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Assessment of muscle shortening and static posture in children with persistent asthma

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Abstract

Asthmatic patients experience an increase in airway resistance that overburdens both respiratory and non-respiratory muscles. The objective of the present study was to determine whether children with persistent asthma present muscle shortening and postural changes. The 60 boys evaluated, aged 7–12 (pubertal ages up to Tanner stage G2) were divided into three age- and BMI-matched groups of equal number: CON (no history of asthma or allergy); MPA (mild persistent asthma); SPA (severe persistent asthma). Pulmonary function, muscle shortening and static posture were evaluated. The SPA group presented higher protraction of the head and shoulder compared with the CON group [9.5 (6.0–12.0) degrees vs 5.5 (0.0–12.0) degrees, P < 0.05; 0.89 (0.80–0.94) anterior/posterior ratio vs 0.94 (0.87–1.1) anterior/posterior ratio, P < 0.01)]. Severe asthmatic patients also presented shortening of arm flexor and posterior muscle of the thigh compared with the CON group [18.0 (10.0–24.0) degrees vs 12.0 (6.0–16.0) degrees, P < 0.05; and 16.5 (10.0–38.5) cm vs 8.0 (0.0–21.0) cm, respectively, P < 0.05]. Chest expansion at axillar and xiphoid levels were limited in SPA subjects compared with CON subjects [3.7 (1.5–6.5) cm vs 5.5 (2.0–8.0) cm and 4.7 (1.5–6.5) vs 6.0 (3.5–8.0) cm, respectively, P < 0.01]. SPA subjects also presented a higher incidence of lumbar spine straightening compared with CON and MPA subjects. Moderate asthmatic subjects presented intermediate values compared with severe and control subjects in five out nine evaluated outcomes. Our data suggest that severe asthmatic children present postural adaptations and muscle shortening that seem to be related to disease severity.

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Abbreviations

FEV1 :

Forced expiratory volume in 1 s

CON:

Subjects with no history of atopic disorders or respiratory disease

MPA:

Subjects with mild persistent asthma

SPA:

Subjects with severe persistent asthma

FVC:

Forced vital capacity

FEF25–75% :

Forced expiratory flow between 25 and 75% of vital capacity

BMI:

Body mass index

NS:

Not significant

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Acknowledgements

Financial support was provided by: Conselho Nacional de Desenvolvimento Cientifico e Tecnologico (CNPq) and Fundação de Amparo Pesquisa do Estado Sao Paulo (FAPESP).

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Authors and Affiliations

  1. Department of Physical Therapy, School of Medicine, University of Sao Paulo, Av. Dr. Arnaldo, 455, Sao Paulo, Brazil

    Erica A. Lopes, Adriana Fanelli-Galvani, Camilla C. V. Prisco, Raquel C. Gonçalves & Celso R. F. Carvalho

  2. Allergy and Immunology Unit, Department of Pediatrics, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil

    Cristina M. A. Jacob

  3. Darcy Vargas Children’s Hospital, Sao Paulo, Brazil

    Adriana Fanelli-Galvani & Anna L. B. Cabral

  4. Department of Medicine, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil

    Milton A. Martins

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  1. Erica A. Lopes
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  3. Camilla C. V. Prisco
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  8. Celso R. F. Carvalho
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Correspondence to Celso R. F. Carvalho.

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Lopes, E.A., Fanelli-Galvani, A., Prisco, C.C.V. et al. Assessment of muscle shortening and static posture in children with persistent asthma. Eur J Pediatr 166, 715–721 (2007). https://doi.org/10.1007/s00431-006-0313-y

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  • DOI: https://doi.org/10.1007/s00431-006-0313-y

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