OBJECTIVE: What is the effect of an acute increase in respiratory demand on postural control compared to quiet breathing?
METHODS: A systematic review was conducted. Electronic databases were systematically searched until October 18, 2022 on studies reporting changes in center of pressure (CoP) motion related to an acute manipulation of respiratory demand compared to quiet breathing during upright standing in healthy participants and/or participants with a clinical condition.
RESULTS: Twenty-one studies in healthy participants showed that voluntary (not metabolic-induced) hyperventilation or inspiratory resistive loading significantly increased CoP motion, while breath-holding decreased CoP motion, compared to quiet breathing (p< 0.05). Manipulating respiratory rate or breathing patterns did not reveal consistent results. Four studies showed that people with low back pain showed similar CoP responses to increasing respiratory demand (p> 0.05), except for breathing at different rates, whereas they showed greater CoP motion during quiet breathing.
CONCLUSIONS: The extent of postural disturbance depended on the breathing mode and how it was quantified (i.e., CoP coupled with breathing movement or overall CoP measures). Voluntary hyperventilation and inspiratory resistive loading increased postural sway. For voluntary hyperventilation, this could be explained by CoP motion being directly coupled to chest wall movements whereas metabolic-induced hyperventilation did not increase CoP motion or CoP coupling with breathing. Breath-holding decreased postural sway. Patients with low back pain show greater postural sways than pain-free individuals during quiet breathing, although they exhibit similar postural adaptations to respiratory-related challenges as controls.
目的:与安静呼吸相比,呼吸需求的急性增加对姿势控制有什么影响?
方法:进行了系统评价。直到2022年10月18日,对电子数据库进行了系统搜索,研究报告了与健康参与者和/或有临床状况的参与者直立站立时安静呼吸相比,与呼吸需求的急性操纵有关的压力中心(CoP)运动变化。
结果:对健康参与者的21项研究表明,自愿(非代谢诱导)换气过度或吸气阻力负荷显着增加CoP运动,当屏气减少CoP运动时,与安静呼吸相比(p<0.05)。操纵呼吸频率或呼吸模式没有显示一致的结果。四项研究表明,腰背痛患者对呼吸需求增加表现出相似的CoP反应(p>0.05),除了呼吸频率不同,而他们在安静呼吸时表现出更大的CoP运动。
结论:姿势障碍的程度取决于呼吸模式及其量化方式(即,CoP与呼吸运动或整体CoP测量相结合)。自愿过度换气和吸气阻力负荷增加了姿势摇摆。对于自愿过度换气,这可以解释为CoP运动与胸壁运动直接相关,而代谢诱导的过度换气不会增加CoP运动或CoP与呼吸的耦合.屏住呼吸减少了姿势摇摆。在安静呼吸期间,腰痛患者比无痛患者表现出更大的姿势摇摆,尽管它们对与呼吸相关的挑战表现出与对照组相似的姿势适应。