Here we present the cases of 3 females referred to our outpatient clinic complaining dyspnea during daily activity, in particular during walking. A careful history enabled us to determine that dyspnea was significantly reduced when they walked with upper-limb support. Methods. Subjects underwent respiratory function tests (FEV1, FVC, DLCO), chest X-ray, echocardiogram with non-invasive PAPs measurement, blood sample testing and ventilatory evaluation by means of portable respiratory inductive plethysmography (LifeShirt System, LS). LS accurately estimates ventilation, ventilatory pattern and the synchrony of rib cage-abdominal motion (phase angle, PhA) at rest and during exercise both in patients and in healthy subjects. Subjects performed six-minute walking tests (6MWT) with and without a rollator while equipped with LS. Results. All exams were normal. LS evaluation during 6MWT showed an higher PhA during 6MWT without rollator: 26±11° and 17±3° without and with rollator respectively. Conclusion. During 6MWT without upper-limb support an evident increase in PhA was observed. This is an indicator of rib cage-abdominal motion asynchrony, which in turn could induce dyspnea. We suggest that postural change during walking without upper-limb support may occur in otherwise elderly subjects and this could explain the dyspnea.
Unexplained dyspnea could be ascribable to postural changes
BERNARDI, Eva;MANDOLESI, Gaia;POMIDORI, Luca;COGO, Annaluisa
2014
Abstract
Here we present the cases of 3 females referred to our outpatient clinic complaining dyspnea during daily activity, in particular during walking. A careful history enabled us to determine that dyspnea was significantly reduced when they walked with upper-limb support. Methods. Subjects underwent respiratory function tests (FEV1, FVC, DLCO), chest X-ray, echocardiogram with non-invasive PAPs measurement, blood sample testing and ventilatory evaluation by means of portable respiratory inductive plethysmography (LifeShirt System, LS). LS accurately estimates ventilation, ventilatory pattern and the synchrony of rib cage-abdominal motion (phase angle, PhA) at rest and during exercise both in patients and in healthy subjects. Subjects performed six-minute walking tests (6MWT) with and without a rollator while equipped with LS. Results. All exams were normal. LS evaluation during 6MWT showed an higher PhA during 6MWT without rollator: 26±11° and 17±3° without and with rollator respectively. Conclusion. During 6MWT without upper-limb support an evident increase in PhA was observed. This is an indicator of rib cage-abdominal motion asynchrony, which in turn could induce dyspnea. We suggest that postural change during walking without upper-limb support may occur in otherwise elderly subjects and this could explain the dyspnea.I documenti in SFERA sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
