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 Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 14  |  Issue : 4  |  Page : 220-223

Effect of respiratory muscle stretch gymnastics on chest expansion and peak expiratory flow rate among sawmill workers


1 Department of Physiotherapy, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India
2 Department of Physical Medicine and Rehabilitation, Rajah Muthiah Medical College and Hospital, Annamalai University, Chidambaram, Tamil Nadu, India
3 Department of Physical Therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Satam Bin Abdul-Aziz University, Akharj, Saudi Arabia
4 Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry, India

Date of Submission14-Aug-2022
Date of Acceptance27-Oct-2022
Date of Web Publication16-Dec-2022

Correspondence Address:
S Parthasarathy
Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ajprhc.ajprhc_70_22

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  Abstract 


Introduction: Sawmill workers are subjected to high levels of wood dust, which can significantly impair lung function. Many studies have found restrictive abnormalities associated with decreased breathing muscle strength and chest expansion. Respiratory muscle stretch gymnastics (RMSG) has been proposed as an additional form of rehabilitation for patients suffering from respiratory diseases. RMSG is intended to reduce chest wall stiffness, particularly in the respiratory muscles of the chest wall. Objective: The objective of this study was to look into the impact of RMSG on chest expansion and peak expiratory flow rate (PEFR) in sawmill workers. Methodology: Fifty randomly selected sawmill workers aged 30–50 years in Chidambaram town were given RMSG training twice daily, four times each of five patterns for 4 weeks. A structured questionnaire was used to interview the subjects. Height, weight, and chest measurements were all part of the physical examination. Before and after training, the physiological parameter PEFR was measured. The extent of chest expansion was the primary outcome measure. Data Analysis and Outcomes: The Statistical Package for Social Sciences (SPSS) version 16 was used to evaluate and analyze the data, with the level of significance set at P < 0.05. The dependent t-test revealed a significant difference in chest expansion between pre- and posttraining (2.441.11) and (3.780.616) with a P = 0.001. At P = 0.001, there was also a statistically significant difference in the mean values of PEFR (341.80 77.13) and (479.8058.24). Conclusion: The study found that RMSG training improves chest expansion and pulmonary function (PEFR). According to the findings, RMSG is a simple, safe, and effective technique for increasing the overall functional capacity of sawmill workers. Our study clearly demarcates the difference in an angle that 40° or 45° recumbency is useful. With not much literature in such workers, we can say that this study is one of the early works in this field.

Keywords: Chest expansion, gymnastics, peak expiratory flow rate, respiratory muscles. strength, sawmill workers


How to cite this article:
Shanmugananth E, Chandramouli E, Nambi S G, Parthasarathy S. Effect of respiratory muscle stretch gymnastics on chest expansion and peak expiratory flow rate among sawmill workers. Asian J Pharm Res Health Care 2022;14:220-3

How to cite this URL:
Shanmugananth E, Chandramouli E, Nambi S G, Parthasarathy S. Effect of respiratory muscle stretch gymnastics on chest expansion and peak expiratory flow rate among sawmill workers. Asian J Pharm Res Health Care [serial online] 2022 [cited 2023 Feb 6];14:220-3. Available from: http://www.ajprhc.com/text.asp?2022/14/4/220/363942




  Introduction Top


Work- and industry-associated decrease in lung function is reported extensively.[1] Sawmill workers are exposed to high levels of wood dust which can significantly lower their lung function.[2],[3] Many studies showed restrictive abnormalities with reduced respiratory muscle strength and chest expansion.[4],[5],[6] Respiratory muscle stretch gymnastics (RMSG) has been proposed as a valuable additional form of rehabilitation for patients with respiratory diseases. RMSG is designed to decrease chest wall stiffness, particularly in the chest wall respiratory muscles.[7] Therefore, the purpose of this study was to investigate the effectiveness of RMSG on chest wall motion and peak expiratory flow rate (PEFR) among sawmill workers.


  Methodology Top


The study was a multicenter study conducted at four sawmills in and around Chidambaram town, two in Pondicherry, and one in Gujarat (Surendranagar). The study was approved by the institutional research committee, and individual consent was taken from workers. The study was in accordance with the Declaration of Helsinki. A simple and random sample technique was used to select 50 healthy male sawmill workers for the study population who were willing for the study. The inclusion criteria were age between 30 and 50 years, nonsmokers, and working for at least 1 year. Workers with any known history of cardiopulmonary disorders, endocrine disorders, neurological, orthopedic, or rheumatological disorders, trauma, congenital defects, or administrative workers in sawmills were excluded from the study.

Data collection techniques

Subjects were interviewed using a structured questionnaire. Physical examination includes height, weight, and chest expansion, and physiological parameters PEFR were measured. Informed consent was obtained from all the subjects.

Procedure

Workers were interviewed using a structured medical and occupational questionnaire based on respiratory symptoms and on the current job description, duration, and a history of previous employment. Height and weight (cms) were determined using an inch tape and a weighing machine. The measuring equipment was validated.

