Respiratory Kinematics in Profoundly Hearing-Impaired Speakers

1977 ◽  
Vol 20 (2) ◽  
pp. 373-408 ◽  
Author(s):  
Linda L. Forner ◽  
Thomas J. Hixon

Anteroposterior diameters of the rib cage and abdomen were measured in profoundly hearing-impaired individuals in a standing position during respiratory maneuvers and utterance tasks. Data were charted in relative motion diagrams (rib cage vs abdomen) which enabled graphic solution for lung volume change, relative volume displacements of the rib cage and abdomen, and chest wall configuration. Function during resting tidal breathing was within normal limits. Function during utterance was frequently deviant in one or more of the following regards: (1) linguistic programming, (2) mechanical adjustments of respiratory origin, and (3) mechanical adjustments of the larynx and upper airway. Deviancies in mechanical adjustments of respiratory origin were confined mainly to lung volume events. Overall function is discussed with respect to the potential muscular mechanisms governing different respiratory behaviors. We conclude that both a lack of normal auditory sensation and inappropriate early speech skill instruction are responsible for the respiratory behaviors observed. Implications for clinical endeavors are detailed and data are presented to illustrate the power of biofeedback in managing speech disorders in the profoundly hearing impaired, when those disorders are partially respiratory based.

1986 ◽  
Vol 29 (3) ◽  
pp. 313-324 ◽  
Author(s):  
Jeannette D. Hoit ◽  
Thomas J. Hixon

Diameter changes of the rib cage and abdomen were recorded during tidal breathing and speech production in 12 adult male subjects grouped on the basis of prominence on three body type components: relative fatness, relative musculoskeletal development, and relative linearity. Data were charted to solve for lung volume, volume displacements of the rib cage and abdomen, and muscular mechanism. Tidal breathing differed across subject groups with regard to depth, rate, and chest wall configuration. Subjects rated high in relative fatness breathed deeper, slower, and with a greater chest wall deformation from relaxation than did other subjects: Speech breathing differed across subject groups with regard to relative volume contributions of the rib cage and abdomen, abdomeren excursions, rib cage paradoxing, and chest wall configuration. Subjects rated high in relative fatness demonstrated substantial abdomen contributions to lung volume change, large abdomen excursions, frequent rib cage paradoxing, and marked chest wall deformations from relaxation. By contrast, subjects rated high in relative linearity demonstrated large rib cage contributions to lung volume change; small abdomen excursions, and slight chest wall deformations from relaxation. Subjects rated high in relative musculoskeletal development generally represented a mixture of characteristics of the other two subject groups in their speech breathing performance. Functional differences are discussed in relation to possible underlying mechanism and inferences are drawn concerning evaluation and management of individuals with speech breathing disorders.


1989 ◽  
Vol 32 (3) ◽  
pp. 466-480 ◽  
Author(s):  
Megan M. Hodge ◽  
Anne Putnam Rochet

Chest wall kinematic records were obtained from 10 healthy young women in the upright, seated position during resting breathing, conversation, and reading aloud. Breathing frequency, lung volume levels relative to resting end-expiratory level, and relative volume displacements of the rib cage and abdomen were measured. Compared to conversation, group results for reading revealed three differences: an increase in syllables spoken per breath, an absence of filled pauses, and a slight upward shift in end-inspiratory and end-expiratory lung volume levels. Compared to resting breathing, group results for speech revealed four differences: a background chest wall configuration characterized by a relatively larger rib cage and smaller abdomen, slight increases in breathing frequency and in lung volume expenditure, and a slight decrease in rib cage contribution to lung volume displacement. The physical characteristic most strongly associated with rib cage contribution to lung volume displacement in resting breathing was height (r = .76). In comparing the relationship between the same respiratory behavior during resting breathing and speech, a correlation of .83 was obtained for rib cage contribution to volume displacement in the two conditions and of .60 for end-inspiratory volume level in the two conditions. Somewhat weaker positive correlations were obtained for lung volume expenditure and for breathing frequency in the two conditions. Comparison of the present findings for women to those recently reported for comparable men (Holt & Hixon, 1987) revealed no remarkable differences in speech breathing characteristics. Results suggest that certain physical characteristics and task variables may have greater functional importance than gender in determining normative speech breathing behaviors.


