Inspiratory inhibitory reflex caused by the chest wall vibration in man

doi:10.1016/0034-5687(80)90065-1

Respiration Physiology

Volume 39, Issue 3, March 1980, Pages 345-353

Respiration Physiolo...

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Abstract

The effects of chest wall vibrations on tidal volume (VT), inspiratory time (TI) and expiratory time (TE) were measured in normal man during rebreathing. Two vibrators, frequency 100 Hz, were applied bilaterally over the 7th to 10th intercostal spaces anterior to the mid-axillary line. The vibrators were triggered by chest wall movement during the inspiratory phase once or twice, intermittently, every 4–10 breaths. The VT and TI of ‘vibrated’ breaths were decreased compared with preceding control breaths. These effects were clearly paralleled by a reduction in averaged integrated EMG recordings from the diaphgram. The initial time course of the integrated EMG activities in vibrated and non-vibrated breaths were almost equal. However, the relationship between VT and TI of vibrated breaths was shifted downward from that of the non-vibrated (control) breaths. The depression of VT was augmented as the VT of control breath increased. The findings suggest that supraspinal intercostal inhibitory reflex normally contributes to the phase switching mechanism of respiration in man.

References (21)

J.G. Colebatch et al.
Reduction in inspiratory activity in response to sternal vibration
Respir. Physiol.
(1977)
S.C. Gandevia et al.
Changes in the pattern of breathing caused by chest vibration
Respir. Physiol.
(1976)
I. Homma et al.
Respiration in man affected by TVR contractions elicited in inspiratory intercostal muscles
Respir. Physiol.
(1978)
J. Remmers
Inhibition of inspiratory activity by intercostal muscle afferents
Respir. Physiol.
(1970)
J. Remmers et al.
Action of intercostal muscle afferents on the respiratory rhythm of anaesthetized cats
Respir. Physiol.
(1975)
T.E. Boyed et al.
Vagal inhibition of inspiration and accompnying changes of respiratory rhythm
J. Neurohysiol.
(1939)
G.W. Bradley et al.
Steady state effects of Co₂ and temperature on the relationship between lung volume and inspiratory duration (Hering-Breuer threshold curve)
Acta Physiol. Scand.
(1974)
D. Burke et al.
The response of human muscle spindle endings to vibration of non-contracting muscles
J. Physiol. (London)
(1976)
F.J. Clark et al.
On the regulation of depth and rate of breathing
J. Physiol. (London)
(1972)
L.R. Duffner et al.
Effect of whole-body vertical vibration on respiration in human subjects
J. Appl. Physiol.
(1962)

There are more references available in the full text version of this article.

Cited by (32)

