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Postural Assessment of Patients with COPD: A Look at Muscle Strength, Shoulder Protraction and Body Center of Gravity
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A5876 - Postural Assessment of Patients with COPD: A Look at Muscle Strength, Shoulder Protraction and Body Center of Gravity
Author Block: D. C. de Abreu1, K. Maynard da Silva1, Y. R. De Souza2, B. Figueira1, G. Avolio1, M. Figueiredo1, R. Rufino3, C. H. Costa4; 1State University of Rio de Janeiro, Rio de Janeiro, Brazil, 2Physiotherapy, Veiga de Almeida University, Rio de Janeiro, Brazil, 3State University of Rio de Janeiro, Rio De Janeiro 22261-020, Brazil, 4Pneumologia, HUPE, Rio de Janeiro, Brazil.
Introduction: Chronic obstructive pulmonary disease (COPD) is a treatable disease with repercussion throughout the body, resulting in decreased functional capacity. The patient with COPD presents as main postural alterations the thoracic kyphosis, promoting protraction of the shoulders, anterior projection of the head and flexion of the trunk, altering the center of gravity, which can impair the overall muscular performance, besides the loss of the peripheral muscular strength, which may increase the risk of falls in these patients. Postural alteration may alter respiratory muscle mechanics. Studies suggest that there is an intimate relationship between posture and breathing. The aim of this trial was to correlate shoulder protraction with the projection of the center of gravity and peripheral muscle strength in patients with COPD. Methods: Four patients from the COPD Outpatient Clinic of the Pedro Ernesto University Hospital (HUPE) with diagnosis of chronic obstructive pulmonary disease (COPD) were selected according to criteria established by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). They were submitted to postural evaluation by photogrammetry using the Postural Evaluation Software (SAPO) using measures of projection of the center of gravity (anterior displacement), the angle between the spinal process of C7 and the acromion on the horizontal axis (shoulder protraction). The measurement of peripheral muscle strength through handgrip strength dynamometry was performed by Jamar dynamometer (Paterson Medical). Results: Shoulder Protraction presented a marked angulation in patients with COPD (168 ± 14), a significant anterior deviation from the center of gravity (1.8 ± 0.5), mean peripheral muscle strength of 25 ± 2. There was a strong correlation between shoulder protraction with change in the center of gravity, r = 0.858, and moderate correlation with handgrip strength, r = 0.631. Conclusion: This study requires a greater number of patients, but suggests that postural changes may influence the functional and respiratory capacity of these patients.
Author Block: D. C. de Abreu1, K. Maynard da Silva1, Y. R. De Souza2, B. Figueira1, G. Avolio1, M. Figueiredo1, R. Rufino3, C. H. Costa4; 1State University of Rio de Janeiro, Rio de Janeiro, Brazil, 2Physiotherapy, Veiga de Almeida University, Rio de Janeiro, Brazil, 3State University of Rio de Janeiro, Rio De Janeiro 22261-020, Brazil, 4Pneumologia, HUPE, Rio de Janeiro, Brazil.
Introduction: Chronic obstructive pulmonary disease (COPD) is a treatable disease with repercussion throughout the body, resulting in decreased functional capacity. The patient with COPD presents as main postural alterations the thoracic kyphosis, promoting protraction of the shoulders, anterior projection of the head and flexion of the trunk, altering the center of gravity, which can impair the overall muscular performance, besides the loss of the peripheral muscular strength, which may increase the risk of falls in these patients. Postural alteration may alter respiratory muscle mechanics. Studies suggest that there is an intimate relationship between posture and breathing. The aim of this trial was to correlate shoulder protraction with the projection of the center of gravity and peripheral muscle strength in patients with COPD. Methods: Four patients from the COPD Outpatient Clinic of the Pedro Ernesto University Hospital (HUPE) with diagnosis of chronic obstructive pulmonary disease (COPD) were selected according to criteria established by the Global Initiative for Chronic Obstructive Lung Disease (GOLD). They were submitted to postural evaluation by photogrammetry using the Postural Evaluation Software (SAPO) using measures of projection of the center of gravity (anterior displacement), the angle between the spinal process of C7 and the acromion on the horizontal axis (shoulder protraction). The measurement of peripheral muscle strength through handgrip strength dynamometry was performed by Jamar dynamometer (Paterson Medical). Results: Shoulder Protraction presented a marked angulation in patients with COPD (168 ± 14), a significant anterior deviation from the center of gravity (1.8 ± 0.5), mean peripheral muscle strength of 25 ± 2. There was a strong correlation between shoulder protraction with change in the center of gravity, r = 0.858, and moderate correlation with handgrip strength, r = 0.631. Conclusion: This study requires a greater number of patients, but suggests that postural changes may influence the functional and respiratory capacity of these patients.
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