Indian Journal of Physiotherapy & Occupational Therapy-An International Journal

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Effect of Postural Brace for Correcting Forward Shoulder Posture and Kyphosis in Patients with Chronic Obstructive Pulmonary Disease: A Pilot Study


Affiliations
1 SDM College of Physiotherapy, Dharwad, India
2 Respiratory Medicine, JNMedical College Belgaum, KLE University, India
     

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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 -4cmH2O 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 (PIMax)

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 TIMT is beneficial in improving posture and the strength of inspiratory muscles of COPD patients.


Keywords

COPD, Posture, Kyphosis, Forward Shoulder Posture, Maximal Inspiratory Pressure
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  • Hillegass and Sadowsky. Essentials of cardio pulmonary physiotherapy, 2nd ed. WB Saunders company,2001.p. 742.

  • Verheul AJ, Dekhuizen PN.Diaphragm dysfunction in patients with COPD. Ned Tijdschr Geneeskd.2003;147(18): 855-60.

  • Roussos CS, Macklem PT. The Respiratory Muscles. N Engl J Med 1982;307:786-97.

  • Arora NS, Rochester DF. COPD and human diaphragm muscle dimensions. Chest 1987;91:719-24.

  • Rochester DF, Braun NMT, Arora NS. Respiratory muscle strength in chronic obstructive pulmonary disease. Am Rev Respir Dis 1979;199(suppl): 151-154.

  • Bellemare F, Grassino A. Force reserve of the diaphragm in patients with chronic obstructive pulmonary disease.J Appl Physiol 1983;55:8-15.

  • Morrison NJ, Richardson J, Dunn L, Pardy R. Respiratory muscle performance in normal elderly subjects and patients with COPD. Chest 1989; 95: 90–91.

  • Hamilton AL, Killian KJ, Summers E, Jones NL. Muscle strength, symptom intensity, and exercise capacity in patients with cardio respiratory disorders. Am J Respir Crit Care Med 1995;152:2021-31.

  • Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease 2010. Available at (http://www.goldcopd.org/uploads/users/ files/GOLDReport_April112011.pdf).October 19, 2011.

  • Nield MA. Inspiratory muscle training protocol using a pressure threshold device: effect on dyspnea in chronic obstructive pulmonary disease. Arch Phys Med Rehabil. 1999;80:100-2.

  • Kisner C, Colby LA. Therapeutic exercise: Foundations and techniques. 3rded:Philadelphia:FADavisCo;1996.p.111-710

  • Gaude G S, Nadagouda S. Nebulized corticosteroids in the management of acute exacerbation of COPD. Lung India.2010 octdec; 27(4): 230-235.

  • Kendall FP, Kendall E, Provance PG, Rodgers MM,RomaniWA. Muscles testing and function with posture and pain. 5th ed. Baltimore,MD :Lippincott Williams and Wilkins;2005.p.49-244.

  • Hall MC,BrodyTL. Therapeutic exercise. Moving toward function. Philadelphia: Lippincott Williams &Wilkins. Publ;1999:.p.557-60

  • Peterson DE, Blankenship KR, Robb BJ, Walker MJ, Bryan JM, Stetts DM, Mincey LM, Simmons G. Investigations of the validity and reliability of four objective techniques for measuring forward shoulder posture. JOSPT.(25).1997.p.34-41.

  • Sobush DC, Simoneau GG, Dietz KE, Levene JA, Grossman RE, Smith WB. The Lennie test for measuring scapular position in healthy young adult females: A reliability and validity study. JOSPT.1996;23(1):39-50.

  • Ensurd KE, Black DM, Harris F, Ettinger B, CummingS SR, Colrelates of Kyphosis in older women. The fracture intervention trial research group.J Am Geriatri Soc,1997;45:682-87.

  • Bembalgi V. A cross sectional study of skeletal deformities in post menopausal women in urban and rural areas.Indian journal of physiotherapy and occupational therapy,2010 june; 4(2): 87-88.

  • Sachs CM, Enright LP ,Hinckley Stukovsky KD, Rui Jiang and R Graham B, for the Multhi-Ethnic Study of Atherosclerosis Lung Study. Performance of Maximal Inspiratory Pressure Tests and Maximal Inspiratory Pressure Reference Equations For 4 Race/Ethnic Groups. Respiratory Care 2009;54(10):1321-1328,

  • Wen AS, Woo MS, Keens TG. How many maneuvers are required to measure maximal respiratory pressure accurately? Chest 1997; 111:802-807.

  • Weir JP. Quantifying test-retest reliability using the intraclass correlation coefficient and the SEM. J Strength Cond Res. 2005;19(1):231-40.

  • Peat JK, Mellis C, Williams K, Xuan W. Health science research: a handbook of quantative methods. London: SAGE Publications; 2002.

  • Harvill L. Standard error of measurement. Educ Meas. 1991;10:33-41.

  • O’Sullivan BS, Schmitz JT. Physical rehabilitation assessment and treatment. 4th ed. Philadelphia: FA Davis Company. publ; 2001:445-465.


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  • Effect of Postural Brace for Correcting Forward Shoulder Posture and Kyphosis in Patients with Chronic Obstructive Pulmonary Disease: A Pilot Study

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Authors

Ravi Savadatti
SDM College of Physiotherapy, Dharwad, India
Gajanan. S. Gaude
Respiratory Medicine, JNMedical College Belgaum, KLE University, India
Prashant Mukkannava
SDM College of Physiotherapy, Dharwad, India

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 -4cmH2O 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 (PIMax)

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 TIMT is beneficial in improving posture and the strength of inspiratory muscles of COPD patients.


Keywords


COPD, Posture, Kyphosis, Forward Shoulder Posture, Maximal Inspiratory Pressure

References