Deep Diaphragmatic Breathing-Anatomical and Biomechanical Consideration

Background: Deep diaphragmatic breathing (DDB) involves slow and fully contraction of the diaphragm with expansion of the belly during inhalation, and slow and fully contraction of the abdominal muscles with reduction of the belly during exhalation. It is the key component of the holistic mind-body exercises commonly used for patients with multimorbidity. Purpose: The purpose of this study was to re-visit and address the fundamental anatomical and biomechanical consideration of the DDB with the relevant literature. Method: Peer-reviewed publications from last the 15 years were retrieved, reviewed, and analyzed. Findings: In this article, we described the updated morphological and anatomical characteristics of the diaphragm. Then, we elucidated in a biomechanical approach how and why the DDB can work on the gastrointestinal, cardiopulmonary, and nervous systems as well as on regulating the intra-abdominopelvic pressure and mind-body interaction to coordinate the diaphragm-pelvic floor-abdominal complex for a variety of physical and physiological activities. Conclusion: Understanding of this updated DDB knowledge may help holistic healthcare professionals including holistic nurses provide better patient education and care management during the DDB or DDB-based mind-body intervention time.

The honest sound of physical effort

Acoustic correlates of physical effort are still poorly understood, even though effort is vocally communicated in a variety of contexts with crucial fitness consequences, including both confrontational and reproductive social interactions. In this study 33 lay participants spoke during a brief, but intense isometric hold (L-sit), first without any voice-related instructions, and then asked either to conceal their effort or to imitate it without actually performing the exercise. Listeners in two perceptual experiments then rated 383 recordings on perceived level of effort (n = 39 listeners) or categorized them as relaxed speech, actual effort, pretended effort, or concealed effort (n = 102 listeners). As expected, vocal effort increased compared to baseline, but the accompanying acoustic changes (increased loudness, pitch, and tense voice quality) were under voluntary control, so that they could be largely suppressed or imitated at will. In contrast, vocal tremor at approximately 10 Hz was most pronounced under actual load, and its experimental addition to relaxed baseline recordings created the impression of concealed effort. In sum, a brief episode of intense physical effort causes pronounced vocal changes, some of which are difficult to control. Listeners can thus estimate the true level of exertion, whether to judge the condition of their opponent in a fight or to monitor a partner’s investment into cooperative physical activities.

Numerical investigation of respiratory drops dynamics released during vocalization

Release of drops from a human body has been the focus of many recent investigations because of the current COVID-19 pandemic. Indirect virus transmission from asymptomatic individuals has been proved to be one of the major infectious routes and difficult to quantify, detect, and mitigate. We show in this work a detailed and novel numerical investigation of drops released during vocalization from a thermal manikin using a large eddy simulation coupled with Lagrangian tracking of drops. The vocalization experiment was modeled using existing data from the literature for modeling exhaled airflow, emission rate, and size distribution. Particular focus was on the definition of the boundary conditions for the exhalation process. Turbulence was compared with experimental data for the near mouth region for 75 exhalation breathing cycles and showed the sensitivity of different modeling assumptions at the mouth inlet. The results provide insights of special interest for understanding drop dynamics in speech-like exhalation modes, modeling the mouth inlet boundary conditions, and providing data for verifying other more simplified models.

Vocal and locomotor coordination develops in association with the autonomic nervous system

In adult animals, movement and vocalizations are coordinated, sometimes facilitating, and at other times inhibiting, each other. What is missing is how these different domains of motor control become coordinated over the course of development. We investigated how postural-locomotor behaviors may influence vocal development, and the role played by physiological arousal during their interactions. Using infant marmoset monkeys, we densely sampled vocal, postural and locomotor behaviors and estimated arousal fluctuations from electrocardiographic measures of heart rate. We found that vocalizations matured sooner than postural and locomotor skills, and that vocal-locomotor coordination improved with age and during elevated arousal levels. These results suggest that postural-locomotor maturity is not required for vocal development to occur, and that infants gradually improve coordination between vocalizations and body movement through a process that may be facilitated by arousal level changes.

Laryngeal Symptoms in Weightlifting Athletes

OBJECTIVES

A preliminary investigation to explore (1) the influence of different exercise conditions on the prevalence and nature of reported sensory and auditory-perceptual voice symptoms, and (2) whether type of self-reported laryngeal behaviors used during weightlifting are related to report of laryngeal symptoms in weightlifting athletes.

STUDY DESIGN

Prospective self-completion questionnaire design.

METHODS

A total of 89 people (36 males, 53 females) who self-identified as individuals who regularly partook in exercise completed a self-report questionnaire administered using Qualtrics software.

RESULTS

Weightlifting was part of 78.7% (n = 70/89) of participants' workout routine. Nearly half (46%, n = 12/26) of self-identified weightlifting athletes reported suffering from at least one laryngeal symptom (throat pain, change in voice, or globus sensation), which was significantly higher (P= 0.008) than that reported by the cardiovascular group (14%, n = 4/29). The most prevalent laryngeal symptom reported by 25.3% (n = 17) of participants after weightlifting was the presence of a globus sensation (ie, the feeling of something stuck in their throat). Throat pain after heavy lifting and a change in voice quality after weightlifting was reported by 22.9% (n = 16) and 11.4% (n = 8) of participants respectively. There were no significant differences (P> 0.05) between reported laryngeal symptoms and the self-reported laryngeal behaviors used during weightlifting (ie, breath hold during the lift, simultaneous release of breath during the lift, or grunting/yelling during the lift).

CONCLUSIONS

As weightlifting increases in popularity, many participants may find themselves experiencing throat pain or hoarseness after heavy lifts. Whilst a particular cause of these symptoms in weightlifters cannot be identified from this study, the reported presence of pain, globus sensation, and change in voice by this group indicates the need for further research.

Effect of airway control by glottal structures on postural stability

Maintenance of upright posture involves complex neuromotor processes that include control of thoracic and abdominal pressures. Control of airflow by glottal structures is a primary determinant of thoracic pressure and may have a role in control of postural stability. This study aimed to investigate the effect of modulation of airway control on upright postural stability during postural perturbations. Standing balance was gently perturbed in the sagittal plane during 7 breathing/voicing tasks that ranged from completely closed (breath-hold), to partially opened (voicing) or completely open (sigh) glottal conditions in 11 healthy adults. Dependent measures were peak amplitude of displacement of the thorax and center of pressure (CoP). When the glottis was completely open during sigh, thoracic displacement in response to the perturbation was greater than in all other conditions, regardless of direction of perturbation (post hoc, all P < 0.002). The absolute amplitude of CoP displacement was greater with backward perturbation (main effect, Direction P = 0.001) and was greater at both extremes of glottal modulation (glottis closed and completely open) than when the glottis was partially opened during counting out loud (post hoc, all P < 0.04). These results show that airway modulation affects postural control during upright perturbations. The thorax was more stable when the glottis was engaged than when it was required to remain open, whereas control of CoP displacement appeared more optimal during the natural dynamic mid-range airway modulation of voicing. These data suggest that glottal control influences balance, and that glottal control strategies may be an important consideration for patients with breathing and/or balance disorders.