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Compensation of Respiratory-Related Postural Perturbation Is Achieved by Maintenance of Head-to-Pelvis Alignment in Healthy Humans

Article dans une revue avec comité de lecture
Author
ATTALI, Valérie
353778 CHU Pitié-Salpêtrière [AP-HP]
CLAVEL, Louis
466360 Institut de Biomecanique Humaine Georges Charpak
542093 Neurophysiologie Respiratoire Expérimentale et Clinique [UMRS 1158]
RIVALS, Isabelle
45449 Equipe de Statistique Appliquée (UMRS 1158) [ESA]
RÉMY-NÉRIS, Ségolène
542093 Neurophysiologie Respiratoire Expérimentale et Clinique [UMRS 1158]
ccSKALLI, Wafa
466360 Institut de Biomecanique Humaine Georges Charpak
ccSANDOZ, Baptiste
175453 Arts et Métiers ParisTech
466360 Institut de Biomecanique Humaine Georges Charpak
SIMILOWSKI, Thomas
353778 CHU Pitié-Salpêtrière [AP-HP]
541997 Sorbonne Université - Faculté de Médecine [SU FM]
542093 Neurophysiologie Respiratoire Expérimentale et Clinique [UMRS 1158]
ccROUCH, Philippe
99538 Laboratoire de biomécanique [LBM]
247321 Laboratoire de Mécanique et Technologie [LMT]

URI
http://hdl.handle.net/10985/14975
DOI
10.3389/fphys.2019.00441
Date
2019
Journal
Frontiers in Physiology

Abstract

The maintenance of upright balance in healthy humans requires the preservation of a horizontal gaze, best achieved through dynamical adjustments of spinal curvatures and a pelvic tilt that keeps the head-to-pelvis alignment close to vertical. It is currently unknown whether the spinal and pelvic compensations of respiratory-related postural perturbations are associated with preservation of the head-to-pelvis vertical alignment. We tested this hypothesis by comparing postural alignment variables at extreme lung volume (total lung capacity, TLC; residual volume, RV) with their reference value at functional residual capacity (FRC). Forty-eight healthy subjects [22 women; median age of 34 (26; 48) years] were studied using low dose biplanar X-rays (BPXR; EOS system). Personalized three-dimensional models of the spine and pelvis were reconstructed at the three lung volumes. Extreme lung volumes were associated with changes of thoracic curvature bringing it outside the normal range. Maximal inspiration reduced thoracic kyphosis [T1–T12 angle = 47◦ (37; 56), −4◦ variation (−9; 1), p = 0.0007] while maximal expiration induced hyperkyphosis [T1–T12 angle = 63◦ (55; 68); C10◦ variation (5; 12), p = 9 × 10−12]. Statistically significant (all p < 0.01) cervical and pelvic compensatory changes occurred [C3–C7 angle: C4◦ (−2; 11) and pelvic tilt C1◦ (0; 3) during maximal inspiration; C3–C7 angle: −7◦ (−18; −1) and pelvic tilt C5◦ (1; 8) during maximal expiration], resulting in preserved head-to-pelvis alignment (no change in the angle between the vertical plane and the line connecting the odontoid process and the midpoint of the line connecting the center of the two femoral heads ODHA). Lung volume related postural perturbations were more marked as a function of age, but age did not affect the head-to-pelvis alignment. These findings should help understand balance alterations in patients with chronic respiratory diseases that modify lung volume and rib cage geometry.

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