considered positive for EIA. OEP was performed with 8 cameras at a frequency of 60 Hz and 89 markers were placed on the thoraco-abdominal surface of participants. Following bronchoprovocation testing on a treadmill, series of OEP and spirometry were conducted between 5 and 30 minutes after exercise. To obtain the ideal cut-off point, a receiver operating characteristic (ROC) curve was constructed for the largest EEVcw. The highest Youden index was used as criteria to obtain the cut-off point with the best sensitivity and specificity. RESULTS Of the 40 children studied, 16 had EIA. According to the ROC curve, the cut-off point of 0.185% for EEWcw provided mean sensitivity (95% confidence interval) of 93.75% (0.69-0.99), for a specificity of 83.33% (0.63-0.95), when using the largest increase in the period of 5-30 minutes post-exercise. The low area of the ROC was 0.93 (0.85-1.00) for p < 0.001. CONCLUSION OEP can be accurately used to replace spirometry in asthmatic children unable to adequately execute the required manoeuvres.
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Affiliation(s)
| | - Murilo Carlos Amorim de Britto
- b Department of Pediatric Pulmonology , Instituto de Medicina Integral Prof. Fernando Figueira , Pernambuco, Recife , Brazil
| | - Andrea Aliverti
- c Department of Bioengineering , Politecnico di Milano , Milano , Italy
| | - Jéssica Brito Noronha
- a Department of Physiotherapy , Universidade Federal de Pernambuco , Pernambuco, Recife , Brazil
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Rodrigues IM, Bernardina GRD, Sarro KJ, Baroni G, Cerveri P, Silvatti AP. Thoracoabdominal breathing motion pattern and coordination of professional ballet dancers. Sports Biomech 2017; 18:51-62. [DOI: 10.1080/14763141.2017.1380223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | | | - Karine Jacon Sarro
- Faculty of Physical Education, State University of Campinas, Campinas, Brazil
| | - Guido Baroni
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Pietro Cerveri
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
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Pessoa MF, Brandão DC, Sá RBD, Barcelar JDM, Rocha TDDS, Souza HCMD, Dornelas de Andrade A. Vibrating Platform Training Improves Respiratory Muscle Strength, Quality of Life, and Inspiratory Capacity in the Elderly Adults: A Randomized Controlled Trial. J Gerontol A Biol Sci Med Sci 2017; 72:683-688. [PMID: 27384328 DOI: 10.1093/gerona/glw123] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 06/10/2016] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
| | | | - Rafaela Barros de Sá
- Departamento de Fisioterapia, Universidade Federal de Pernambuco, Recife, Brazil
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Chest Wall Kinematics Using Triangular Cosserat Point Elements in Healthy and Neuromuscular Subjects. Ann Biomed Eng 2017; 45:1963-1973. [PMID: 28451990 DOI: 10.1007/s10439-017-1840-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Accepted: 04/21/2017] [Indexed: 10/19/2022]
Abstract
Optoelectronic plethysmography (OEP) is a noninvasive method for assessing lung volume variations and the contributions of different anatomical compartments of the chest wall (CW) through measurements of the motion of markers attached to the CW surface. The present study proposes a new method for analyzing the local CW kinematics from OEP measurements based on the kinematics of triangular Cosserat point elements (TCPEs). 52 reflective markers were placed on the anterior CW to create a mesh of 78 triangles according to an anatomical model. Each triangle was characterized by a TCPE and its kinematics was described using four time-variant scalar TCPE parameters. The total CW volume ([Formula: see text]) and the contributions of its six compartments were also estimated, using the same markers. The method was evaluated using measurements of ten healthy subjects, nine patients with Pompe disease, and ten patients with Duchenne muscular dystrophy (DMD), during spontaneous breathing (SB) and vital capacity maneuvers (VC) in the supine position. TCPE parameters and compartmental volumes were compared with [Formula: see text] by computing the phase angles [Formula: see text] (for SB) and the correlation r (for VC) between them. Analysis of [Formula: see text] and r of the outward translation parameter [Formula: see text] of each TCPE revealed that for healthy subjects it provided similar results to those obtained by compartmental volumes, whereas for the neuromuscular patients the TCPE method was capable of detecting local asynchronous and paradoxical movements also in cases where they were undistinguished by volumes. Therefore, the TCPE approach provides additional information to OEP that may enhance its clinical evaluation capabilities.
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Takashima S, Nozoe M, Mase K, Kouyama Y, Matsushita K, Ando H. Effects of posture on chest-wall configuration and motion during tidal breathing in normal men. J Phys Ther Sci 2017; 29:29-34. [PMID: 28210033 PMCID: PMC5300799 DOI: 10.1589/jpts.29.29] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 09/20/2016] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to clarify the impact of postural changes during tidal breathing on the configuration and motion of chest-wall in order to further breathing motion evaluation. [Subjects and Methods] Chest-wall configuration and motion in the supine, right lateral, and sitting positions were measured using optoelectronic plethysmography in 15 healthy adult men. [Results] The anteroposterior diameters of the chest wall were significantly lower in the supine position for the pulmonary and abdominal rib cages, whereas the mediolateral diameters in the lateral position were lowest for the abdominal rib cage. Regarding chest-wall motion, both craniocaudal and anteroposterior motions of the anterior surface of the pulmonary and abdominal rib cages were significantly greater in the sitting position. Regarding motion of the left lateral abdominal rib cage, lateral motion was greatest in the lateral position. [Conclusion] Chest-wall configuration and motion changed according to posture in healthy men, particularly in the pulmonary and abdominal rib cages.
