International Research Leader: Dr Mary Massery

Dr Mary Massery – she’s a hot name in research right now and for good reason. Mary’s research focuses on the link between motor performance, posture, balance and breathing.

Dr Mary challenges us to think about which other body systems affect good posture and stable balance. It is not just about strong core muscles! That is important, however Dr Mary encourages us to look at all the body systems for a child- how are breathing, the senses, the skin, the cardiovascular and pulmonary systems affecting a child’s balance and posture?

She compares the trunk of the body to a can of soft drink (or soda pop- since she is from the US!) Think of the gas inside an aluminium can of soft drink and the way it creates internal pressure that makes the can strong. Once you release the gas by opening the can (pssshhhhh) the aluminium tin can be easily crushed because the air inside was creating pressure, that helped the can feel strong and keep its shape. So too with the breath in our lungs- it is critical to the strength of our trunk and therefore our postural control and balance!

So when the aluminium can is open, it is flimsy and easily crushed.

When the can is sealed at top and bottom, the carbonation from within exerts a greater outward pressure, than the pressure outside the can, making it strong.

This concept is especially important for kids, whose musculoskeletal systems are still developing. When our breathing is modulated through intra-thoracic pressure (ITP) and intra-abdominal pressure (IAP) this creates adequate pressure for postural control and breathing, and the musculoskeletal system is developed around correct alignment. If not, the immature spine and rib cage are likely to develop with deformities that further limit respiration.

Pushing activities recruit the vocal folds at the top of the trunk, creating pressure that makes the core strong. Pulling activities stimulate the glottis and pelvic floor to also create internal pressure for a strong core. Imagine yourself at the start of a Tug-o-war; “grab the rope, take the strain” as you lean into your legs, the glottis and pelvic floor instinctively close to help your body create a strong core by trapping your breath!

Want to find out more? Read more about Dr Mary Massery and her research here.

Research Articles

Massery, M., Multisystem Consequences of Impaired Breathing Mechanics and/or Postural Control, in Cardiovascular and Pulmonary Physical Therapy Evidence and Practice, ed. 4., D. Frownfelter and E. Dean, Editors. 2006, Elsevier Health Sciences: St. Louis, MO. p. 695-717.

Hodges, P.W. and S.C. Gandevia, Activation of the human diaphragm during a repetitive postural task. Journal of Physiology, 2000. 522 Pt 1: p. 165-75.

Hodges, P.W., et al., Intra-abdominal pressure increases stiffness of the lumbar spine. J Biomech, 2005. 38(9): p. 1873- 80.

Kolar, P., et al., Stabilizing function of the diaphragm: dynamic MRI and synchronized spirometric assessment. J Appl Physiol, 2010. 109(4): p. 1064-71.

Hamaoui, A., et al., Postural disturbances resulting from unilateral and bilateral diaphragm contractions: a phrenic nerve stimulation study. J Appl Physiol 2014. 117(8): p. 825-32.

Hamaoui, A., E. Gonneau, and S. Le Bozec, Respiratory disturbance to posture varies according to the respiratory mode. Neuroscience Letters, 2010. 475(3): p. 141-144.

Inal-Ince, D., et al., Effects of scoliosis on respiratory muscle strength in patients with neuromuscular disorders. Spine J, 2009. 9(12): p. 981-6.

Massery, M.P., Chest development as a component of normal motor development: implications for pediatric physical therapists. Pediatric Physical Therapy, 1991. 3(1): p. 3-8.

Massery, M., et al., Effect of airway control by glottal structures on postural stability. J Appl Physiol, 2013. 115(4): p. 483-90.

Frownfelter, D., et al., Do abdominal cutouts in thoracolumbosacral orthoses increase pulmonary function? Clin Orthop Relat Res, 2014. 472(2): p. 720-6.