Forward Head Posture Examination and its Association with Lung Expiratory Function in Chronic Obstructive Pulmonary Disease (COPD) Patient: A Case Series

The expiratory function of the lung could be easily measured by using the peak flow meter, and is recorded as a peak flow rate (PFR). This function has been known to be effectively correlated with mucus clearance and effective cough. Other than general muscle weakness, COPD patients generally have altered body structures to the chronic hyperventilation condition. Structural adaptations include thoracic kyphosis with forward head posture (FHP). This study aimed to quantify the severity of FHP and observe its impacts on PFR in COPD patients. We recruited a small cohort of COPD patients in the outpatient clinic of the Medical Rehabilitation Department, Persahabatan Hospital, Jakarta. The peak flow meter will be used to measure PFR, while FHP will be measured as occiput to wall distance, measured in centimeters. Additional records such as submaximal exercise testing, peak cough flow (PCF) and COPD Assessment Test (CAT) score will be obtained as well. An independent T-test will be performed on the data to obtain the difference of PFR among severity grades of FHP. In this study, eight patients acquired, they were all above the age of 60, classified as the geriatric population. We obtained underweight median Body Mass Index (BMI) 18.29 kg/m2 (15.05-22.04), COPD GOLD A to C, limited chest expansion, and median CAT score of 14 (4-30). This study also exhibited a median OWD of 8.10 cm (6.80-9.30), PFR 227.50 ml (70-400), and PCF 255 ml (180-410). These results showed that postural changes could simply be measured and may have an impact on respiratory biomechanics, which deems comprehensive COPD care.