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Affiliation(s)
- Sachie Takashima
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Japan
| | - Masafumi Nozoe
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Japan
| | - Kyoshi Mase
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Japan
| | - Yusuke Kouyama
- Department of Rehabilitation, Takarazuka City Hospital, Japan
| | - Kazuhiro Matsushita
- Department of Rehabilitation, Hyogo College of Medicine Sasayama Medical Center, Japan
| | - Hiroshi Ando
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Japan
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Thoracoabdominal mobility is improved in subjects with tetraplegia after one year of wheelchair rugby training. Sci Sports 2016. [DOI: 10.1016/j.scispo.2016.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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LoMauro A, Cesareo A, Agosti F, Tringali G, Salvadego D, Grassi B, Sartorio A, Aliverti A. Effects of a multidisciplinary body weight reduction program on static and dynamic thoraco-abdominal volumes in obese adolescents. Appl Physiol Nutr Metab 2016; 41:649-58. [PMID: 27175804 DOI: 10.1139/apnm-2015-0269] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
The objective of this study was to characterize static and dynamic thoraco-abdominal volumes in obese adolescents and to test the effects of a 3-week multidisciplinary body weight reduction program (MBWRP), entailing an energy-restricted diet, psychological and nutritional counseling, aerobic physical activity, and respiratory muscle endurance training (RMET), on these parameters. Total chest wall (VCW), pulmonary rib cage (VRC,p), abdominal rib cage (VRC,a), and abdominal (VAB) volumes were measured on 11 male adolescents (Tanner stage: 3-5; BMI standard deviation score: >2; age: 15.9 ± 1.3 years; percent body fat: 38.4%) during rest, inspiratory capacity (IC) maneuver, and incremental exercise on a cycle ergometer at baseline and after 3 weeks of MBWRP. At baseline, the progressive increase in tidal volume was achieved by an increase in end-inspiratory VCW (p < 0.05) due to increases in VRC,p and VRC,a with constant VAB. End-expiratory VCW decreased with late increasing VRC,p, dynamically hyperinflating VRC,a (p < 0.05), and progressively decreasing VAB (p < 0.05). After MBWRP, weight loss was concentrated in the abdomen and total IC decreased. During exercise, abdominal rib cage hyperinflation was delayed and associated with 15% increased performance and reduced dyspnea at high workloads (p < 0.05) without ventilatory and metabolic changes. We conclude that otherwise healthy obese adolescents adopt a thoraco-abdominal operational pattern characterized by abdominal rib cage hyperinflation as a form of lung recruitment during incremental cycle exercise. Additionally, a short period of MBWRP including RMET is associated with improved exercise performance, lung and chest wall volume recruitment, unloading of respiratory muscles, and reduced dyspnea.
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Affiliation(s)
- Antonella LoMauro
- a Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Ambra Cesareo
- a Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
| | - Fiorenza Agosti
- b Experimental Laboratory for Auxo-endocrinological Research, Istituto Auxologico Italiano, IRCCS, Milan and Piancavallo (VB), Italy
| | - Gabriella Tringali
- b Experimental Laboratory for Auxo-endocrinological Research, Istituto Auxologico Italiano, IRCCS, Milan and Piancavallo (VB), Italy
| | - Desy Salvadego
- c Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Bruno Grassi
- c Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Alessandro Sartorio
- b Experimental Laboratory for Auxo-endocrinological Research, Istituto Auxologico Italiano, IRCCS, Milan and Piancavallo (VB), Italy.,d Division of Metabolic Diseases and Auxology, Istituto Auxologico Italiano, IRCCS, Piancavallo (VB), Italy
| | - Andrea Aliverti
- a Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy
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Nozoe M, Mase K, Tsutou A. Regional chest wall volume changes during various breathing maneuvers in normal men. JOURNAL OF THE JAPANESE PHYSICAL THERAPY ASSOCIATION 2015; 14:12-8. [PMID: 25792893 DOI: 10.1298/jjpta.vol14_002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Accepted: 09/01/2011] [Indexed: 11/23/2022]
Abstract
PURPOSE The purpose of this study is to investigate the regional chest wall volume changes during various breathing maneuvers in normal men with an optical reflectance system (OR), which tracks reflective markers in three dimensions. METHODS Chest wall volume was measured by the OR system [VL(CW)], and lung volume was measured by hot wire spirometry [VL(SP)] in 15 healthy men during quiet breathing (QB), during breathing at a rate of 50 tidal breaths/min paced using a metronome (MT: metronome-paced tachypnea), and during a maximal forced inspiratory and expiratory maneuver (MFIE maneuver). RESULTS There were few discrepancies between VL(CW) and VL(SP) for QB and MT. In the MFIE maneuver, however VL(CW) was often underestimated compared with VL(SP), particularly during forced maximal expiration, because of pulmonary rib cage volume changes. Furthermore, the regional chest wall volume changes were affected by breathing maneuver alternation. In the pulmonary and abdominal rib cage, inspiratory reserve volume was larger than expiratory reserve volume, respectively, and in the abdomen, expiratory reserve volume was larger than inspiratory reserve volume. CONCLUSION Alternation of breathing maneuvers affects regional chest wall volume changes.