Dyspnea
2022, Handbook of Clinical Neurology
Citation Excerpt :
Studies of the role of respiratory muscle sensory afferents in generating the sense of effort or work are relatively few. Chest wall vibration has been used to activate the muscle spindles and Golgi-tendon organs of the respiratory muscles and has been shown to impact respiratory control (Colebatch et al., 1977; Homma, 1980; Sempik and Patrick, 1981; Bolser et al., 1988; Kondo et al., 1989). When inspiratory muscles are vibrated during inspiration (in-phase vibration), “dyspnea,” “breathlessness,” or “breathing discomfort” are reduced (see Table 11.1), whereas vibration out-of-phase with the breathing cycle increases “breathlessness” (Homma et al., 1984).
The clinical term dyspnea (a.k.a. breathlessness or shortness of breath) encompasses at least three qualitatively distinct sensations that warn of threats to breathing: air hunger, effort to breathe, and chest tightness. Air hunger is a primal homeostatic warning signal of insufficient alveolar ventilation that can produce fear and anxiety and severely impacts the lives of patients with cardiopulmonary, neuromuscular, psychological, and end-stage disease. The sense of effort to breathe informs of increased respiratory muscle activity and warns of potential impediments to breathing. Most frequently associated with bronchoconstriction, chest tightness may warn of airway inflammation and constriction through activation of airway sensory nerves. This chapter reviews human and functional brain imaging studies with comparison to pertinent neurorespiratory studies in animals to propose the interoceptive networks underlying each sensation. The neural origins of their distinct sensory and affective dimensions are discussed, and areas for future research are proposed. Despite dyspnea's clinical prevalence and impact, management of dyspnea languishes decades behind the treatment of pain. The neurophysiological bases of current therapeutic approaches are reviewed; however, a better understanding of the neural mechanisms of dyspnea may lead to development of novel therapies and improved patient care.
Workshop: Tuning the 'cough center'
2011, Pulmonary Pharmacology and Therapeutics
Citation Excerpt :
Noticeably, the inspiratory component of all the evoked reflexes was inhibited, and the overall intensity of coughing and sneezing reduced [80]. In healthy humans, chest wall vibrations applied bilaterally over the 7th–10th intercostal spaces significantly inhibit the volume and time components of the breathing pattern [89]. By using a similar technique, Kondo et al. [81] showed that cough threshold to citric acid was significantly increased during chest wall vibrations, suggesting that inputs from intercostal muscles and/or costovertebral joints have an inhibitory effect on cough sensitivity.
The Workshop considered the mechanisms whereby the ‘cough center’ could be tuned by various afferent inputs. There were particular presentations on the effects of inputs from the nose, mouth, respiratory tract and lungs, cerebral cortex, somatic tissues and the pharynx. From all these sites cough induced from the lungs could be increased or decreased in its strength or modified in its pattern. Thus ‘tuning’ of cough could be due to the interaction of afferent inputs, or to the sensitization or desensitization of brainstem neural pathways. The pattern of response depended on the ‘type’ of cough being studied and, in some instances, on the timing of the sensory input into the brainstem. Cough inputs could also affect various ‘non-cough’ motor outputs from the brain, although this was not the main theme of the Workshop. The main conclusion was that cough is not a stereotyped output from the medullary ‘cough center’, but that its pattern and strength depend on many afferent inputs acting on the ‘cough center’.
Effect of intrapulmonary percussive ventilation on expiratory flow limitation in chronic obstructive pulmonary disease patients
2009, Journal of Critical Care
Citation Excerpt :
On the other hand, rhythmic vibrations of the intercostals muscles could be a major factor influencing the control of breathing. Afferent activity from intercostal muscle spindles is known to alter the pattern of phrenic nerve activity in anesthetized cats, and rib cage vibration changes the pattern of breathing both in cats and in humans [37,38]. After the session of IPV, the mean sputum production was 20 mL.
The aims of this prospective study were (1) to select, after weaning and extubation, chronic obstructive pulmonary disease (COPD) patients with expiratory flow limitation (EFL) measured by the negative expiratory pressure method and (2) to assess, in these patients, the short-term (30 minutes) physiologic effect of a session of intrapulmonary percussive ventilation (IPV).
All COPD patients who were intubated and needed weaning from mechanical ventilation were screened after extubation. The patients were placed in half-sitting position and breathed spontaneously. The EFL and the airway occlusion pressure after 0.1 second (P0.1) were measured at the first hour after extubation. In COPD patients with EFL, an IPV session of 30 minutes was promptly performed by a physiotherapist accustomed to the technique. Expiratory flow limitation, gas exchange, and P0.1 were recorded at the end of the IPV session.
Among 35 patients studied after extubation, 25 patients presented an EFL and were included in the study. Intrapulmonary percussive ventilation led to a significant improvement in EFL, respectively, before and 30 minutes after IPV (65.4 ± 18.2 vs 35.6 ± 22.8; P < .05). Three patients were not expiratory flow limited after IPV. Intrapulmonary percussive ventilation led to a significant decrease in P0.1 (3.9 ± 1.6 vs 2.8 ± 1.1; P < .05). Thirty minutes of IPV led to a significant increase in Pao₂ and pH and a decrease in Paco₂ and respiratory rate (P < .05).
In COPD patients, a session of IPV allowed a significant reduction of EFL and of P01 and a significant improvement of gas exchange.
Workshop - Cough: Exercise, speech and music
