Cough determinants in patients with neuromuscular disease

Trebbia, Grégoire; Lacombe, Mathieu; Fermanian, Christophe; Falaize, Line; Lejaille, Michèle; Louis, A.; Devaux, Christian; Raphaël, Jean Claude; Lofaso, Frédéric

doi:10.1016/j.resp.2005.01.001

Cited by 116 publications

(91 citation statements)

References 27 publications

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“…Because the diaphragm muscles are the main factor of ventilation, decreased hemidiaphragmatic excursion and reduced rib cage expansion due to contracture may cause inspiratory restriction [17]. Trebbia et al also reported that the maximal inspiratory capacity contributed 44% of the variance in the PCF of 155 neuromuscular patients, while the ERV contributed 13% of the variance [18]. They concluded that augmenting inspiration was crucial to the improvement of PCF, but that the role of the expiratory muscles could not be ignored.…”

Section: Discussionmentioning

confidence: 99%

Differences in the Peak Cough Flow among Stroke Patients With and Without Dysphagia

Kimura

Takahashi

Wada

et al. 2013

J UOEH

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: Coughing is an important protective mechanism for keeping the airway clear, and adequate voluntary coughing reduces the risk of aspiration in patients with deglutition disorders. The purpose of this study was to compare the peak cough f low (PCF) of stroke patients with and without dysphagia and to identify the physical and respiratory determinants of PCF. Using a spirometer, we measured and compared the PCFs of 10 stroke patients with dysphagia (SPD), 20 stroke patients without dysphagia (SP) and 10 gender and age matched healthy controls (HC) recruited by using a notice at a clinic and in newspapers. The PCF of the SPD (mean ± SD, 160.1 ± 68.7 l/min) was significantly lower than that of the SP and HC (297.2 ± 114.2 l/min and 462.0 ± 84.4 l/min, respectively; one-way ANOVA, Scheffe's test, P < 0.05). The vital capacity (VC) and inspiratory reserve volume (IRV) of the SPD were lower than those of the HC. Stepwise multivariate regression analysis revealed that IRV and ambulation function (Functional Ambulation Categories, FAC) contributed 50% and 17% to the variance of PCF (P < 0.05), respectively. It is suggested that respiratory function, especially IRV, is important for maintaining PCF in SPD.

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Section: Discussionmentioning

confidence: 99%

Differences in the Peak Cough Flow among Stroke Patients With and Without Dysphagia

Kimura

Takahashi

Wada

et al. 2013

J UOEH

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“…PCF values ≥160 L/min in patients with neuromuscular disease who exhibit respiratory failure are a predictor of successful extubation and decannulation 28) . In patients with advanced COPD or neuromuscular disease, when respiratory function decreases severely, non-invasive ventilation or mechanically assisted coughing is used for sputum expectoration 5,6,8,18,29) . In patients whose disease has not yet progressed to a relatively advanced stage, physical therapists now introduce huffing and manually assisted coughing 1,6,8) .…”

Section: Discussionmentioning

confidence: 99%

“…D i f f i c u l t y i n e x p e c t o r a t i o n c a u s e d b y n e u r o m u s c u l a r a n d p u l m o n a r y d i s e a s e s , particularly chronic obstructive pulmonary disease (COPD), increases the risk of pulmonary infection due to the accumulation of airway secretions [1][2][3][4][5] . In patients with respiratory or neuromuscular disease, it is important to maintain exhalation capacity.…”

Section: Introductionmentioning

confidence: 99%

The Effects of Strength Training of Pelvis Elevator Muscles on Exhalation Capacity in Healthy Men

2007

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Abstract. The effects on expiratory muscle strength and exhalation capacity of increased pelvis elevator muscles strength caused by strength training are not known. Twenty-six male students were randomized to either a training group or a control group. The training group had pelvis elevator muscles strength training twice daily for 4 weeks. At the beginning and end of the study, pelvis elevator muscle strength, maximum expiratory muscle strength (PE max ), and peak cough flow (PCF) were measured, and pulmonary function testing (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV 1.0 ), peak expiratory flow rate (PFR)) was performed. In the training group, significant increases were seen in pelvis elevator muscles strength, PE max , and FEV 1.0 ; no changes were seen in FVC, PFR, or PCF. No significant correlation was seen between change in pelvis elevator muscles strength and changes in exhalation capacity parameters in the training group. Strength training of the pelvis elevator muscles increases respiratory muscle strength, which would suggest that such training could increase exhalation capacity. However, the increase in pelvis elevator muscles strength that occurred as a result of training could not fully account for the changes in expiratory muscle strength or other parameters of exhalation capacity noted after training.

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“…Chatwin et al (15) found that although MIE and exsufflation alone were better than unassisted cough, they were not significantly better than assisted cough, in a mixed adult and child sample. In a small study of 10 patients with neurodegenerative conditions, Trebbia et al (18) found a combination of MAC and manual hyperinflation significantly improved PCF.…”

Section: The Problem Of Retained Secretionsmentioning

confidence: 98%

Management of respiratory problems in people with neurodegenerative conditions: a narrative review

2012

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Cough determinants in patients with neuromuscular disease

Cited by 116 publications

References 27 publications

Differences in the Peak Cough Flow among Stroke Patients With and Without Dysphagia

Differences in the Peak Cough Flow among Stroke Patients With and Without Dysphagia

The Effects of Strength Training of Pelvis Elevator Muscles on Exhalation Capacity in Healthy Men

Management of respiratory problems in people with neurodegenerative conditions: a narrative review

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