Navegando por Autor "Marques, Layana"
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Artigo Effects of positioning on cough peak flow and muscular electromyographic activation in duchenne muscular dystrophy(Respiratory Care, 2020) Dourado Junior, Mário Emílio Teixeira; Marques, Layana; Santos, Ilsa Priscila; Marcelino, Ana Aline; Fonseca, Jessica Danielle Medeiros da; Aliverti, Andrea; Sarmento, Antonio; Resqueti, Vanessa Regiane; Fregonezi, Guilherme Augusto de Freitas; https://orcid.org/0000-0002-9462-2294Advanced stages of Duchenne muscular dystrophy (DMD) result in muscle weakness and the inability to generate an effective cough. Several factors influence the effectiveness of cough in patients with DMD. The aim of this study was to assess whether differences in positioning affect cough peak flow (CPF) and muscular electromyographic activation in subjects with DMD compared with paired healthy subjects. METHODS: Optoelectronic plethysmography and surface electromyography were used to assess chest wall volumes, chest wall inspiratory capacity, CPF, breathing pattern, and electromyographic activity of sternocleidomastoid, scalene, rectus abdominis, and external oblique muscles during inspiratory and expiratory cough phases in the supine position, supine position with headrest raised at 45 , and sitting with back support at 80 in 12 subjects with DMD and 12 healthy subjects. RESULTS: Subjects with DMD had lower CPF (P < .01) in comparison to control subjects in all positions; the DMD group also exhibited lower CPF (P 5 .045) in the supine position versus 80 . Moreover, the relative volume contributions of the rib cage and abdominal compartments to tidal volume modified significantly with posture. The electromyographic activity during inspiratory and expiratory cough phases was lower in subjects with DMD compared to healthy subjects for all evaluated muscles (P < .05), but no significant differences were observed with posture change. CONCLUSIONS: In subjects with DMD, posture influenced CPF and the relative contribution of the rib cage and abdominal compartments to tidal volume. However, muscular electromyographic activation was not influenced by posture in subjects with DMD and healthy subjects.Artigo Multiparametric analysis of sniff nasal inspiratory pressure test in middle stage amyotrophic lateral sclerosis(Frontiers in Neurology, 2018-05-02) Dourado Junior, Mário Emílio Teixeira; Sarmento, Antonio; Aliverti, Andrea; Marques, Layana; Pennati, Francesca; Fregonezi, Guilherme; Fregonezi, Vanessa Regiane Resqueti; https://orcid.org/0000-0002-9462-2294The relaxation rates and contractile properties of inspiratory muscles are altered with inspiratory muscle weakness and fatigue. This fact plays an important role in neuromuscular disorders patients and had never been extensively studied in amyotrophic lateral sclerosis (ALS). In this cross-sectional study, these parameters were investigated non-invasively through nasal inspiratory sniff pressure test (SNIP) in 39 middle stage spinal onset ALS subjects and compared with 39 healthy controls. ALS patients were also divided into three subgroups according to a decline in their percentage of predicted forced vital capacity (FVC%pred) as well as a decline in the ALS functional rating scale score and its respiratory subscore (R-subscore) in order to determine the best parameter linked to early respiratory muscle weakness. When compared with healthy subjects, middle stage ALS subjects exhibited a significantly lower (p < 0.0001) maximum relaxation rate and maximum rate of pressure development (MRPD), as well as a significantly higher (p < 0.0001) tau (τ), contraction time, and half-relaxation time. The results from receiver operating characteristic curves showed that MRPD (AUC 0.735, p < 0.001) and FVC%pred (AUC 0.749, p = 0.009) were the best discriminator parameters between ALS patients with ≤30 and >30 points in the ALS functional rating scale. In addition, 1/2RT (AUC 0.720, p = 0.01), FVC%pred (AUC 0.700, p = 0.03), τ (AUC 0.824, p < 0.0001), and MRPD (AUC 0.721, p = 0.01) were the parameters more sensitive in detecting a fall of three points in the R-subscore. On the other hand, MRPD (AUC 0.781, p < 0.001), τ (AUC 0.794, p = 0.0001), and percentage of predicted of SNIP (AUC 0.769, p = 0.002) were the parameters able to detect a fall in 30% of the FVC%pred in middle stage ALS patients. The contractile properties and relaxation rates of the diaphragm are altered in middle stage spinal onset ALS when compared with healthy subjects. These parameters are able to discriminate between those middle stage ALS subjects with early decline in inspiratory muscle function and those who not.Artigo Thoracoabdominal asynchrony and paradoxical motion in Duchenne muscular dystrophy and healthy subjects during cough: a case control study(Wiley, 2021) Dourado Junior, Mário Emílio Teixeira; Marques, Layana; Fregonezi, Guilherme Augusto de Freitas; Marcelino, Ana Aline; Sarmento, Antonio; Pennati, Francesca; Aliverti, Andrea; Resqueti, Vanessa Regiane; https://orcid.org/0000-0002-9462-2294Objective:To assess thoracoabdominal asynchrony (TAA) and inspiratory para-doxical motion at different positionings in subjects with Duchenne muscular dys-trophy (DMD) versus healthy subjects during quiet spontaneous breathing (QB) andcough.Methods:This is a case control study with a matched‐pair design. We assessed 14DMD subjects and 12 controls using optoelectronic plethysmography (OEP) duringQB and spontaneous cough in 3 positions: supine, supine with headrest raised at45°, 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 thepercentage of inspiratory time the RCp (IPRCp), RCa (IPRCa), and AB (IPAB) moved inopposite directions.Results:During cough, DMD group showed higher RCp and RCaθ(p< .05), RCp andABθ(p< .05) in supine and 45° positions, and higher RCp and Rcaθ(p= .006) only insupine position compared with controls. Regarding the intragroup analysis, duringcough, DMD group presented higher RCp and ABθ(p= .02) and RCa and ABθ(p= .002) in supine and higher RCa and ABθ(p= .002) in 45° position when com-pared to 80°. Receiver operating characteristic curve analyzes were able to dis-criminate TAA between controls and DMD in RCa supine position (area under thecurve: 0.81, sensibility: 78.6% and specificity: 91.7%,p= .001).Conclusion:Subjects with DMD yields TAA with insufficient deflation of chest wallcompartments and rib cage distortion during cough, by noninvasive assessment.