The relation between thoracic paraspinal tissues and pressure sensitivity measured by a digital algometer (original) (raw)
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Segmental paraspinal tissue texture change has been proposed to be an important diagnostic sign of intervertebral somatic dysfunction. The nature and existence of these regions is speculative. The aim of this study was to examine whether deep, medial, paraspinal regions identified as having abnormal texture by palpation are confirmed as being more sensitive to pressure measured by a digital algometer. An osteopath examined the thoracic regions of 32 subjects (26 asymptomatic, six with mild thoracic symptoms) to detect an abnormal to palpation and tender (AbPT) site in each individual. Three non-tender and normal to palpation (NT) regions (immediately above, below and opposite the AbPT site) were also located. A digital pressure
Measurement of maximal expiratory pressure: effect of holding the lips
Thorax, 1992
Background Minor differences in technique may account for the wide range of published normal values of maximum expiratory and inspiratory pressures. The effects of holding the lips while the subject performed a maximal expiratory pressure manoeuvre were investigated in this study. Methods Maximum static expiratory pressures (PEmax) obtained with a cylindrical tube by means of lip compression by the subject and technician aided compression were compared in 20 men (mean age 27 years) and 20 women (mean age 28 years). Results Technician aided lip compression was associated with higher maximum expiratory pressure than compression by the subject in both men (195 v 110 cm H20) and women (134 v 80 cm H20). Conclusion Compression of the lips and corners of the mouth should be performed by a trained technician for maximum expiratory pressure measurements when a cylindrical mouthpiece is used. (Thorax 1992;47:961-963) Measurement of maximum expiratory pressures PEmax under static conditions provides quantitative information about expiratory muscle function and is a useful measure of this in various pulmonary and neuromuscular disorders."A Large variations in PEmax are reported in normal subjects.'5 One possible explanation for this variation is that different laboratories use different measuring techniques.' 3 8 Black and Hyatt suggest the use of a large, rigid circular mouthpiece with an adequate seal around the lips but it is often difficult to prevent leakage during expiration. We compared PEmax in a group of normal subjects-firstly, with the subjects holding their lips to the tube and then with help from the technician.
Comparison of three protocols for measuring the maximal respiratory pressures
Fisioterapia em Movimento, 2015
Introduction To avoid the selection of submaximal efforts during the assessment of maximal inspiratory and expiratory pressures (MIP and MEP), some reproducibility criteria have been suggested. Criteria that stand out are those proposed by the American Thoracic Society (ATS) and European Respiratory Society (ERS) and by the Brazilian Thoracic Association (BTA). However, no studies were found that compared these criteria or assessed the combination of both protocols. Objectives To assess the pressure values selected and the number of maneuvers required to achieve maximum performance using the reproducibility criteria proposed by the ATS/ERS, the BTA and the present study. Materials and method 113 healthy subjects (43.04 ± 16.94 years) from both genders were assessed according to the criteria proposed by the ATS/ERS, BTA and the present study. Descriptive statistics were used for analysis, followed by ANOVA for repeated measures and post hoc LSD or by Friedman test and post hoc Wilcox...
The Electromyographic Activity of Thoracic Paraspinal Muscles Identified as Abnormal with Palpation
J Manip Physiol Ther, 2007
Objective: The aim of this study was to compare the electromyographic (EMG) activity of deep muscles in the thoracic paravertebral gutter (PVG) detected as abnormal to palpation (AbPT) and reported as tender by the subject with muscles underlying nontender (NT), normal to palpation sites under various experimental conditions. Methods: Twelve subjects (mean age, 25.42 years; range, 22-43 years) participated in this study. Fine-wire, bipolar intramuscular electrodes were inserted, under real-time ultrasonic guidance, into the deep paravertebral muscle mass underlying 1 AbPT and 2 NT sites (1 segment above and below the AbPT site) in the thoracic PVG regions. Electromyographic activity was recorded under the following conditions: resting prone, prone active trunk extension, application of pressure (300 kPa) to adjacent spinous processes, resting seated, passive and active seated trunk rotation, and supporting 2-kg weights in outstretched arms. Results: Mean EMG activity was highest at the AbPT site, relative to NT sites, under all conditions, with a significant between-group effect of site (F 2,31 = 4.13, P = .03) and large between-group effect size (D 2 = 0.21). There was also a trend for lower percentage change from baseline resting at the AbPT sites, relative to the NT sites, in response to the demand of other conditions. There were large variations in EMG activity within and between individuals, and large SDs accompanied the mean values of EMG activity in all cases. Conclusion: Increased motor activity may be a contributing factor to tissue changes in the PVG detected with palpation. However, caution must be used when interpreting these results because of the large variations, small sample size, and issues associated with EMG normalization.
Circulatory and respiratory responses to lower body negative pressure in man
The Japanese Journal of Physiology, 1989
Circulatory and ventilatory responses to lower body negative pressure (LBNP) were simultaneously investigated in 8 healthy men before, during, and after the application of-20,-40, and-60 mmHg pressure. Minute ventilation (VE) decreased during LBNP due to a fall in respiratory frequency with sustained tidal volume. The cardiac output (Q) was reduced in proportion to the applied LBNP exposure, while VE decreased to almost the same level at all LBNP applications. In spite of decreased 1'E, end-tidal Poz and P~oz were increased and decreased, respectively, indicating a relative alveolar hyperventilation. The ventilation equivalent for 02 (VE/ Voz) increased, while the cardiac output equivalent for 02 (Q/ Voz) decreased. The relation between VE/ Voz and Q/ Voz showed a significant negative correlation (r =-0.93, p <0.01). The veno-arterial CO2 concentration difference (Cv~oz-Ca~oz) increased with LBNP, due to a fall in Ca~oz with constant Cv~oz. The constant CV~oz indicated a constant tissue acid-base balance. These observations suggest the existence of a ventilatory mechanism improving the efficiency of respiration in order to compensate for the sustained LBNP depression of Q at a given gas exchange.
