• Respiratory care · Nov 2020

    Effects of Positioning on Cough Peak Flow and Muscular Electromyographic Activation in Duchenne Muscular Dystrophy.

    • Layana Marques, Guilherme Augusto de Freitas Fregonezi, Ilsa Priscila Santos, Ana Aline Marcelino, Medeiros da Fonsêca Jéssica Danielle JD PneumoCardioVascular Lab, Hospital Universitario Onofe Lopes, Empresa Brasileira de Serviços Hospitalares, Natal, Brazil. , Mario Emílio Teixeira Dourado-Júnior, Andrea Aliverti, Antonio Sarmento, and Resqueti Vanessa Regiane VR PneumoCardioVascular Lab, Hospital Universitario Onofe Lopes, Empresa Brasileira de Serviços Hospitalares, Natal, Brazil. vanessaresqueti@hotm.
    • PneumoCardioVascular Lab, Hospital Universitario Onofe Lopes, Empresa Brasileira de Serviços Hospitalares, Natal, Brazil.
    • Respir Care. 2020 Nov 1; 65 (11): 1668-1677.

    BackgroundAdvanced stages of Duchenne muscular dystrophy (DMD) result in muscle weakness and the inability to generate an effective cough. Several factors influence the effectiveness of cough in patients with DMD. The aim of this study was to assess whether differences in positioning affect cough peak flow (CPF) and muscular electromyographic activation in subjects with DMD compared with paired healthy subjects.MethodsOptoelectronic plethysmography and surface electromyography were used to assess chest wall volumes, chest wall inspiratory capacity, CPF, breathing pattern, and electromyographic activity of sternocleidomastoid, scalene, rectus abdominis, and external oblique muscles during inspiratory and expiratory cough phases in the supine position, supine position with headrest raised at 45°, and sitting with back support at 80° in 12 subjects with DMD and 12 healthy subjects.ResultsSubjects with DMD had lower CPF (P < .01) in comparison to control subjects in all positions; the DMD group also exhibited lower CPF (P = .045) in the supine position versus 80°. Moreover, the relative volume contributions of the rib cage and abdominal compartments to tidal volume modified significantly with posture. The electromyographic activity during inspiratory and expiratory cough phases was lower in subjects with DMD compared to healthy subjects for all evaluated muscles (P < .05), but no significant differences were observed with posture change.ConclusionsIn subjects with DMD, posture influenced CPF and the relative contribution of the rib cage and abdominal compartments to tidal volume. However, muscular electromyographic activation was not influenced by posture in subjects with DMD and healthy subjects.Copyright © 2020 by Daedalus Enterprises.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…