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Affiliation(s)
- Masafumi Nozoe
- Department of Rehabilitation, Hyogo College of Medicine Sasayama Medical Center Kurooka 5, Sasayama, Hyogo, 669-2321 Japan ; Division of Preventive Health Sciences, Department of Community Health Sciences, Faculty of Health Sciences, Kobe University Graduate School of Health Sciences
| | - Kyoshi Mase
- Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University
| | - Akimitsu Tsutou
- Division of Preventive Health Sciences, Department of Community Health Sciences, Faculty of Health Sciences, Kobe University Graduate School of Health Sciences
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Kortianou EA, Aliverti A, Louvaris Z, Vasilopoulou M, Nasis I, Asimakos A, Zakynthinos S, Vogiatzis I. Limitation in tidal volume expansion partially determines the intensity of physical activity in COPD. J Appl Physiol (1985) 2014; 118:107-14. [PMID: 25398190 DOI: 10.1152/japplphysiol.00301.2014] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In patients with chronic obstructive pulmonary disease (COPD), reduced levels of daily physical activity are associated with the degree of impairment in lung, peripheral muscle, and central hemodynamic function. There is, however, limited evidence as to whether limitations in tidal volume expansion also, importantly, determine daily physical activity levels in COPD. Eighteen consecutive patients with COPD [9 active (forced expiratory volume in 1 s, FEV1: 1.59 ± 0.64 l) with an average daily movement intensity >1.88 m/s(2) and 9 less active patients (FEV1: 1.16 ± 0.41 l) with an average intensity <1.88 m/s(2)] underwent a 4-min treadmill test at a constant speed corresponding to each individual patient's average movement intensity, captured by a triaxial accelerometer during a preceding 7-day period. When chest wall volumes, captured by optoelectronic plethysmography, were expressed relative to comparable levels of minute ventilation (ranging between 14.5 ± 4.3 to 33.5 ± 4.4 l/min), active patients differed from the less active ones in terms of the lower increase in end-expiratory chest wall volume (by 0.15 ± 0.17 vs. 0.45 ± 0.21 l), the greater expansion in tidal volume (by 1.76 ± 0.58 vs. 1.36 ± 0.24 l), and the larger inspiratory reserve chest wall volume (IRVcw: by 0.81 ± 0.25 vs. 0.39 ± 0.27 l). IRVcw (r(2) = 0.420), expiratory flow (r(2) change = 0.174), and Borg dyspnea score (r(2) change = 0.123) emerged as the best contributors, accounting for 71.7% of the explained variance in daily movement intensity. Patients with COPD exhibiting greater ability to expand tidal volume and to maintain adequate inspiratory reserve volume tend to be more physically active. Thus interventions aiming at mitigating restrictions on operational chest wall volumes are expected to enhance daily physical activity levels in COPD.
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Affiliation(s)
- Eleni A Kortianou
- National and Kapodistrian University of Athens, Department of Physical Education and Sports Sciences, Athens, Greece; National and Kapodistrian University of Athens, 1st Department of Critical Care Medicine, Evangelismos Hospital, Athens, Greece; Technological Educational Institute of Central Greece, Department of Physiotherapy, Lamia, Greece
| | - Andrea Aliverti
- Dipartimento di Elettronica, Informazione e Bioingeneria, Politecnico di Milano, Italy
| | - Zafeiris Louvaris
- National and Kapodistrian University of Athens, Department of Physical Education and Sports Sciences, Athens, Greece
| | - Maroula Vasilopoulou
- National and Kapodistrian University of Athens, Department of Physical Education and Sports Sciences, Athens, Greece
| | - Ioannis Nasis
- National and Kapodistrian University of Athens, Department of Physical Education and Sports Sciences, Athens, Greece
| | - Andreas Asimakos
- National and Kapodistrian University of Athens, 1st Department of Critical Care Medicine, Evangelismos Hospital, Athens, Greece
| | - Spyros Zakynthinos
- National and Kapodistrian University of Athens, 1st Department of Critical Care Medicine, Evangelismos Hospital, Athens, Greece
| | - Ioannis Vogiatzis
- National and Kapodistrian University of Athens, Department of Physical Education and Sports Sciences, Athens, Greece; National and Kapodistrian University of Athens, 1st Department of Critical Care Medicine, Evangelismos Hospital, Athens, Greece;
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Vogiatzis I, Zakynthinos S. Factors limiting exercise tolerance in chronic lung diseases. Compr Physiol 2013; 2:1779-817. [PMID: 23723024 DOI: 10.1002/cphy.c110015] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The major limitation to exercise performance in patients with chronic lung diseases is an issue of great importance since identifying the factors that prevent these patients from carrying out activities of daily living provides an important perspective for the choice of the appropriate therapeutic strategy. The factors that limit exercise capacity may be different in patients with different disease entities (i.e., chronic obstructive, restrictive or pulmonary vascular lung disease) or disease severity and ultimately depend on the degree of malfunction or miss coordination between the different physiological systems (i.e., respiratory, cardiovascular and peripheral muscles). This review focuses on patients with chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD) and pulmonary vascular disease (PVD). ILD and PVD are included because there is sufficient experimental evidence for the factors that limit exercise capacity and because these disorders are representative of restrictive and pulmonary vascular disorders, respectively. A great deal of emphasis is given, however, to causes of exercise intolerance in COPD mainly because of the plethora of research findings that have been published in this area and also because exercise intolerance in COPD has been used as a model for understanding the interactions of different pathophysiologic mechanisms in exercise limitation. As exercise intolerance in COPD is recognized as being multifactorial, the impacts of the following factors on patients' exercise capacity are explored from an integrative physiological perspective: (i) imbalance between the ventilatory capacity and requirement; (ii) imbalance between energy demands and supplies to working respiratory and peripheral muscles; and (iii) peripheral muscle intrinsic dysfunction/weakness.
