Shoulder and thoracic spine mobility are impaired in patients with chronic obstructive pulmonary disease

Abstract

Patients with Chronic Obstructive Pulmonary Disease (COPD) often complain about difficulties in performing activities above shoulders height. These difficulties have been associated with altered lung mechanics; however, musculoskeletal mechanisms may also contribute to restrict the biomechanics of the upper body quadrant, increasing the effort. The purpose of this research was to explore the capacity of this population to fully elevate the arms in the standing upright position and the contribution of the thoracic spine posture and mobility to such task. Fifteen patients with COPD and nineteen age-matched healthy controls volunteered to participate in this study. Sagittal alignment and range of motion (ROM) of the thoracic spine and shoulder joint were measured, using a computer software, in digital lateral photographs obtained in 3 different testing positions: arms at rest, arms parallel to the ground (90º of shoulder flexion) and full arm elevation. Patients with COPD showed significantly less shoulder flexion (~11º) and thoracic spine extension (~5º) ROM than their healthy counterparts in full arm elevation position. These findings suggest that this population may show mobility impairments of the upper body quadrant that possibly contribute for further deteriorating functionality in their daily living.