Abstract
Background: Forward leaning position is freequently used to reduce dyspnea but thoracic respiratory movements in this position are not known. Objective: To study respiratory movements in supine and standing leaning forward position with support of the forarms among patients with emphysema and severe COPD and study respiratory movements in the forward leaning position during dyspnea. Method: Nineteen patients with emphysema and severe COPD GOLD 3 and 4 underwent spirometric measurement and position of their diaphragm was assessed. Respiratory movements during quiet and deep breathing were measured in supine and standing forward leaning position using the RMMI. Patients then bicycled with target work rate set as fixed fractions of the peak work rate tolerated in a pre-program incremental exercise test. When dismounting the bicycle, respiratory movements were measured in the forward leaning position. Patients rated their level of dyspnoea at rest and after bicycling. Results: Participants, 8 men and 11 women mean age 61±7 years and mean BMI 23.59±4.63. Respiratory movements during quiet breathing in supine position were significantly (abdominal p=.025, lower- and upper thoracic p=.020) greater than in the forward leaning position. In forward leaning during dyspnea, lower- and upper thoracic movements were significantly (p=.001; p=.005, respectively) less than abdominal movements. Mean dyspnea on 0-10 scale was 0,95±1.13 at rest and 5.5± 0.96 at the end of bicycling. Conclusion: Respiratory movements in the forward leaning position are less than in supine. Indicating that patients with emphysema and severe COPD use this position to reduce respiratory effort.
- © 2013 ERS