1973 ◽  
Vol 16 (1) ◽  
pp. 78-115 ◽  
Author(s):  
Thomas J. Hixon ◽  
Michael D. Goldman ◽  
Jere Mead

The chest wall has been treated as a two-part kinematic system comprised of the rib cage and diaphragm-abdomen in parallel, and wherein the volume displaced by each part is linearly related to the motions of points within it. Using measurements of changes in anteroposterior diameters of the rib cage and abdomen, we studied subjects in upright and supine postures during several respiratory maneuvers and utterance tasks. Results are charted in relative motion diagrams (rib cage vs abdomen), which include the relaxed configuration of the chest wall and departures therefrom during utterances. For conversation, reading, and singing, lung volume events were restricted to the midvolume range and were dependent upon body posture and utterance loudness. Relative volume contributions of the two parts differed for subjects and utterances and ranged from all rib cage displacement to all abdominal displacement. During utterances, the chest wall was distorted from its relaxed configuration, and differently so in the two postures studied. Potential mechanisms responsible for these distortions are discussed. We conclude that the distortions observed constitute a “volume platform” or posturing of the chest wall, off of which the speaker produces speech but does not significantly further distort the system in providing the changes in driving pressure required for typical utterances.


1986 ◽  
Vol 60 (3) ◽  
pp. 928-934 ◽  
Author(s):  
J. C. Smith ◽  
J. Mead

A three degree of freedom description of movement of the human chest wall is presented. In addition to the standard variables representing surface displacements of the rib cage and abdominal wall in transverse planes, the description includes a variable representing axial displacements of the chest wall associated with postural movements of the spine and pelvis. A simple technique was developed for quantifying the axial displacements using a single measurement by magnetometry of changes in the distance between a point on the anterior surface of the rib cage near the xiphisternum and a point on the abdominal surface near the pubic symphysis. It was found that axial displacements produced by either flexion-extension of the spine or rotation of the pelvis in the standing postures can be treated as a single degree of freedom. The chest wall displacements induced over the range of axial displacement examined were as large as those normally accompanying a change in lung volume on the order of 30–50% of the vital capacity. It is concluded, however, that although this additional degree of freedom can cause large chest wall displacements, it probably cannot independently change lung volume. This implies that the system is constrained so that there are only a limited number of independent modes of chest wall movement that are capable of producing significant changes in lung volume. It also suggests that the system is constructed so that lung volume can be relatively independent of certain postural distortions of the chest wall.


1991 ◽  
Vol 70 (4) ◽  
pp. 1554-1562 ◽  
Author(s):  
J. D. Road ◽  
A. M. Leevers ◽  
E. Goldman ◽  
A. Grassino

Active expiration is produced by the abdominal muscles and the rib cage expiratory muscles. We hypothesized that the relative contribution of these two groups to expiration would affect diaphragmatic length and, hence, influence the subsequent inspiration. To address this question we measured the respiratory muscle response to expiratory threshold loading in spontaneously breathing anesthetized dogs. Prevagotomy, the increase in lung volume (functional residual capacity) and decrease in initial resting length of the diaphragm were attenuated by greater than 50% of values predicted by the passive relationships. Diaphragmatic activation (electromyogram) increased and tidal volume (VT) was preserved. Postvagotomy, effective expiratory muscle recruitment was abolished. The triangularis sterni muscle remained active, and the increase in lung volume was attenuated by less than 15% of that predicted by the passive relationship. Diaphragmatic length was shorter than predicted. VT was not restored, even though costal diaphragmatic and parasternal intercostal electromyogram increased. During expiratory threshold loading with abdominal muscles resected and vagus intact, recruitment of the rib cage expiratory muscles produced a reduction in lung volume comparable with prevagotomy; however, diaphragmatic length decreased markedly. Both the rib cage and abdominal expiratory muscles may defend lung volume; however, their combined action is important to restore diaphragmatic initial length and, accordingly, to preserve VT.


1989 ◽  
Vol 67 (4) ◽  
pp. 1438-1442 ◽  
Author(s):  
G. A. Farkas ◽  
M. Estenne ◽  
A. De Troyer

A change from the supine to the head-up posture in anesthetized dogs elicits increased phasic expiratory activation of the rib cage and abdominal expiratory muscles. However, when this postural change is produced over a 4- to 5-s period, there is an initial apnea during which all the muscles are silent. In the present studies, we have taken advantage of this initial silence to determine functional residual capacity (FRC) and measure the subsequent change in end-expiratory lung volume. Eight animals were studied, and in all of them end-expiratory lung volume in the head-up posture decreased relative to FRC [329 +/- 70 (SE) ml]. Because this decrease also represents the increase in lung volume as a result of expiratory muscle relaxation at the end of the expiratory pause, it can be used to determine the expiratory muscle contribution to tidal volume (VT). The average contribution was 62 +/- 6% VT. After denervation of the rib cage expiratory muscles, the reduction in end-expiratory lung volume still amounted to 273 +/- 84 ml (49 +/- 10% VT). Thus, in head-up dogs, about two-thirds of VT result from the action of the expiratory muscles, and most of it (83%) is due to the action of the abdominal rather than the rib cage expiratory muscles.


