Thoracoabdominal Asynchrony and Paradoxical motion in Duchen
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A research was performed to test thoracoabdominal asynchrony (TAA) and inspiratory paradoxical motion in subjects with Duchenne muscular dystrophy (DMD) versus healthy subjects at different positions during quiet spontaneous breathing (QB) and cough.

During QB and spontaneous cough, researchers measured 14 DMD subjects and 12 controls using optoelectronic plethysmography (OEP) in three positions: supine, supine with headrest lifted at 45°, and sitting with back support at 80°. The TAA was determined by measuring the phase angle (theta) between the upper (RCp) and lower (RCa) rib cages and the abdomen (AB), as well as the percentage of time the RCp (IPRCp), RCa (IPRCa), and AB (IPAB) shifted in opposite directions during inspiration.

Results:
--During cough, DMD group showed higher RCp and RCa theta, RCp and AB theta in supine and 45° positions, and higher RCp and Rca theta only in supine position compared with controls.

--Regarding the intragroup analysis, during cough, DMD group presented higher RCp and AB theta and RCa and AB theta in supine and higher RCa and AB theta in 45° position when compared to 80°.

--Receiver operating characteristic curve analyzes were able to discriminate TAA between controls and DMD in RCa supine position (area under the curve: 0.81, sensibility: 78.6% and specificity: 91.7%).

Conclusively, Subjects with DMD yields TAA with insufficient deflation of chest wall compartments and rib cage distortion during cough, by noninvasive assessment.

Source: https://onlinelibrary.wiley.com/doi/10.1002/ppul.25412?af=R
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