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Affiliation(s)
- Ioannis Vogiatzis
- Department of Physical Education and Sport Sciences, National and Kapodistrian University of Athens, Greece.
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Acosta J, Bradley A, Raja V, Aliverti A, Badiyani S, Motta A, Moriconi S, Parker K, Rajesh P, Naidu B. Exercise improvement after pectus excavatum repair is not related to chest wall function†. Eur J Cardiothorac Surg 2013; 45:544-8. [DOI: 10.1093/ejcts/ezt473] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Illi SK, Hostettler S, Aliverti A, Spengler CM. Compartmental chest wall volume changes during volitional hyperpnoea with constant tidal volume in healthy individuals. Respir Physiol Neurobiol 2013; 185:410-5. [DOI: 10.1016/j.resp.2012.08.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 07/30/2012] [Accepted: 08/23/2012] [Indexed: 11/30/2022]
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Silvatti AP, Sarro KJ, Cerveri P, Baroni G, Barros RML. A 3D kinematic analysis of breathing patterns in competitive swimmers. J Sports Sci 2012; 30:1551-60. [DOI: 10.1080/02640414.2012.713976] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Compartmental chest wall volume changes during volitional normocapnic hyperpnoea. Respir Physiol Neurobiol 2011; 177:294-300. [DOI: 10.1016/j.resp.2011.05.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2011] [Revised: 04/28/2011] [Accepted: 05/10/2011] [Indexed: 11/22/2022]
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Layton AM, Garber CE, Thomashow BM, Gerardo RE, Emmert-Aronson BO, Armstrong HF, Basner RC, Jellen P, Bartels MN. Exercise ventilatory kinematics in endurance trained and untrained men and women. Respir Physiol Neurobiol 2011; 178:223-9. [PMID: 21708294 DOI: 10.1016/j.resp.2011.06.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Revised: 06/03/2011] [Accepted: 06/13/2011] [Indexed: 10/18/2022]
Abstract
To determine how increased ventilatory demand impacts ventilatory kinematics, we compared the total chest wall volume variations (V(CW)) of male and female endurance-trained athletes (ET) to untrained individuals (UT) during exercise. We hypothesized that training and gender would have an effect on V(CW) and kinematics at maximal exercise. Gender and training significantly influenced chest wall kinematics. Female ET did not change chest wall end-expiratory volume (V(CW,ee)) or pulmonary ribcage (V(RCp,ee)) with exercise, while female UT significantly decreased V(CW,ee) and V(RCp,ee) with exercise (p<0.05). Female ET significantly increased pulmonary ribcage end-inspiratory volume (V(RCp,ei)) with exercise (p<0.05), while female UT did not change V(RCp,ei) with exercise. Male ET significantly increased V(RCp,ei) with exercise (p<0.05); male UT did not. Men and women had significantly different variation of V(CW) (p<0.05). Women demonstrated the greatest variation of V(CW) in the pulmonary ribcage compartment (V(RCp)). Men had even volumes variation of the V(RCp) and the abdomen (V(Ab)). In conclusion, gender and training had a significant impact on ventilatory kinematics.
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Affiliation(s)
- Aimee M Layton
- Department of Biobehavioral Sciences, Teachers College, Columbia University, 525 120th St., New York, NY 10027, USA.
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Vogiatzis I, Athanasopoulos D, Habazettl H, Kuebler WM, Wagner H, Roussos C, Wagner PD, Zakynthinos S. Intercostal muscle blood flow limitation in athletes during maximal exercise. J Physiol 2009; 587:3665-77. [PMID: 19451206 PMCID: PMC2742289 DOI: 10.1113/jphysiol.2009.171694] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2009] [Accepted: 05/13/2009] [Indexed: 11/08/2022] Open
Abstract
We investigated whether, during maximal exercise, intercostal muscle blood flow is as high as during resting hyperpnoea at the same work of breathing. We hypothesized that during exercise, intercostal muscle blood flow would be limited by competition from the locomotor muscles. Intercostal (probe over the 7th intercostal space) and vastus lateralis muscle perfusion were measured simultaneously in ten trained cyclists by near-infrared spectroscopy using indocyanine green dye. Measurements were made at several exercise intensities up to maximal (WRmax) and subsequently during resting isocapnic hyperpnoea at minute ventilation levels up to those at WRmax. During resting hyperpnoea, intercostal muscle blood flow increased linearly with the work of breathing (R2 = 0.94) to 73.0 +/- 8.8 ml min-1 (100 g)-1 at the ventilation seen at WRmax (work of breathing approximately 550-600 J min-1), but during exercise it peaked at 80% WRmax (53.4 +/- 10.3 ml min-1 (100 g)-1), significantly falling to 24.7 +/- 5.3 ml min-1 (100 g)-1 at WRmax. At maximal ventilation intercostal muscle vascular conductance was significantly lower during exercise (0.22 +/- 0.05 ml min-1 (100 g)-1 mmHg-1) compared to isocapnic hyperpnoea (0.77 +/- 0.13 ml min-1 (100 g)-1 mmHg-1). During exercise, both cardiac output and vastus lateralis muscle blood flow also plateaued at about 80% WRmax (the latter at 95.4 +/- 11.8 ml min-1 (100 g)-1). In conclusion, during exercise above 80% WRmax in trained subjects, intercostal muscle blood flow and vascular conductance are less than during resting hyperpnoea at the same minute ventilation. This suggests that the circulatory system is unable to meet the demands of both locomotor and intercostal muscles during heavy exercise, requiring greater O2 extraction and likely contributing to respiratory muscle fatigue.
