Thoracoabdominal asynchrony and paradoxical motion in middle stage amyotrophic lateral sclerosis

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dc.creatorAntonio José Sarmento da Nóbrega
dc.creatorGuilherme Augusto de Freitas Fregonezi
dc.creatorMario Emílio Teixeira Dourado Junior
dc.creatorAndrea Aliverti
dc.creatorArmèle Dornelas de Andrade
dc.creatorVerônica Franco Parreira
dc.creatorVanessa Regiane Resqueti
dc.date.accessioned2022-03-21T14:46:56Z
dc.date.accessioned2025-09-09T00:05:42Z
dc.date.available2022-03-21T14:46:56Z
dc.date.issued2019-01
dc.description.sponsorshipCNPq - Conselho Nacional de Desenvolvimento Científico e Tecnológico
dc.description.sponsorshipCAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior
dc.format.mimetypepdf
dc.identifier.doihttps://doi.org/10.1016/j.resp.2018.06.012
dc.identifier.issn1569-9048
dc.identifier.urihttps://hdl.handle.net/1843/40270
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofRespiratory Physiology & Neurobiology
dc.rightsAcesso Aberto
dc.subjectParede torácica
dc.subjectTosse
dc.subjectDiafragma
dc.subjectRespiração
dc.subjectEsclerose lateral amiotrófica
dc.subject.otherChest wall volumes
dc.subject.otherCough
dc.subject.otherDiaphragm impairment
dc.subject.otherInspiratory paradox time
dc.subject.otherPhase angle
dc.subject.otherQuiet breathing
dc.titleThoracoabdominal asynchrony and paradoxical motion in middle stage amyotrophic lateral sclerosis
dc.typeArtigo de periódico
local.citation.epage25
local.citation.spage16
local.citation.volume259
local.description.resumoAim: To 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). Methods: Phase 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. Results: During quiet breathing, significantly higher RCa and AB θ (p < .05), IPRCa (p = 0.001) and IPAB (p < 0.05) were observed in ALS patients as compared to controls. In ALS patients, correlations between RCa and AB θ with forced vital capacity (FVC) (r=–0.773, p < 0.01), vital capacity (r=–0.663, p < 0.05) and inspiratory capacity (IC) (r=–0.754, p < 0.01), as well as between RCp and RCa θ with FVC (r=–0.608, p < 0.05) and CPF (r=–0.601, p < 0.05) were found. During coughing, correlations between RCp and AB θ with CPF (r=–0.590, p < 0.05), IC (r=–0.748, p < 0.01) and VT,CW (r=–0.608, p < 0.05), as well as between RCa and AB θ with CPF (r=–0.670, p < 0.05), IC (r=–0.713, p < 0.05) and peak expiratory flow (r=–0.727, p < 0.05) were also observed in ALS patients. ALS patients with paradoxical motion presented lower vital capacity and FVC%pred (p < 0.05) compared to those without paradoxical motion. Conclusions: Middle stage ALS patients exhibit TAA and paradoxical motion during quiet spontaneous breathing and coughing. In addition, diaphragmatic weakness (i.e. decrease in excursion of the RCa and AB compartments) was observed earlier in the lower ribcage rather than the abdominal compartment in this population.
local.identifier.orcidhttps://orcid.org/ 0000-0001-6391-5652
local.identifier.orcidhttp://orcid.org/0000-0003-4938-7018
local.identifier.orcidhttps://orcid.org/ 0000-0002-9462-2294
local.identifier.orcidhttps://orcid.org/ 0000-0002-2950-0231
local.identifier.orcidhttps://orcid.org/ 0000-0001-9430-4395
local.identifier.orcidhttp://orcid.org/0000-0003-0374-9319
local.identifier.orcidhttps://orcid.org/ 0000-0003-4817-9364
local.publisher.countryBrasil
local.publisher.departmentEEF - DEPARTAMENTO DE FISIOTERAPIA
local.publisher.initialsUFMG
local.url.externahttps://reader.elsevier.com/reader/sd/pii/S1569904818301368?token=70D2DAE1FA2495AA01DFFE1432188C5D8C22F9584A8638D3A33575C28C5E864947070D4A0E2F56A908E271AA00FAFE9A&originRegion=us-east-1&originCreation=20220321142547

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