Thoracoabdominal asynchrony and paradoxical motion in middle stage amyotrophic lateral sclerosis

Publication date: Available online 30 June 2018Source: Respiratory Physiology &NeurobiologyAuthor(s): Antonio Sarmento, Guilherme Fregonezi, Mario Emílio Teixeira Dourado-Junior, Andrea Aliverti, Armele Dornelas de Andrade, Verônica Franco Parreira, Vanessa ResquetiAbstractAimTo assess thoracoabdominal asynchrony (TAA) and the presence of paradoxical motion in middle stage amyotrophic lateral sclerosis (ALS) and its relationships with chest wall tidal volume (VT,CW), breathing pattern and cough peak flow (CPF).MethodsPhase angle (θ) between upper (RCp) and lower ribcage (RCa) and abdomen (AB), as well as percentage of inspiratory time for the lower ribcage (IPRCa) and abdomen (IPAB) moving in opposite directions were quantified using optoelectronic plethysmography in 12 ALS patients during quiet breathing and coughing. Paradoxical motion of the compartments was based on threshold values of θ and IP, obtained in twelve age and sex matched healthy persons.ResultsDuring quiet breathing, significantly higher RCa and AB θ (p 
Source: Respiratory Physiology and Neurobiology - Category: Respiratory Medicine Source Type: research

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Source: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration - Category: Neurology Authors: Source Type: research
e;n M Abstract INTRODUCTION: The aim of this study was to assess several air-pressure settings for MI-E to determine their effect on peak cough flow (PCF), and to compare the best pressures with those are more common used in the literature (±40cmH2O) in patients with neuromuscular disorders (NMD). METHODS: Adults with NMD in whom MI-E was indicated were recruited. Assisted PCF was measured by an external pneumotachograph. The protocol included 9 PCF measures per patient: 1 baseline (non-assisted), 4 with increasing inspiratory pressures without negative pressure (10, 20, 30 and 40cmH2O or maximum toler...
Source: Archivos de Bronconeumologia - Category: Respiratory Medicine Authors: Tags: Arch Bronconeumol Source Type: research
Conclusions: Referrals to WoSLTVU continue to increase. The survival benefits of NIV appear to be confirmed in real life practice. Early referral was not seen to further improve survival. Respiratory management has increased physiotherapy involvement with cough assessment and augmentation. Further work to assess the impact of this change on patient outcomes is required.References: 1. Bourke SC, Tomlinson M, Williams TL et al. Effects of non-invasive ventilation on survival and quality of life in patients with amyotrophic lateral sclerosis: a randomised controlled trial. Lancet Neurol 2006 Feb; 5(2):140-147.2. National Inst...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Noninvasive Ventilatory Support Source Type: research
Conclusions: Individually tailored MI-E can improve and possibly extend the use of non-invasive therapy in ALS, and laryngoscopy can become a valuable tool in this respect.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Noninvasive Ventilatory Support Source Type: research
In conclusion, the appreciation of the efficiency of the cough by the patient rest subjective, its evaluation by the DET in prone position allows of identified by advantage an ineffective cough.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical Problems Source Type: research
Introduction: Sniff nasal inspiratory pressure (SNIP) is reliable for the diaphragm strength assessment in Amyotrophic lateral sclerosis (ALS) patients (pts). Recent studies in pts with neuromuscolar diseases demonstrated SNIP improvement after training.Aim: To determine if SNIP can improve after training in ALS pts, and to compare SNIP value before and after respiratory function tests (RFTs).Methods: We recruited 103 consecutive ALS pts at Bari Regional referring Centre, (62/41=M/F);80/103 had spinal onset. They performed 5-10 sniffs, and best value was recorded(S1). Spirometry, peak cough flow(PCF) and peak expiratory fl...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical respiratory physiology, exercise and functional imaging Source Type: research
The use of assisted cough techniques in Amyotrophic Lateral Sclerosis (ALS) has been an important advance in their care. The aim of this study is determine a functional parameter that could predict if manually assisted cough is more effective than MI-E in ALS. We performed a prospective study (January 2016-September 2017) that included all ALS patients managed in our Respiratory Care Unit. The subjects underwent a clinical evaluation including demographic data, neurological evaluation (ALSFRS-R score and Norris scale bulbar subscore) and functional respiratory evaluation, which included spirometry, the measurement of respi...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical respiratory physiology, exercise and functional imaging Source Type: research
Muscle&Nerve,Volume 0, Issue ja, -Not available-.
Source: Muscle and Nerve - Category: Internal Medicine Authors: Source Type: research
Introduction: Respiratory muscle weakness with increment of pulmonary infection is one of the main causes of mortality and morbidity in patients with Amyotrophic Lateral Sclerosis (ALS). The effectiveness of cough gradually decreased with the increase of the expiratory and bulbar muscle weakness. The indication for mechanical cough assistance is given when the CoughPEF is 160 l/min) or a maximal expiratory pressure (MEP)
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Rehabilitation and Chronic Care Source Type: research
Background: Mechanical assistance cough for patients with neuromuscular disorders (NMD) is commonly used, but there is no adaptation model established. Currently is performed subjectively by the physiotherapist following the pressures recommended in the current literature (LRP) as optimal (±40CmH2O).Aim: To check if LRP are the most optimal pressures to achieve the better peak cough flow (PCF).Method: Repeated measures study was performed to evaluate the effectiveness measured by PCF. Subjects adults with cough assist (CA) criteria (PCFbaseline
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Physiotherapists Source Type: research
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