Influence of 4 Interfaces in the Assessment of Maximal Respiratory Pressures
Respiratory Care, 2012
BACKGROUND: The measurement of maximal respiratory pressure (MRP) is a procedure widely used in clinical practice to evaluate respiratory muscle strength through the maximal inspiratory pressure (P Imax ) and maximal expiratory pressure (P Emax ). Its clinical applications include diagnostic procedures and evaluating responses to interventions. However, there is great variability in the equipment and measurement procedures. Understanding the impacts of the characteristics of different interfaces can augment the repeatability of this method and help to establish widely applicable predictive equations. The aim of this study was to evaluate the influence of 4 different interfaces on a subject's capacity to generate MRP and the impact of these interfaces on the repeatability of these measurements. METHODS: Fifty healthy subjects (mean ؎ SD age 26.36 ؎ 4.89 y) with normal spirometry were evaluated. MRP was measured by a digital manometer connected to 4 interfaces using different combinations of mouthpieces and tubes. The following variables were analyzed: maximum mean pressure, peak pressure, plateau pressure, and plateau variation. Analysis of variance for repeated measures or a Friedman test was used to compare the 4 interfaces, with P < .008 after Bonferroni adjustment considered significant. RESULTS: There was no significant difference between the 4 interfaces with respect to maximum mean pressure, peak pressure, plateau pressure, or plateau variation for P Imax (P > .49) or P Emax (P > .11), nor did the number of tests performed to fulfill the criteria of repeatability for P Imax (P ؍ .69) or P Emax (P ؍ .47) differ among the 4 interfaces. CONCLUSIONS: P Imax and P Emax values seem not to be influenced by the different interfaces studied, suggesting that patient comfort and availability of interfaces can be considered. Key words: maximal inspiratory pressure; maximal expiratory pressure; muscle strength; mouthpiece. [Respir Care 2012;57(3):392-398.
Model studies of the effects of the thoracic pressure on the circulation
Annals of Biomedical Engineering, 1987
Two models of the cardiovascular system subjected to changes in intrathoracic pressure (ITP) are used to simulate the response to normal and positive pressure ventilation and the Mueller maneuver. The first model, based on our earlier modet for cardiopulmonary resusc#ation and cardiac assist by ITP variations, is based on lumped parameter representation of the cardiovascular system with two ventricles which function based on the time-varying elastance concept using their transmural pressures as the load. The ITP is assumed to be equally distributed in the thoracic cavity and equally affecting all cardiovascular structures within the chest. The model shows that a decrease in ITP is associated with an initial decrease in aortic pressure and flow and an increase in left ventricular end-diastolic and end-systolic volumes. A transient decrease in left ventricular volume which was suggested to occur by a few studies cannot be predicted based on this model. Such a decrease in left ventricular volume can be only predicted when a pericardial constraint is included, as done in the second model. Positive pressure interventions are associated with decreased heart volumes and cardiac output which is primarily a "preload" effect. In general the model reasonably predicts the hemodynamics as a function of the ITP changes and may be used as a tool to investigate the response of the cardiovascular system to various ITP interventions.
Sri Lankan Journal of Anaesthesiology, 2014
Thoracoscopy is usually performed with one lung ventilation using a double lumen endotracheal tube. These surgeries can also be performed with a single lumen tube and double lung ventilation and the use of a capnothorax to cause a partial lung collapse. Lung collapse and capnothorax can cause adverse respiratory and cardio-vascular effects. Therefore the insufflation pressure needs to be safe and minimum. Our study was to record respiratory, haemodynamic parameters and the insufflation pressure of the capnothorax created during thoracoscopy procedures. With an insufflation pressure of 6-8mmHg an adequate lung collapse can be obtained for thoracoscopy. This pressure did not have any adverse respiratory or cardiovascular effects.
standard'' pressure supports Physiological effects of alveolar, tracheal, and
2015
Pressure support (PS) is characterized by a pressure plateau, which is usually generated at the ventilator level (PS vent). We have built a PS device in which the pressure plateau can be obtained at the upper airway level (PS aw) or at the alveolar level (PS A). The effect of these different PS modes was evaluated in seven healthy men during air breathing and 5% CO 2 breathing. Minute ventilation during air breathing was higher with PS A than with PS aw and lower with PS vent (16 Ϯ 3, 14 Ϯ 3, and 11 Ϯ 2 l/min, respectively). By contrast, there were no significant differences in minute ventilation during 5% CO 2 breathing (25 Ϯ 5, 27 Ϯ 7, and 23 Ϯ 5 l/min, respectively). The esophageal pressure-time product per minute was lower with PS A than with PS aw and PS vent during air breathing (29 Ϯ 26, 44 Ϯ 44, and 48 Ϯ 30 cmH 2 O•s, respectively) and 5% CO 2 breathing (97 Ϯ 40, 145 Ϯ 62, and 220 Ϯ 41 cmH 2 O • s, respectively). In conclusion, during PS, moving the inspiratory pressure plateau from the ventilator to the alveolar level reduces pressure output, particularly at high ventilation levels.
Intradiscal pressure variation under spontaneous ventilation
23rd International Conference on Optical Fibre Sensors, 2014
The pressure measured in the intervertebral discs is a response to the loads acting on the spine. External loads, such as the reaction forces resulting from locomotion, manual handling and collisions are probably the most relevant in studying spine trauma. However, the physiological functions such as breathing and hearth rate also participate in subtle variations of intradiscal pressure that can be observed only in vivo at resting. Present work is an effort to measure the effect of breathing on intradiscal pressure of an anesthetized sheep.