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

E Shanmugananth; E Chandramouli; S Gopal Nambi; S Parthasarathy

doi:10.4103/ajprhc.ajprhc_70_22

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

E Shanmugananth¹, E Chandramouli², S Gopal Nambi³, S Parthasarathy⁴
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 Submission	14-Aug-2022
Date of Acceptance	27-Oct-2022
Date of Web Publication	16-Dec-2022

Correspondence Address:
S Parthasarathy
Department of Anaesthesiology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Puducherry
India

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajprhc.ajprhc_70_22

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 Jun 8];14:220-3. Available from: http://www.ajprhc.com/text.asp?2022/14/4/220/363942

Introduction

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

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

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

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.

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