2009, Pulmonary Pharmacology and Therapeutics
Citation Excerpt :
Interestingly, the inspiratory component of all the evoked reflexes was inhibited, and the overall intensity of coughing and sneezing was reduced [26]. In healthy humans, chest wall vibrations applied bilaterally over the 7th to 10th intercostal spaces significantly inhibit the volume and time components of the breathing pattern [27]. By using a similar technique, Kondo et al. [28] provided evidence that cough threshold to citric acid is significantly increased during chest wall vibrations, suggesting that inputs from intercostals muscles and/or costovertebral joints have an inhibitory effect on cough sensitivity.
Twelve distinguished scientists attended the workshop, heard three presentations, and took part in the discussions. Fontana first described his unpublished studies on cough in exercise and during hyperventilation with healthy subjects. Both activities depressed cough induced by inhalation of distilled water aerosol (fog). The possible mechanisms were discussed. Gibson then described the successful use of speech therapy to treat chronic cough, and discussed the possible mechanisms, centering on the role of the larynx and its neural control. A comparison was made with the ability of speech and laughter to precipitate cough. Widdicombe discussed the scanty literature on the effect of singing and playing wind instruments on cough, most of the evidence being anecdotal. In the discussion periods several matters for future study arose. It is usually not clear if the modulation of cough, its depression, enhancement or excitation, arose primarily at peripheral sites (reflexes from the airways), or at a cortical level, or both. Nor is it clear whether the same results would be obtained with provoked cough and with spontaneous cough. But all three aspects of ‘behavioual’ changes in cough sensitivity (exercise, speech and music) could be further explored, and current techniques should make this possible.
Introduction of respiratory pattern generators into models of respiratory control
2005, Respiratory Physiology and Neurobiology
We have adapted two models previously proposed as respiratory pattern generators (RPGs) into a neurochemical feed back control model of ventilation. The RPG models, non-dimensional as originally presented, consisted of oscillating circuits of either two or five interconnected neurons [Matsugu, M., Duffin, J., Poon, C.-S., 1998. Entrainment, instability, quasi-periodicity, and chaos in a compound neural oscillator. J. Comput. Neurosci. 5, 35–51; Botros, S.M., Bruce, E.N., 1990. Neural network implementation of a three-phase model of respiratory rhythm generation. Biol. Cybern. 63, 143–153]. The neurochemical model into which they were integrated [Longobardo, G., Evangelisti, C.J., Cherniack, N.S., 2002. Effects of neural drives on breathing in the awake state in humans. Respir. Physiol. 129, 317–333] included the effects of cerebral blood flow variation with CO₂, vagal stretch receptors input and a multicompartment model of carbon dioxide stores. The methodology is described whereby these neuronal oscillator networks were quantified, a necessary step for their inclusion as RPGs in broader models of the overall control of respiration. Subsequent simulations of the ventilation response to carbon dioxide with either respiratory pattern generator model exhibited only a limited range in which tidal volume and frequency increased with increasing respiratory drive. With both models, frequency peaked and then declined, as did ventilation when $P_{C O_{2}}$ was greater than normal. The range of the models was extended if the respiratory pattern generators were considered to be composed of multiple neuronal oscillators or a single oscillator in which there was increasing phasic input that was gated or pacemaker driven.
Oscillation of the lung by chest-wall vibration
2001, Respiration Physiology
Vibration of the thoracic surface has been shown to modify the drive to breathe and the sensation of dyspnea. It has been suggested that respiratory muscle afferents generate these effects. The possibility that the consequences of chest-wall vibration also involve intra-pulmonary afferents led us to investigate whether such vibration reaches the airways. Two vibratory stimuli were independently applied to four chest-wall sites and two control sites on eight healthy subjects. During separate breath holds, the vibrator was held on each site while subjects periodically opened and closed the pharynx. Airway pressure (P_aw) was measured at the mouth. Spectral analysis of P_aw showed pressure oscillations occurred at the same frequency as that of the vibrators when the pharynx was open; oscillation amplitude was vastly reduced when the pharynx was closed. Oscillation amplitude was also significantly larger during vibration at greater amplitude. These data demonstrate that vibration over the chest-wall vibrates the lung and could potentially excite intrapulmonary receptors.

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¹: The Department of Physiology, The Tokyo Jikei University School of Medicine, 3-25-8 Nishishimbashi Minatoku Tokyo, Japan.

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Inspiratory inhibitory reflex caused by the chest wall vibration in man

Abstract

Respir. Physiol.

Respir. Physiol.

Respir. Physiol.

Respir. Physiol.

Respir. Physiol.

Vagal inhibition of inspiration and accompnying changes of respiratory rhythm

J. Neurohysiol.

Steady state effects of Co2 and temperature on the relationship between lung volume and inspiratory duration (Hering-Breuer threshold curve)

Acta Physiol. Scand.

The response of human muscle spindle endings to vibration of non-contracting muscles

J. Physiol. (London)

On the regulation of depth and rate of breathing

J. Physiol. (London)

Effect of whole-body vertical vibration on respiration in human subjects

J. Appl. Physiol.

Steady state effects of Co₂ and temperature on the relationship between lung volume and inspiratory duration (Hering-Breuer threshold curve)