The relationship between pulmonary and swallowing functions in patients with neuromuscular diseases followed up by a tertiary referral center: a cross-sectional study

Sarmet, Max; Mangilli, Laura Davison; Costa, Geovanna; Paes, Juliana Peres Ribeiro Soares; Codeço, Vitor Martins; Million, Janae Lyon; Maldaner, Vinicius

doi:10.1080/14015439.2021.1879254

Cited by 2 publications

(4 citation statements)

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“…The efforts adopted in understanding the effect of this single-session breathing exercise on patients with ALS are justified considering the importance of upper airway spaces in ventilation [1,7]. Researchers hypothesize that the maintenance of these spaces could improve the clinical evolution of ALS concerning respiratory and swallowing outcomes, in line with previous results obtained by Waito el al.…”

Section: Discussionsupporting

confidence: 65%

“…Considering the study results on acute upper airway constriction and expansion, the authors consider that this breathing exercise may have the potential to play a role in ventilation and may serve to improve outcomes in patients with weakness of the pharyngeal muscles [1] (which can cause decreased pharyngeal pressure) [3] and/or impaired swallowing (which compromises airway safety in patients with ALS) [2,7]. The efficacy of TR3 performed systematically in a therapeutic context is a key outcome to be assessed in further investigations.…”

Section: Discussionmentioning

confidence: 99%

“…The present article is a cross-sectional study approved by the HC/UFG Ethics Committee (Approval number 3981050-19/08/2018). Participants diagnosed with probable-definite ALS (revised El Escorial criteria) [2,[4][5][6][7][8][9] who were treated at the Tertiary Referral Center for Neuromuscular Diseases of Hospital de Apoio de Brasılia, Brazil [7] were enrolled in this study. Informed consent was obtained from the subjects.…”

Section: Study Design and Participantsmentioning

confidence: 99%

“…In this pilot study, the valve resistance was empirically set at 8 cmH 2 O for all participants because it is a value slightly above the expiratory positive airway pressure usually used in non-invasive ventilation employed in the treatment of patients with ALS [1,7]. The second technique, known as pressurized apnea, does not require RMET.…”

Section: Interventionmentioning

confidence: 99%

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A Pilot Study of the Breath Stacking Technique Associated with Respiratory Muscle Endurance Training in Patients with Amyotrophic Lateral Sclerosis: Videofluoroscopic Findings in the Upper Airway

Dorça

Sarmet

Rocha

et al. 2021

Advances in Respiratory Medicine

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Introduction: Bulbar impairment represents a hallmark feature of amyotrophic lateral sclerosis (ALS) that significantly impacts survival and quality of life. Respiratory complications arise because of the weakness of the upper airway and respiratory muscles leading to respiratory failure, impaired swallowing, and reduced airway safety. Breath stacking and respiratory muscle endurance training are techniques that have been described to improve respiratory and bulbar function in patients with ALS. Considering the above, a respiratory technique named TR3 was developed. This study aimed to measure the acute effects of this technique on the upper airway through videofluoroscopy and to assess its clinical trial feasibility in patients with ALS. Material and methods: In this cross-sectional study, we enrolled participants diagnosed with ALS to perform a single session of TR3. Epidemiological data and baseline assessments were collected. The assessments included kinematics from videofluoroscopy measuring the retropalatal airspace size, the size of the narrowest airway, and the pharyngeal area during rest and TR3. Results: Eight participants were included. During TR3, an acute increase of 15% was observed in the retropalatal airspace size (t = 5.14, p < 0.01), a 123% increase was observed in the size of the narrowest airway (t = -4.18, p < 0.001), and a 277% increase was observed in the pharyngeal area (t = -5.34, p < 0.001). Conclusions: During the intervention, TR3 showed acute effects in increasing pharyngeal constriction, pharyngeal expansion, retropalatal airspace size, and post-lingual narrowest airway size and is feasible for a larger research program. A clinical trial (NCT04226144) is already being conducted to assess the chronic therapeutic effects of this technique and its impact on the clinical evolution of ALS.

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Section: Discussionsupporting

confidence: 65%