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Affiliation(s)
- Ioannis Vogiatzis
- Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, M. Simou, G. P. Livanos Laboratories, National and Kapodistrian University of Athens, Athens, Greece.
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Wang HK, Lu TW, Liing RJ, Shih TTF, Chen SC, Lin KH. Relationship Between Chest Wall Motion and Diaphragmatic Excursion in Healthy Adults in Supine Position. J Formos Med Assoc 2009; 108:577-86. [DOI: 10.1016/s0929-6646(09)60376-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Guenette JA, Querido JS, Eves ND, Chua R, Sheel AW. Sex differences in the resistive and elastic work of breathing during exercise in endurance-trained athletes. Am J Physiol Regul Integr Comp Physiol 2009; 297:R166-75. [DOI: 10.1152/ajpregu.00078.2009] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
It is not known whether the high total work of breathing (WOB) in exercising women is higher due to differences in the resistive or elastic WOB. Accordingly, the purpose of this study was to determine which factors contribute to the higher total WOB during exercise in women. We performed a comprehensive analysis of previous data from 16 endurance-trained subjects (8 men and 8 women) that underwent a progressive cycle exercise test to exhaustion. Esophageal pressure, lung volumes, and ventilatory parameters were continuously monitored throughout exercise. Modified Campbell diagrams were used to partition the esophageal-pressure volume data into inspiratory and expiratory resistive and elastic components at 50, 75, 100 l/min and maximal ventilations and also at three standardized submaximal work rates (3.0, 3.5, and 4.0 W/kg). The total WOB was also compared between sexes at relative submaximal ventilations (25, 50, and 75% of maximal ventilation). The inspiratory resistive WOB at 50, 75, and 100 l/min was 67, 89, and 109% higher in women, respectively ( P < 0.05). The expiratory resistive WOB was 131% higher in women at 75 l/min ( P < 0.05) with no differences at 50 or 100 l/min. There were no significant sex differences in the inspiratory or expiratory elastic WOB across any absolute minute ventilation. However, the total WOB was 120, 60, 50, and 45% higher in men at 25, 50, 75, and 100% of maximal exercise ventilation, respectively ( P < 0.05). This was due in large part to their much higher tidal volumes and thus higher inspiratory elastic WOB. When standardized for a given work rate to body mass ratio, the total WOB was significantly higher in women at 3.5 W/kg (239 ± 31 vs. 173 ± 12 J/min, P < 0.05) and 4 W/kg (387 ± 53 vs. 243 ± 36 J/min, P < 0.05), and this was due exclusively to a significantly higher inspiratory and expiratory resistive WOB rather than differences in the elastic WOB. The higher total WOB in women at absolute ventilations and for a given work rate to body mass ratio is due to a substantially higher resistive WOB, and this is likely due to smaller female airways relative to males and a breathing pattern that favors a higher breathing frequency.
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Golemati S, Moupagiatzis I, Athanasopoulos D, Vasilopoulou M, Roussos C, Vogiatzis I. Comparative analysis of phase difference estimation methods quantifying asynchronies between compartmental chest wall volume signals. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2009; 2009:2871-2874. [PMID: 19963785 DOI: 10.1109/iembs.2009.5333106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Asynchronous breathing movements may be observed in the presence of pulmonary disease, such as chronic obstructive pulmonary disease (COPD). This study was undertaken in an attempt to propose a reliable methodology to quantify this asynchrony. Five methods for estimating phase differences between two signals, based on the phase angle of the Fourier Transform (PhD(FT)), paradoxical motion (PhD(PM)), the Lissajous figure (PhD(LF)), maximal linear correlation (PhD(P)) and least-squares filtering (PhD(LS)), were compared. Frequency-modulated signals, simulating compartmental chest wall volumes, were used to evaluate the methods. Breathing asynchrony was quantified in two ways; by estimating (a) a single PhD value for the entire recording and (b) time-varying PhDs, representing non-stationarities of human breathing. PhD(PM) and PhD(LF) had the lowest average errors (4%), and PhD(LS) had a slightly higher error. PhD(FT) had zero error when estimating a single PhD value but a considerable error when estimating time-varying PhDs. PhD(P) presented the highest errors in all cases. An application of this methodology is proposed in real compartmental chest wall volume signals of normal and COPD subjects. Preliminary results indicate that the methodology is promising in quantifying differences in asynchronous breathing between thoracic volumes of COPD patients and healthy controls.
