Sliwka A1, Pilinski R1, Marciniak K2, Plewa W1, Magdalena P1, Kujawa J3, Nowobilski R1
1Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland, 2University Hospital, Krakow, Poland, 3Center of Rehabilitation and Orthopaedics in Krakow, Krakow, Poland
Background: Proper postural stability is generated by the balance between the pelvic floor, the multifidus, the diaphragm and the transverse abdominal muscles [Szczygieł, 2017]. The diaphragm performs its stabilizing role and at the same time works as the main inspiratory muscle [Kolar, 2012]. Postural disturbances affect the sub-optimal position of the diaphragm´s attachments, what may determine its respiratory efficiency [Kolar, 2012].
Purpose: The aim of the study was to evaluate the changes of respiratory drive (P0.1 and P0.1max), maximal inspiratory and expiratory pressure (PI max, PEmax) after an alignment correction and specific postural muscle activation has been made in accordance with Model of Bobath Clinical Practice (MBCP) [Michielsen,2017]
Methods: The study involved 55 healthy subjects [43F/12M; age 22.8 (SD=2.45); BMI=22.97 (SD=5.44)], randomly assigned to the experimental group (correction of alignment and specific postural muscle activation according to MBCP) or to the control group (awaiting re-examination). The subjects underwent two assessments of the following variables of the respiratory drive: P0.1, P0.1max, PImax and PEmax, with the use of Master Scope Spirometer.
Results: The control group included 25 subjects (20F/5M; age: 23.40 SD=3.01; BMI: 23.71 SD=7.78) and the experimental group 30 subjects (23F/7M; age: 22.43 SD=1.85; BMI: 22.52 SD=2.09). The groups were homogeneous in terms of age, sex, BMI, level of physical activity and initial values of the studied dependent variables p>0.05.
As a result of the applied intervention, P0.1 in the experimental group increased p=0.04 (88.9 vs 107.26), which was not observed in the control group (90.38 vs 84.93; p>0.05). The intervention did not change P0.1 max (E=30.3 vs 26.69; C=25.79 vs 27.00). No differences were found between the groups in the results of PI max measurements taken before and after the intervention (E =68.9 vs 68.9; C=69.8 vs 73.8), whilst the decrease of PE max values was observed only in the experimental group p=0.02 (E=75.43 vs. 70.22; C=77.63 vs. 81.24)
Conclusion(s): Proper posture, which guarantees optimal position of diaphragm's attachment, may influence its inspiratory efficiency as reported by the higher efficiency of respiratory drive during normal breathing (P0.1 value). The results confirm that one-time intervention based on the principles of MBCP allows for the improvement of alignment and activation of central stabilization muscles.
Implications: Physiotherapy aimed at improving postural alignment and activating central stabilization muscles, allows for more effective diaphragm work.
Keywords: Diaphragm, posture, respiratory drive
Funding acknowledgements: The research was supported by founds of Jagiellonian University Medicl College in Krakow, Poland.
Purpose: The aim of the study was to evaluate the changes of respiratory drive (P0.1 and P0.1max), maximal inspiratory and expiratory pressure (PI max, PEmax) after an alignment correction and specific postural muscle activation has been made in accordance with Model of Bobath Clinical Practice (MBCP) [Michielsen,2017]
Methods: The study involved 55 healthy subjects [43F/12M; age 22.8 (SD=2.45); BMI=22.97 (SD=5.44)], randomly assigned to the experimental group (correction of alignment and specific postural muscle activation according to MBCP) or to the control group (awaiting re-examination). The subjects underwent two assessments of the following variables of the respiratory drive: P0.1, P0.1max, PImax and PEmax, with the use of Master Scope Spirometer.
Results: The control group included 25 subjects (20F/5M; age: 23.40 SD=3.01; BMI: 23.71 SD=7.78) and the experimental group 30 subjects (23F/7M; age: 22.43 SD=1.85; BMI: 22.52 SD=2.09). The groups were homogeneous in terms of age, sex, BMI, level of physical activity and initial values of the studied dependent variables p>0.05.
As a result of the applied intervention, P0.1 in the experimental group increased p=0.04 (88.9 vs 107.26), which was not observed in the control group (90.38 vs 84.93; p>0.05). The intervention did not change P0.1 max (E=30.3 vs 26.69; C=25.79 vs 27.00). No differences were found between the groups in the results of PI max measurements taken before and after the intervention (E =68.9 vs 68.9; C=69.8 vs 73.8), whilst the decrease of PE max values was observed only in the experimental group p=0.02 (E=75.43 vs. 70.22; C=77.63 vs. 81.24)
Conclusion(s): Proper posture, which guarantees optimal position of diaphragm's attachment, may influence its inspiratory efficiency as reported by the higher efficiency of respiratory drive during normal breathing (P0.1 value). The results confirm that one-time intervention based on the principles of MBCP allows for the improvement of alignment and activation of central stabilization muscles.
Implications: Physiotherapy aimed at improving postural alignment and activating central stabilization muscles, allows for more effective diaphragm work.
Keywords: Diaphragm, posture, respiratory drive
Funding acknowledgements: The research was supported by founds of Jagiellonian University Medicl College in Krakow, Poland.
Topic: Musculoskeletal
Ethics approval required: Yes
Institution: Jagiellonian University Medical College
Ethics committee: Local Ethics Commitee of Jagiellonian University
Ethics number: KBET/215/B/2012
All authors, affiliations and abstracts have been published as submitted.
