Respiratory Movements of Patients with Severe Chronic Obstructive Lung Disease and Emphysema in Supine and Forward Standing Leaning

Objective: To investigate respiratory movements in supine and forward standing leaning position among patients with emphysema and severe chronic obstructive pulmonary disease (COPD) during rest and dyspnea. Methodology: Nineteen patients with emphysema and severe COPD underwent lung function measurement and positional assessment of diaphragm. Respiratory movements during quiet and deep breathing were measured in supine and standing forward leaning using the Respiratory Movement Measuring Instrument (RMMI) (MTT, Arleyni 8, Reykjavik, Iceland). Patients then bicycled with the work rate 87% of the peak work rate tolerated in a pre-program incremental exercise test. Immediately after dismounting the bicycle, respiratory movements were measured in forward leaning. Results: For participants with mean age of 61 ± 7 years and mean body mass index of 23.59 ± 4.63, respiratory movements during quiet breathing in supine were significantly (abdominal p = 0.025, lower- and upper-thoracic p = 0.020) greater than in forward leaning. In the case forward leaning during dyspnea, lower- and upper-thoracic movements were significantly (p = 0.001; p = 0.005, respectively) less than abdominal. Conclusion: This study indicates that the diaphragm of patients with severe COPD and emphysema is active in forward leaning position during rest and dyspnea.