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Vogiatzis I, Athanasopoulos D, Boushel R, Guenette JA, Koskolou M, Vasilopoulou M, Wagner H, Roussos C, Wagner PD, Zakynthinos S. Contribution of respiratory muscle blood flow to exercise-induced diaphragmatic fatigue in trained cyclists. J Physiol 2008; 586:5575-87. [PMID: 18832419 DOI: 10.1113/jphysiol.2008.162768] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
We investigated whether the greater degree of exercise-induced diaphragmatic fatigue previously reported in highly trained athletes in hypoxia (compared with normoxia) could have a contribution from limited respiratory muscle blood flow. Seven trained cyclists completed three constant load 5 min exercise tests at inspired O(2) fractions (FIO2) of 0.13, 0.21 and 1.00 in balanced order. Work rates were selected to produce the same tidal volume, breathing frequency and respiratory muscle load at each FIO2 (63 +/- 1, 78 +/- 1 and 87 +/- 1% of normoxic maximal work rate, respectively). Intercostals and quadriceps muscle blood flow (IMBF and QMBF, respectively) were measured by near-infrared spectroscopy over the left 7th intercostal space and the left vastus lateralis muscle, respectively, using indocyanine green dye. The mean pressure time product of the diaphragm and the work of breathing did not differ across the three exercise tests. After hypoxic exercise, twitch transdiaphragmatic pressure fell by 33.3 +/- 4.8%, significantly (P < 0.05) more than after both normoxic (25.6 +/- 3.5% reduction) and hyperoxic (26.6 +/- 3.3% reduction) exercise, confirming greater fatigue in hypoxia. Despite lower leg power output in hypoxia, neither cardiac output nor QMBF (27.6 +/- 1.2 l min(-1) and 100.4 +/- 8.7 ml (100 ml)(-1) min(-1), respectively) were significantly different compared with normoxia (28.4 +/- 1.9 l min(-1) and 94.4 +/- 5.2 ml (100 ml)(-1) min(-1), respectively) and hyperoxia (27.8 +/- 1.6 l min(-1) and 95.1 +/- 7.8 ml (100 ml)(-1) min(-1), respectively). Neither IMBF was different across hypoxia, normoxia and hyperoxia (53.6 +/- 8.5, 49.9 +/- 5.9 and 52.9 +/- 5.9 ml (100 ml)(-1) min(-1), respectively). We conclude that when respiratory muscle energy requirement is not different between normoxia and hypoxia, diaphragmatic fatigue is greater in hypoxia as intercostal muscle blood flow is not increased (compared with normoxia) to compensate for the reduction in PaO2, thus further compromising O(2) supply to the respiratory muscles.
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Affiliation(s)
- Ioannis Vogiatzis
- Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, National and Kapodistrian University of Athens, Greece.
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Guenette JA, Witt JD, McKenzie DC, Road JD, Sheel AW. Respiratory mechanics during exercise in endurance-trained men and women. J Physiol 2007; 581:1309-22. [PMID: 17412775 PMCID: PMC2170830 DOI: 10.1113/jphysiol.2006.126466] [Citation(s) in RCA: 154] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The purpose of this study was to compare the mechanics of breathing including the measurement of expiratory flow limitation, end-expiratory lung volume, end-inspiratory lung volume, and the work of breathing in endurance-trained men (n=8) and women (n=10) during cycle exercise. Expiratory flow limitation was assessed by applying a negative expiratory pressure at the mouth. End-expiratory lung volume and end-inspiratory lung volume were determined by having subjects perform inspiratory capacity manoeuvres. Transpulmonary pressure, taken as the difference between oesophageal and airway opening pressure, was plotted against volume and integrated to determine the work of breathing. Expiratory flow limitation occurred in nine females (90%) and three males (43%) during the final stage of exercise. Females had a higher relative end-expiratory lung volume (42+/-8 versus 35+/-5% forced vital capacity (FVC)) and end-inspiratory lung volume (88+/-5 versus 82+/-7% FVC) compared to males at maximal exercise (P<0.05). Women also had a higher work of breathing compared to men across a range of ventilations. On average, women had a work of breathing that was twice that of men at ventilations above 90 l min(-1). These data suggest that expiratory flow limitation may be more common in females and that they experience greater relative increases in end-expiratory lung volume and end-inspiratory lung volume at maximal exercise compared to males. The higher work of breathing in women is probably attributed to their smaller lung volumes and smaller diameter airways. Collectively, these findings suggest that women utilize a greater majority of their ventilatory reserve compared to men and this is associated with a higher cost of breathing.