1993 ◽  
Vol 74 (5) ◽  
pp. 2242-2252 ◽  
Author(s):  
J. G. Venegas ◽  
K. Tsuzaki ◽  
B. J. Fox ◽  
B. A. Simon ◽  
C. A. Hales

Apparently conflicting differences between the regional chest wall motion and gas transport have been observed during high-frequency ventilation (HFV). To elucidate the mechanism responsible for such differences, a positron imaging technique capable of assessing dynamic chest wall volumetric expansion, regional lung volume, and regional gas transport was developed. Anesthetized supine dogs were studied at ventilatory frequencies (f) ranging from 1 to 15 Hz and eucapnic tidal volumes. The regional distribution of mean lung volume was found to be independent of f, but the apex-to-base ratio of regional chest wall expansion favored the lung bases at low f and became more homogeneous at higher f. Regional gas transport per unit of lung volume, assessed from washout maneuvers, was homogeneous at 1 Hz, favored the bases progressively as f increased to 9 Hz, and returned to homogeneity at 15 Hz. Interregional asynchrony (pendelluft) and right-to-left differences were small at this large regional scale. Analysis of the data at a higher spatial resolution showed that the motion of the diaphragm relative to the excursions of the rib cage decreased as f increased. These differences from apex to base in regional chest wall expansion and gas transport were consistent with a simple model including lung, rib cage, and diaphragm regional impedances and a viscous coupling between lungs and chest wall caused by the relative sliding between pleural surfaces. To further test this model, we studied five additional animals under open chest conditions. These studies resulted in a homogeneous and f-independent regional gas transport. We conclude that the apex-to-base distribution of gas transport observed during HFV is not caused by intrinsic lung heterogeneity but rather is a result of chest wall expansion dynamics and its coupling to the lung.


1980 ◽  
Vol 49 (6) ◽  
pp. 946-952 ◽  
Author(s):  
C. A. Bradley ◽  
N. R. Anthonisen

The effects of a variety of restrictive procedures on lung mechanics were studied in eight healthy subjects. Rib cage restriction decreased total lung capacity (TLC) by 43% and significantly increased elastic recoil and maximum expiratory flow (MEF). Subsequent immersion of four subjects with rib cage restriction resulted in no further change in either parameter; shifts of blood volume did not reverse recoil changes during rib cage restriction. Abdominal restriction decreased TLC by 40% and increased MEF and elastic recoil, but recoil was increased significantly less than was the case with rib cage restriction. Further, at a given recoil pressure, MEF was less during rib cage restriction than during either abdominal restriction or no restriction. Measurements of the unevenness of inspired gas distribution by the single-breath nitrogen technique showed increased unevenness during rib cage restriction, which was significantly greater than that during abdominal restriction. We conclude that lung volume restriction induces changes in lung function, but the nature of these changes depends on how the restriction is applied and therefore cannot be ascribed to low lung volume breathing per se.


1978 ◽  
Vol 45 (4) ◽  
pp. 581-589 ◽  
Author(s):  
V. P. Vellody ◽  
M. Nassery ◽  
W. S. Druz ◽  
J. T. Sharp

With a linearized respiratory magnetometer, measurements of anteroposterior and lateral diameters of both the rib cage and the abdomen were made at functional residual capacity and continuously during tidal breathing. Twenty-five subjects with normal respiratory systems were studied in the sitting, supine, lateral decubitus, and prone body positions. When subjects changed from sitting to supine position anteroposterior diameters of both rib cage and abdomen decreased while their lateral diameters increased. Both anteroposterior and lateral tidal excursions of the rib cage decreased; those of the abdomen increased. When subjects turned from supine to lateral decubitus position both anteroposterior diameters increased and the lateral diameters decreased. This was associated with an increase in both lateral excursions and a decrease in the abdominal anteroposterior excursions. Diameters and tidal excursions in the prone position resembled those in the supine position. Diameter changes could be explained by gravitational effects. Differences in tidal excursions accompanying body position change were probably related to 1) differences in the distribution of respiratory muscle force, 2) differences in the activity or mechanical advantage of various inspiratory muscles, and 3) local compliance changes in parts of the rib cage and abdomen.


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