Content area
Full text
ABSTRACT
Objectives: 1.To evaluate the effect of postural brace in correcting forward shoulder posture and kyphosis in patients with chronic obstructive pulmonary disease.( COPD)
2. To evaluate the effect of postural correction on inspiratory muscle strength in COPD patients.
Design: A Pilot study comparing baseline values with post-test values.
Subjects: A total of 30 subjects between age group of 45-60 years of either gender, diagnosed to have COPD with forward shoulder posture and Kyphosis were studied.
Methods: Daily inspiratory muscle training(IMT) sessions of 30 minutes' duration and weekly training load increments of -2 to -4cmH20 over a 8-week period with the training device at loads of >30% of baseline maximal inspiratory pressure (PImax) was given. Posture was corrected by a brace and patients were asked to wear it throughout the day for 8 weeks.
Outcome measures: Posture was assessed by Plumbline (PL), intra scapular distance(ISD) and percentage of kyphotic index(KI). Inspiratory muscle strength was measured by deriving maximal inspiratory pressure (PEMax)
Results: All subjects tolerated the training load, improved their inspiratory muscle strength, and reported correction of posture.
Conclusion: A combination of posture correction by a brace and inspiratory muscle training using TEMT is beneficial in improving posture and the strength of inspiratory muscles of COPD patients.
Keywords: COPD, Posture, Kyphosis, Forward Shoulder Posture, Maximal Inspiratory Pressure
Principal, SDM College of Physiotherapy, Dharwad, 2HOD Respiratory Medicine, JNMedical College Belgaum, KLE
INTRODUCTION
There is decreased strength and endurance of diaphragm in COPD.1,2 The inspiratory muscles are placed at a suboptimal length for generation of muscle tension due to overinflation.3 Hence the diaphragm is susceptible to fatigue as a result of increased loading and diminished "capacity" to produce inspiratory force.3,5'6 Inspiratory muscle strength and endurance have been shown to be reduced in COPD.4-7 Patients experiencing dyspnea in COPD benefit from IMT, as strong inspiratory muscles help decrease dyspnea.8 However the efficacy of IMT is controversial and its use in a clinical setting is limited in patients with COPD. Patients with COPD will attend forward head, rounded and elevated shoulders. Posture such as Kyphosis, and forward shoulder posture (FSP) affects the respiratory values in COPD.1-11 There is excessive thoracic flexion in kyphosis and thoracic supportive device such as postural brace can be used to prevent excessive...