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Affiliation(s)
- Jordan A Guenette
- School of Human Kinetics and Faculty of Medicine, Health and Integrative Physiology Laboratory, University of British Columbia, 6108 Thunderbird Blvd, Vancouver, BC, Canada V6T-1Z3
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Vogiatzis I, Georgiadou O, Koskolou M, Athanasopoulos D, Kostikas K, Golemati S, Wagner H, Roussos C, Wagner PD, Zakynthinos S. Effects of hypoxia on diaphragmatic fatigue in highly trained athletes. J Physiol 2007; 581:299-308. [PMID: 17317748 PMCID: PMC2075230 DOI: 10.1113/jphysiol.2006.126136] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Previous work suggests that exercise-induced arterial hypoxaemia (EIAH), causing only moderate arterial oxygen desaturation (SaO2 : 92 +/- 1%), does not exaggerate diaphragmatic fatigue exhibited by highly trained endurance athletes. Since changes in arterial O2 tension have a significant effect on the rate of development of locomotor muscle fatigue during strenuous exercise, the present study investigated whether hypoxia superimposed on EIAH exacerbates the exercise-induced diaphragmatic fatigue in these athletes. Eight trained cyclists (VO2max : 67.0 +/- 2.6 ml kg(-1) min(-1); mean +/- S.E.M.) completed in balanced order four 5 min exercise tests leading to different levels of end-exercise SaO2 (64 +/- 2, 83 +/- 1, 91 +/- 1 and 96 +/- 1%) via variations in inspired O2 fraction (FiO2 : 0.13, 0.17, 0.21 and 0.26, respectively). Measurements were made at corresponding intensities (65 +/- 3, 80 +/- 3, 85 +/- 3 and 90 +/- 3% of normoxic maximal work rate, respectively) in order to produce the same tidal volume, breathing frequency and respiratory muscle load at each FiO2. The mean pressure time product of the diaphragm did not differ across the four exercise tests and ranged between 312 +/- 28 and 382 +/- 22 cmH2O s min(-1). Ten minutes into recovery, twitch transdiaphragmatic pressure (P(di,tw)) determined by bilateral phrenic nerve stimulation, was significantly (P = 0.0001) reduced after all tests. After both hypoxic tests (FiO2 : 0.13, 0.17) the degree of fall in P(di,tw) (by 26.9 +/- 2.7 and 27.4 +/- 2.6%, respectively) was significantly greater (P < 0.05) than after the normoxic test (by 20.1 +/- 3.4%). The greater amount of diaphragmatic fatigue in hypoxia at lower leg work rates (presumably requiring smaller leg blood flow compared with normoxia at higher leg work rates), suggests that when ventilatory muscle load is similar between normoxia and hypoxia, hypoxia exaggerates diaphragmatic fatigue in spite of potentially greater respiratory muscle blood flow availability.
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Affiliation(s)
- Ioannis Vogiatzis
- Department of Critical Care Medicine and Pulmonary Services, Evangelismos Hospital, M. Simou and G. P. Livanos Laboratories, Athens, Greece.
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Holmberg HC, Calbet JAL. Insufficient ventilation as a cause of impaired pulmonary gas exchange during submaximal exercise. Respir Physiol Neurobiol 2007; 157:348-59. [PMID: 17303477 DOI: 10.1016/j.resp.2006.12.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2006] [Revised: 12/18/2006] [Accepted: 12/20/2006] [Indexed: 11/27/2022]
Abstract
Pulmonary ventilation and gas exchange were determined during prolonged skiing (approximately 76% of V(O2, max); cardiac output=26-27 L min(-1)) using diagonal technique (DIA) for 40 min followed by 10 min of double poling (DPOL) and 10 min of leg skiing (LEG). Exercise caused approximately 2-5% reduction of arterial oxygen saturation Sa(O2). For a given cardiac output and V(O2), DPOL presented higher V(E), lower Pa(CO2) and a more efficient pulmonary gas exchange, revealed by higher PA(O2) and Pa(O2) and lower A-aD(O2). The A-aD(O2) widened 2 mmHg L(-1) of cardiac output increase. However, for a given cardiac output and V(O2), exercise mode had an important influence on pulmonary ventilation and gas exchange. Highly trained cross-country skiers' present about 2 units reduction in Sa(O2) from resting values during submaximal exercise at 76% of V(O2, max). Half of the reduction in saturation is accounted for by the rightward-shift of the oxygen dissociation curve of the haemoglobin. The exercise duration has almost no repercussion on pulmonary gas exchange in these athletes, with the small effect on Sa(O2) associated to the increase in body core temperature.
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Affiliation(s)
- H-C Holmberg
- Department of Physiology and Pharmacology, Karolinska Institutet, Stockholm, Sweden.
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Vogiatzis I, Zakynthinos S, Georgiadou O, Golemati S, Pedotti A, Macklem PT, Roussos C, Aliverti A. Oxygen kinetics and debt during recovery from expiratory flow-limited exercise in healthy humans. Eur J Appl Physiol 2006; 99:265-74. [PMID: 17149607 PMCID: PMC1782100 DOI: 10.1007/s00421-006-0342-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2006] [Indexed: 11/30/2022]
Abstract
In healthy subjects expiratory flow limitation (EFL) during exercise can lower O2 delivery to the working muscles. We hypothesized that if this affects exercise performance it should influence O2 kinetics at the end of exercise when the O2 debt is repaid. We performed an incremental exercise test on six healthy males with a Starling resistor in the expiratory line limiting expiratory flow to ∼ 1 l s−1 to determine maximal EFL exercise workload (Wmax). In two more square-wave exercise runs subjects exercised with and without EFL at Wmax for 6 min, while measuring arterial O2 saturation (% SaO2), end-tidal pressure of CO2 (PETCO2) and breath-by-breath O2 consumption \documentclass[12pt]{minimal}
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\begin{document}$${({\dot{V}}\hbox{O}_{2})}$$\end{document} taking into account changes in O2 stored in the lungs. Over the last minute of EFL exercise, mean PETCO2 (54.7 ± 9.9 mmHg) was significantly higher (P < 0.05) compared to control (41.4 ± 3.9 mmHg). At the end of EFL exercise %SaO2 fell significantly by 4 ± 3%. When exercise stopped, EFL was removed, and we continued to measure \documentclass[12pt]{minimal}
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\begin{document}$${{\dot{V}}\hbox{O}_{2}.}$$\end{document} During recovery, there was an immediate step increase in \documentclass[12pt]{minimal}
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\begin{document}$${{\dot{V}}\hbox{O}_{2},}$$\end{document} so that repayment of EFL O2 debt started at a higher \documentclass[12pt]{minimal}
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\begin{document}$${{\dot{V}}\hbox{O}_{2}}$$\end{document} than control. Recovery \documentclass[12pt]{minimal}
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\begin{document}$${{\dot{V}}\hbox{O}_{2}}$$\end{document} kinetics after EFL exercise was best characterized by a double-exponential function with fundamental and slow time constants of 27 ± 11 and 1,020 ± 305 s, compared to control values of 41 ± 10 and 1,358 ± 320 s, respectively. EFL O2 debt was 52 ± 22% greater than control (2.19 ± 0.58 vs. 1.49 ± 0.38 l). We conclude that EFL exercise increases the O2 debt and leads to hypoxemia in part due to hypercapnia.
