Preliminary Report on the effects of Respiratory Muscle Stretch Gymnastics on Chest Wall Mobility in Patients with Chronic Obstructive Pulmonary Disease

Abstract

Objective

To examine the effect of respiratory muscle stretch gymnastics (RMSG) on chest wall mobility, pulmonary function, and dyspnea in daily living in patients with chronic obstructive pulmonary disease (COPD).

Patients And Method

The subjects were 22 consecutive COPD patients who were regularly treated in the outpatient clinic of a medical university rehabilitation hospital. The patients did not have severe limitations in the range of movement in the shoulders, and were unfamiliar with RMSG. Chest wall mobility (difference between chest circumference during deep expiration and deep inspiration), pulmonary function test (forced expiratory volume in 1 s [FEV₁] and vital capacity), and dyspnea in daily living (Fletcher's rating) were measured before and after 4 weeks of RMSG. Four RMSG patterns were demonstrated to each patient to ensure that they could perform the gymnastics without assistance. The patients were instructed to perform each pattern four times during each session (3 sessions per day) for 4 weeks, at which time, the patients were asked to return for re-evaluation.

Results

Chest wall expansion and reduction increased at both the upper (0.8 ±0.2 and 1.3 ± 0.2 cm, respectively) and lower (0.4 ± 0.2 and 0.7 ± 0.2 cm, respectively) chest walls. Vital capacity increased 119 ± 43 mL, while FEV, remained unchanged. Fletcher's rating improved in 12 patients and remained unchanged in 10; it did not worsen in any of the 22 patients.

Conclusion

RMSG increases chest wall mobility, possibly by reducing chest wall elastance in patients with COPD.