Chest expansion (cms) was measured with a tapeline in an upright sitting position at the xiphisternum level. Chest expansion was calculated using the difference in chest wall circumference during the state of maximal expiration and maximal inspiration. Three trials were performed, and the best value was recorded.

PEFR was measured using a validated mini-wright, s peak expiratory flow meter (l/min). The measurement was obtained in the upright sitting position, and the highest of three readings per subject was taken. The PEFR meter is set to 0. The subjects were made to sit and were informed to take a deep breath and were instructed to place their mouth around the mouthpiece of the PEFR meter. The subjects were instructed to exhale as forcefully as possible. Three trials were performed, and the best value was recorded.[8],[9]

Both chest expansion and PEFR values were noted before and after RMSG training.

Respiratory muscle stretch gymnastics training program

Pattern 1: Patients were instructed to elevate and pull their shoulders back. Elevate and pull back both shoulders as you slowly breathe in through your nose. After taking a deep breath, slowly exhale through your mouth while relaxing and lowering your shoulders. Pattern 2: Upper chest stretching uncross your hands on your chest. Pull your elbows back and down slowly while lifting your chin and taking a deep breath through your nose. Relax and exhale slowly through your mouth. Pattern 3: Back muscle stretching keeps your hands clasped in front of your chest. As you slowly inhale through your nose, stretch your back by moving your hands forward and down. After a deep inspiration, slowly exhale and return to the original position. Pattern 4: Lower chest stretching grasp the ends of a face towel at shoulder height with both hands outstretched. After taking a deep breath, raise your arms and slowly exhale. Lower your hands and breathe normally after a deep exhalation. Pattern 5: Elbow elevation one hand should be held behind your head. Breathe deeply through your nose. Stretch your trunk by raising your elbow while slowly exhaling through your mouth. With the sample calculation software, accepting a 95% confidence level and a 5% margin of error with a possible worker population of 500, the needed size is 15 workers. We sampled 50 to overcome dropouts. We hoped for more than a 15% increase in the outcome measures.[10],[11],[12],[13],[14]

Data analysis and results

Most of the data were parametric with two groups, and a student's t-test was used for analyses. Statistical analysis was done using the IBM SPSS statistics version 16 (USA), and the level of significance was set at P < 0.05.

Interpretations

The mean and standard deviation values of baseline characteristics and physical parameters in sawmill workers are shown in [Table 1]. The mean ages were 44 ± 4.21, mean height and weight were 164.18 ± 7.62 and 62.38 ± 5.42, respectively. The mean values of chest expansion were 2.44 ± 1.11. Thus, the findings showed that there was decreased chest expansion in sawmill workers before RMSG training.
Table 1: Mean values of physical parameters in sawmill workers

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Interpretations

Comparison of PEFR measurements in pre and posttraining is shown in [Table 2]. The results showed that there was a significant difference (t = 14.279, P < 0.001) in mean values of PEF (341.80 ± 77.13 and 479.80 ± 58.24), respectively. Thus, the results indicated that there was a significant improvement in PEFR after RMSG training.
Table 2: Mean difference of physical parameters in experimental group exposed to sawdust

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Interpretations

A comparison of chest expansion measurements in pre and posttraining is shown in [Table 3]. The results showed that there was a more significant difference (t = 7.47, P = 0.001) in mean values (2.44 ± 1.11 and 3.78 ± 0.616), respectively. Thus, the study results indicated that there was a highly significant improvement in chest expansion after RMSG training. All fifty workers completed the study and there were no dropouts.
Table 3: Mean difference of peak expiratory flow rate measurements in study group

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  Discussion Top


The current study looked at how RMSG affected PEFR and chest expansion in sawmill workers. RMSG was created to stretch the inspiratory and expiratory intercostal muscles during inspiration and expiration. There was a statistically significant difference in chest expansion and PEFR after RMSG training among apparently healthy sawmill workers in the current study. The method is both effective and safe. According to Putt et al.,[15] the improvement in outcome measures in this study could be due to an increase in pectoralis muscle lengthening. Hagbarth et al.[16] reported RMSG, which was designed to stretch the respiratory muscles, which improved pulmonary function and chest expansion by increasing chest wall compliance and decreasing chest wall stiffness. The current study produced similar results, which were strongly supported by a study.[17] Our study was more clinical than the interpretation of muscle length and all. Thus, we can say that active chest mobilization helps to increase chest wall mobility, flexibility, and thoracic compliance. The limitation of the study is that the sample size is low, and objective measurements of compliance studies were not done. There is no control group or placebo gymnastics to establish the same. As the workers did the job and they know the results, the concept of blinding did not arise. Even though RMSG has been proved beneficial, there is very minimal literature on sawmill workers. Our study is one of the rare such reports.


  Conclusion Top


The present study results showed significant improvement in both chest expansion and PEFR among sawmill workers after 4 weeks of RMSG training. Thus, the study suggested that RMSG is a simple, easy, safe, and effective technique to practice on their own and improve the overall functional capacity of sawmill workers. Future studies are essential to investigate the effectiveness of RMSG on other parameters and rehabilitation methods.

