Effects of gender and posture on thoraco-abdominal kinematics during quiet breathing in healthy adults

doi:10.1016/j.resp.2010.05.018

Respiratory Physiology & Neurobiology

Volume 172, Issue 3, 31 July 2010, Pages 184-191

https://doi.org/10.1016/j.resp.2010.05.018 Get rights and content

Abstract

To investigate the effects of posture and gender on thoraco-abdominal motion and breathing pattern, 34 healthy men and women were studied by Opto-Electronic Plethysmography during quiet breathing in five different postures from seated (with and without back support) to supine position.

Chest wall kinematics and breathing pattern were significantly influenced by position and gender. The progressively increased inclination of the trunk determined a progressive reduction of rib cage displacement, tidal volume, and minute ventilation and a progressive increase of abdominal contribution to tidal volume. Female subjects were characterized by smaller dimensions of the rib cage compartment and during quiet breathing by lower tidal volume, minute ventilation and abdominal contribution to tidal volume than males. The effect of posture on abdominal kinematics was significant only in women. The presence of a back support in seated position determined differences in breathing pattern. In conclusion, posture and gender have a strong influence on breathing and on chest wall kinematics.

Introduction

It is well known that posture influences thoraco-abdominal kinematics during spontaneous quiet breathing. Previous studies (Wade, 1954, Fugl-Meyer, 1974, Sharp et al., 1975, Verschakelen and Demedts, 1995, Lee et al., 2010) have investigated both erect (sitting or standing) and supine positions in healthy subjects, and have shown that quiet breathing is predominantly abdominal in the former and thoracic in the latter position.

On the other hand, the effect of gender on chest wall kinematics is still controversial. While some authors (Fugl-Meyer, 1974, Gilbert et al., 1981) reported a relatively greater rib cage motion in women, others (Sharp et al., 1975, Verschakelen and Demedts, 1995) did not. There is evidence in the literature, however, that the differences in pulmonary function (namely, lung volumes, maximal expiratory flow rates, diffusion surfaces and maximal pulmonary ventilation) between females and males are mostly due to the smaller height and trunk size in women (McClaran et al., 1998). These controversies remain when considering possible interactions between posture and gender on thoraco-abdominal motion during quiet breathing.

In the previous studies, different measurement techniques such as mercury-in-rubber strain gauges (Wade, 1954), linear differential transducers (Konno and Mead, 1967), magnetometers (Fugl-Meyer, 1974, Sharp et al., 1975, Gilbert et al., 1981), and respiratory inductive plethysmography (Verschakelen and Demedts, 1995) were used. The differences in experimental methods, particularly in the kind of measurement they provide (changes of diameters, perimeters, transversal sections), could contribute to the different findings regarding the effects of gender and possible interactions between posture and gender on chest wall kinematics.

Opto-Electronic Plethysmography (OEP, Cala et al., 1996) has been proposed as a new method that, starting from the three-dimensional coordinates of markers positioned on a subject's trunk and acquired by an opto-electronic system for motion analysis, allows the accurate measurement of the kinematics and the volume variations of the chest wall and its compartments (rib cage and abdomen) in different positions: standing, seated, supine (Aliverti et al., 2000), and prone (Aliverti et al., 2001).

The present study was conducted in order to prove the hypothesis that posture, gender and their interaction all have significant effects on rib cage and abdominal kinematics during quiet breathing and to clarify which are the limits of validity of chest wall kinematics measurements when considering different geometrical parameters. For these purposes, we used the novel OEP technique to study a group of healthy female and male subjects in different postures, i.e., different inclinations of the trunk from seated (with and without back support) to supine position. By using the same set of three-dimensional coordinates measured by the same opto-electronic system for motion analysis, we calculated simultaneous variations in diameters, perimeters, transversal sections and volumes at the levels of the rib cage and the abdomen as different descriptors of chest wall kinematics. In this way we aimed to exclude all the possible differences between these parameters due to measurement errors introduced by the different sensors and/or devices, which in part may explain the controversial results reported in the literature.

Section snippets

Subjects

34 healthy adults (17 females, 17 males) were recruited for the present study. The inclusion criteria were: absence of cardiac and pulmonary disease, no smokers, no endurance-trained athletes, and age higher than 18 years. Subjects’ characteristics are shown in Table 1.

The study was approved by the local Ethical committee of IRCCS “E. Medea” Institute where all the data acquisitions were performed and all subjects gave informed consent.

Protocol

For each subject, the data acquisition protocol consisted

Results

The anthropometric characteristics of the entire group and of the two subgroups were divided according to their gender (Table 1). The two gender subgroups were homogeneous in age but not in weight and height (p < 0.01).

Discussion

The main result of the present study is that chest wall kinematics and breathing pattern are significantly influenced by the position of the trunk and by gender. A progressively increased inclination of the trunk determines a progressive reduction of rib cage displacement, tidal volume, and minute ventilation and a progressive increase of abdominal contribution to tidal volume.

Female subjects are characterized by smaller dimensions confined in the rib cage compartment and during quiet breathing

Acknowledgement

The authors gratefully acknowledge M.H. Schwartz for the language revision.

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Effects of gender and posture on thoraco-abdominal kinematics during quiet breathing in healthy adults

Abstract

Introduction

Section snippets

Subjects

Protocol

Results

Discussion

Acknowledgement

Chest

Respir. Physiol. Neurobiol.

Abdominal and thoracic pressures at different lung volumes

J. Appl. Physiol.

Optoelectronic plethysmography in intensive care patients

Am. J. Respir. Crit. Care Med.

Compartmental analysis of breathing in the supine and prone positions by optoelectronic plethysmography

Ann. Biomed. Eng.

Effect of posture on lung and regional chest wall mechanics

Anesthesiology

Breathing pattern and kinematics in normal subjects during speech, singing and loud whispering

Acta Physiol.

Sex differences in thoracic dimensions and configuration

Am. J. Respir. Crit. Care Med.

Chest wall and lung volume estimation by optical reflectance motion analysis

J. Appl. Physiol.

Relative respiratory contribution of the rib cage and the abdomen in males and females with special regard to posture

Respiration

Respiratory muscle action inferred from rib cage and abdominal V–P partitioning

J. Appl. Physiol.