Correction: Reference Equation for Respiratory Pressures in Pediatric Population: A Multicenter Study

Effects of inspiratory muscle training on respiratory muscle strength, respiratory function and functional capacity in adolescents with idiopathic scoliosis : A randomized, controlled trial

BACKGROUND

Adolescent Idiopathic Scoliosis (AIS) may impair respiratory dynamics and affect the performance of inspiratory and expiratory muscles. The benefit of inspiratory muscle training (IMT) is not well investigated in AIS. We aimed to investigate the effects of IMT on respiratory muscle strength, respiratory function and functional capacity in adolescents with mild to moderate AIS.

METHODS

Thirty-six adolescents were randomized into control or IMT groups. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and peak expiratory flow (PEF) were measured by spirometry; respiratory muscle strength by maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP); and functional capacity by 6-min walk test (6MWT) before and after the 8-week-long home-based exercise program. Both groups received conventional exercise program including diaphragmatic breathing exercises, resistive local expansion exercise on the collapsed areas in concave sides of scoliosis, spinal stabilization, strengthening of interscapular muscles and stretching exercises. IMT group also trained with Threshold IMT device for 15 minutes, twice a day for 8 weeks at the intensity of 30% of initial MIP value in addition to conventional exercise program.

RESULTS

FEV1, PEF, MIP, MEP and 6MWT distance significantly improved in both groups. IMT group also showed significant improvement in FVC. The increases in FVC, MIP, MEP and 6MWT distance of IMT group were significantly higher compared to control group.

CONCLUSION

IMT is found to be beneficial for patients with AIS for achieving further improvements in respiratory function, respiratory muscle strength and functional capacity compared to conventional exercise program alone.

Thoracoabdominal asynchrony and paradoxical motion in Duchenne muscular dystrophy and healthy subjects during cough: A case control study

OBJECTIVE

To assess thoracoabdominal asynchrony (TAA) and inspiratory paradoxical motion at different positionings in subjects with Duchenne muscular dystrophy (DMD) versus healthy subjects during quiet spontaneous breathing (QB) and cough.

METHODS

This is a case control study with a matched-pair design. We assessed 14 DMD subjects and 12 controls using optoelectronic plethysmography (OEP) during QB and spontaneous cough in 3 positions: supine, supine with headrest raised at 45°, and sitting with back support at 80°. The TAA was assessed using phase angle (θ) between upper (RCp) and lower rib cage (RCa) and abdomen (AB), as well as the percentage of inspiratory time the RCp (IP_RCp ), RCa (IP_RCa ), and AB (IP_AB ) moved in opposite directions.

RESULTS

During cough, DMD group showed higher RCp and RCa θ (p < .05), RCp and AB θ (p < .05) in supine and 45° positions, and higher RCp and Rca θ (p = .006) only in supine position compared with controls. Regarding the intragroup analysis, during cough, DMD group presented higher RCp and AB θ (p = .02) and RCa and AB θ (p = .002) in supine and higher RCa and AB θ (p = .002) in 45° position when compared to 80°. Receiver operating characteristic curve analyzes were able to discriminate TAA between controls and DMD in RCa supine position (area under the curve: 0.81, sensibility: 78.6% and specificity: 91.7%, p = .001).

CONCLUSION

Subjects with DMD yields TAA with insufficient deflation of chest wall compartments and rib cage distortion during cough, by noninvasive assessment.