Aknowledgment

We are thankful to IQAC/Research cell-Sri Balaji Vidyapeeth, MGMCRI. And Special Thanks to the Deanship of scientific research, Department of Physical therapy and Health Rehabilitation, College of Applied Medical Sciences, Prince Satam Bin Abdul Aziz University, Akharj, Saudi Arabia.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Suchitra MR, Parthasarathy S. Mohamed hanifah evaluation of lung function in automobile diesel mechanics in a semi Urban Town of South India Kumbakonam Urban Rural epidemiological study – KURES 6. Indian J Public Health Res Dev 2020;11:554-7.  Back to cited text no. 1
    
2.
Ito M, Kakizaki F, Tsuzura Y, Yamada M. Immediate effect of respiratory muscle stretch gymnastics and diaphragmatic breathing on respiratory pattern. Respiratory muscle conditioning group. Intern Med 1999;38:126-32.  Back to cited text no. 2
    
3.
Aida N, Shibuya M, Yoshino K, Komoda M, Inoue T. Respiratory muscle stretch gymnastics in patients with post coronary artery bypass grafting pain: Impact on respiratory muscle function, activity, mood and exercise capacity. J Med Dent Sci 2002;49:157-70.  Back to cited text no. 3
    
4.
Leelarungrayub D. Chest mobilization techniques for improving ventilation and gas exchange in chronic lung disease. Chron Obstruct Pulm Dis Curr concepts Pract 2012;20:399-422.  Back to cited text no. 4
    
5.
Moreno MA, Catai AM, Teodori RM, Borges BL, Cesar Mde C, Silva Ed. Effect of a muscle stretching program using the global postural reeducation method on respiratory muscle strength and thoracoabdominal mobility of sedentary young males]. J Bras Pneumol 2007;33:679-86.  Back to cited text no. 5
    
6.
Ganesh BR, Goud A. Short term effects of f respiratory muscle stretch gymnastics versus hold relax PNF on pulmonary functions and chest expansion in elderly individuals – A randomized clinical trial. Int J Appl Res 2017;3:1018-22.  Back to cited text no. 6
    
7.
Wada J, Borges SE, Silva RA, Porras DC, Paisani D, Silva CM. Effects of respiratory muscle stretching on thoracoabdominal mechanics, functional capacity and dyspnea in chronic obstructive pulmonary disease patients. Eur Respir J 2014;44:3662.  Back to cited text no. 7
    
8.
Mohan V, Aziz KB, Kamaruddin K, Leonard JH, Das S, Jagannathan MG. Effect of intercostal stretch on pulmonary function parameters among healthy males. EXCLI J 2012;11:284-90.  Back to cited text no. 8
    
9.
Minoguchi H, Shibuya M, Miyagawa T, Kokubu F, Yamada M, Tanaka H, et al. Cross-over comparison between respiratory muscle stretch gymnastics and inspiratory muscle training. Intern Med 2002;41:805-12.  Back to cited text no. 9
    
10.
Yamada M, Kakizaki F, Sibuya M, Nakayama H, Tsuzura Y, Tanaka K, et al. Clinical effects of four weeks of respiratory muscle stretch gymnastics in patients with chronic obstructive pulmonary disease. Nihon Kyobu Shikkan Gakkai Zasshi 1996;34:646-52.  Back to cited text no. 10
    
11.
Kakizaki F, Shibuya M, Yamazaki T, Yamada M, Suzuki H, Homma I. Preliminary report of the effects of respiratory muscle stretch gymnastics on chest wall mobility in patients with chronic obstructive pulmonary disease. Respir Care 1999;44:409-14.  Back to cited text no. 11
    
12.
Bhasin P, Subramanian A. Effects of short term pulmonary rehabilitation with or without respiratory muscle stretch gymnastics on quality of life in patients with chronic obstructive pulmonary disease. J Physiother Occup Ther 2012;6:187-90.  Back to cited text no. 12
    
13.
Bhasin P, Mishra S. Respiratory muscle stretch gymnastics: An epoch to progress further. J Phys Ther 2012;5:30-2.  Back to cited text no. 13
    
14.
Yamada M, Shibuya M, Kanamaru A. Benefits of respiratory muscle stretch gymnastics in chronic respiratory disease. Showa Univ J Med Sci 1996;8:63-71.  Back to cited text no. 14
    
15.
Putt MT, Watson M, Seale H, Paratz JD. Muscle stretching technique increase vital capacity and range of motion in patients with chronic obstructive pulmonary disease. Arch Phys Med Rehabil 2008;89:1103-7.  Back to cited text no. 15
    
16.
Hagbarth KE, Hägglund JV, Nordin M, Wallin EU. Thixotropic behaviour of human finger flexor muscles with accompanying changes in spindle and reflex responses to stretch. J Physiol 1985;368:323-42.  Back to cited text no. 16
    
17.
Kanamaru A, Sibuya M, Nagai T, Inoue K, Homma I. Stretch gymnastics training in asthmatic children. In: Kaneko M, editor. Fitness for the aged, Disabled and Industrial Worker. Champaign, Illinois: Human Kinetics; 1990. p. 178-81.  Back to cited text no. 17
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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