After-effects of thixotropic conditionings on operational chest wall and compartmental volumes of patients with Parkinson’s disease

Individuals with Parkinson’s disease (PD) present respiratory dysfunctions, mainly due to decreased chest wall expansion, which worsens with the course of the disease. These findings contribute to the restrictive respiratory pattern and the reduction in chest wall volume. According to literature, inspiratory muscle thixotropic conditioning maneuvers may improve lung volumes in these patients. The study aimed to determine the after-effects of respiratory muscle thixotropic maneuvers on breathing patterns and chest wall volumes of PD. A crossover study was performed with twelve patients with PD (8 males; mean age 63.9±8.8 years, FVC(%pred) 89.7±13.9, FEV(1%pred) 91.2±15, FEV(1)/FVC(%pred) 83.7±5.7). Chest wall volumes were assessed using OEP during thixotropic maneuvers. Increases in EIV(CW) (mean of 126mL, p = 0.01) and EEV(CW) (mean of 150mL, p = 0.005) were observed after DI(TLC) (deep inspiration from total lung capacity) due to increases in pulmonary (RCp) and abdominal (RCa) ribcage compartments. Changes in ICo(TLC) (inspiratory contraction from TLC) led to significant EIV(CW) (mean of 224mL, p = 0.001) and EEV(CW) (mean of 229mL, p = 0.02) increases that were mainly observed in the RCp. No significant changes were found when performing DE(RV) (deep expiration from residual volume) and ICo(RV) (Inspiratory contraction from RV). Positive correlations were also observed between the degree of inspiratory contraction during ICo(TLC) and EEV(RCp) (rho = 0.613, p = 0.03) and EIV(RCp) (rho = 0.697, p = 0.01) changes. Thixotropy conditioning of inspiratory muscles at an inflated chest wall volume increases EIV(CW) and EEV(CW) in the ten subsequent breaths in PD patients. These maneuvers are easy to perform, free of equipment, low-cost, and may help patients improve chest wall volumes during rehabilitation.