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Affiliation(s)
- I Vogiatzis
- Department of Critical Care Medicine and Pulmonary Services, G. P. Livanos and M. Simou Laboratories, Evangelismos Hospital, National and Kapodistrian University of Athens, Athens, Greece.
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Binazzi B, Lanini B, Bianchi R, Romagnoli I, Nerini M, Gigliotti F, Duranti R, Milic-Emili J, Scano G. Breathing pattern and kinematics in normal subjects during speech, singing and loud whispering. Acta Physiol (Oxf) 2006; 186:233-46. [PMID: 16497202 DOI: 10.1111/j.1748-1716.2006.01529.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIMS We used for the first time a non-invasive optoelectronic plethysmography to assess breathing movements and to provide a quantitative description of chest wall kinematics during phonation. METHODS Volumes of different chest wall compartments (abdomen and lung apposed to rib cage and abdomen) were assessed using optoelectronic plethysmography in 16 normal Italians (eight men) during reading, singing and high-effort whispering (HW). RESULTS During phonation the breathing pattern was different from quiet breathing and exercise. (1) During phonation, tidal volume and expiratory time increased while inspiratory time decreased. The expiratory volume changes and flows during HW were considerably greater than during vocalization. During HW, the overall end-expiratory thoracic volume significantly decreased as a result of decreased volume of all compartments and essentially impinged on the maximal expiratory flow-volume curve. (2) While, as previously shown, during exercise the expired volume is due entirely to the abdomen, during phonation all three chest wall compartments contribute to it. Under all conditions studied breathing was, on average, more costal in females than in males but this was mainly related to different size rather than gender per se. CONCLUSIONS Physical characteristics have a greater importance than gender in determining breathing pattern and chest wall kinematics during phonation. The activity of the control of expiration during phonation is more complex than during exercise.
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Affiliation(s)
- B Binazzi
- Department of Internal Medicine, Section of Immunoallergology and Respiratory Disease, Università di Firenze, 50134 Firenze, Italy
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Vogiatzis I, Georgiadou O, Golemati S, Aliverti A, Kosmas E, Kastanakis E, Geladas N, Koutsoukou A, Nanas S, Zakynthinos S, Roussos C. Patterns of dynamic hyperinflation during exercise and recovery in patients with severe chronic obstructive pulmonary disease. Thorax 2005; 60:723-9. [PMID: 15964912 PMCID: PMC1747529 DOI: 10.1136/thx.2004.039115] [Citation(s) in RCA: 69] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Not all patients with severe chronic obstructive pulmonary disease (COPD) progressively hyperinflate during symptom limited exercise. The pattern of change in chest wall volumes (Vcw) was investigated in patients with severe COPD who progressively hyperinflate during exercise and those who do not. METHODS Twenty patients with forced expiratory volume in 1 second (FEV(1)) 35 (2)% predicted were studied during a ramp incremental cycling test to the limit of tolerance (Wpeak). Changes in Vcw at the end of expiration (EEVcw), end of inspiration (EIVcw), and at total lung capacity (TLCVcw) were computed by optoelectronic plethysmography (OEP) during exercise and recovery. RESULTS Two significantly different patterns of change in EEVcw were observed during exercise. Twelve patients had a progressive significant increase in EEVcw during exercise (early hyperinflators, EH) amounting to 750 (90) ml at Wpeak. In contrast, in all eight remaining patients EEVcw remained unchanged up to 66% Wpeak but increased significantly by 210 (80) ml at Wpeak (late hyperinflators, LH). Although at the limit of tolerance the increase in EEVcw was significantly greater in EH, both groups reached similar Wpeak and breathed with a tidal EIVcw that closely approached TLCVcw (EIVcw/TLCVcw 93 (1)% and 93 (3)%, respectively). EEVcw was increased by 254 (130) ml above baseline 3 minutes after exercise only in EH. CONCLUSIONS Patients with severe COPD exhibit two patterns during exercise: early and late hyperinflation. In those who hyperinflate early, it may take several minutes before the hyperinflation is fully reversed after termination of exercise.
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Affiliation(s)
- I Vogiatzis
- National and Kapodistrian University of Athens Medical School, Thorax Foundation, Centre for Applied Biomedical Research and Education, 10675 Athens, Greece.
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