1
|
Deiwert DD, Dykstra B, Guilkey JP, Heidorn CE, Erichsen J, Kuszmaul D, Mahon AD. Oxygen uptake efficiency slope in 8- to 12-year-old boys and girls. J Sports Med Phys Fitness 2024; 64:624-630. [PMID: 38916085 DOI: 10.23736/s0022-4707.24.15597-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
BACKGROUND Oxygen uptake efficiency slope (OUES) is an objective physiological measure that can be obtained from a standard graded exercise test. However, there is conflicting evidence regarding sex differences in OUES values in children. Therefore, this study investigated potential sex differences in absolute, ratio-scaled, and allometrically scaled OUES in 8.0- to 12.0-year-old children. METHODS Retrospective and prospective data of 18 boys and 22 girls were utilized. All participants had undergone familiarization before performing a maximal cycle ergometer test to determine OUES. These values were also ratio-scaled and allometrically scaled to mass and body surface area (BSA). Group differences were tested via independent sample t-tests (or Mann-Whitney U if not normally distributed). RESULTS Absolute OUES values (VO2 mL∙min-1/log10VE L∙min-1) were significantly higher in boys compared to girls (1860.8±359.3 vs. 1514.3±212.6). When scaled to mass (VO2 mL∙kg-1∙min-1/log10VE L∙kg-1∙min-1), OUES was no longer significantly different between groups, but when scaled to BSA (VO2 mL∙m-2∙min-1/log10VE L∙m-2∙min-1), OUES was significantly higher in the boys than the girls (1414.4±204.2 vs. 1268.9±134.6). When allometry was applied for mass (OUES/mass0.444) boys had significantly higher value than girls (350.8±46.7 vs. 305.0±31.5). CONCLUSIONS The present study demonstrated that boys had greater OUES values scaled to BSA and allometrically scaled to body mass. These findings provide further evidence of sex differences with OUES values in preadolescent children and implies the need for sex-specific reference values prior to using OUES for the assessment of cardiorespiratory pathology in children.
Collapse
Affiliation(s)
- Donald D Deiwert
- Department of Kinesiology, Indiana University Indianapolis, Indianapolis, IN, USA -
- Department of Kinesiology, Laboratory of Human Performance, Ball State University, Muncie, IN, USA -
| | - Brandon Dykstra
- Department of Kinesiology, Laboratory of Human Performance, Ball State University, Muncie, IN, USA
| | - Justin P Guilkey
- Department of Kinesiology, Laboratory of Human Performance, Ball State University, Muncie, IN, USA
| | - C Eric Heidorn
- Department of Kinesiology, Laboratory of Human Performance, Ball State University, Muncie, IN, USA
| | - Jennifer Erichsen
- Department of Kinesiology, Laboratory of Human Performance, Ball State University, Muncie, IN, USA
| | - Dillon Kuszmaul
- Department of Kinesiology, Laboratory of Human Performance, Ball State University, Muncie, IN, USA
| | - Anthony D Mahon
- Department of Kinesiology, Laboratory of Human Performance, Ball State University, Muncie, IN, USA
| |
Collapse
|
2
|
Pradi N, Rocha Vieira DS, Ramalho O, Lemes ÍR, Cordeiro EC, Arpini M, Hulzebos E, Lanza F, Montemezzo D. Normal values for maximal respiratory pressures in children and adolescents: A systematic review with meta-analysis. Braz J Phys Ther 2024; 28:100587. [PMID: 38277805 PMCID: PMC10839618 DOI: 10.1016/j.bjpt.2023.100587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 11/29/2023] [Accepted: 12/17/2023] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND The non-invasive assessment of maximal respiratory pressures (MRP) reflects the strength of the respiratory muscles. OBJECTIVE To evaluate the studies which have established normative values for MRP in healthy children and adolescents and to synthesize these values through a meta-analysis. METHODS The searches were conducted until October 2023 in the following databases: ScienceDirect, MEDLINE, CINAHL, SciELO, and Web of Science. Articles that determined normative values and/or reference equations for maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) in children and adolescents published in English, Portuguese, or Spanish regardless of the year of publication were included. Two reviewers selected titles and abstracts, in case of conflict, a third reviewer was consulted. Articles that presented sufficient data were included to conduct the meta-analysis. RESULTS Initially, 252 studies were identified, 28 studies were included in the systematic review and 19 in the meta-analysis. The sample consisted of 5798 individuals, and the MIP and MEP values were stratified by sex and age groups of 4-11 and 12-19 years. Values from females 4-11 years were: 65.8 cmH2O for MIP and 72.8 cmH2O for MEP, and for males, 75.4 cmH2O for MIP and 84.0 cmH2O for MEP. In the 12-19 age group, values for females were 82.1 cmH2O for MIP and 90.0 cmH2O for MEP, and for males, they were 95.0 cmH2O for MIP and 105.7 cmH2O for MEP. CONCLUSIONS This meta-analysis suggests normative values for MIP and MEP in children and adolescents based on 19 studies.
Collapse
Affiliation(s)
- Nicole Pradi
- Graduate Program in Physical Therapy, Department of Physical Therapy, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil
| | - Danielle Soares Rocha Vieira
- Graduate Program in Rehabilitation Sciences, Department of Health Sciences, Universidade Federal de Santa Catarina (UFSC), Araranguá, SC, Brazil
| | - Olívia Ramalho
- Graduate Program in Physical Therapy, Department of Physical Therapy, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil
| | - Ítalo Ribeiro Lemes
- Department of Physical Therapy, Universidade Estadual Paulista (UNESP), Presidente Prudente, SP, Brazil
| | - Emanuella Cristina Cordeiro
- Graduate Program in Physical Therapy, Department of Physical Therapy, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil
| | - Maiqueli Arpini
- Graduate Program in Rehabilitation Sciences, Department of Health Sciences, Universidade Federal de Santa Catarina (UFSC), Araranguá, SC, Brazil
| | - Erik Hulzebos
- University Medical Center Utrecht, Department of Child Development and Exercise Center, the Netherlands
| | - Fernanda Lanza
- Graduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Dayane Montemezzo
- Graduate Program in Physical Therapy, Department of Physical Therapy, Universidade do Estado de Santa Catarina (UDESC), Florianópolis, SC, Brazil.
| |
Collapse
|
3
|
Kant-Smits K, Bartels B, Asselman FL, Veldhoen ES, van Eijk RPA, van der Pol WL, Hulzebos EHJ. The RESISTANT study (Respiratory Muscle Training in Patients with Spinal Muscular Atrophy): study protocol for a randomized controlled trial. BMC Neurol 2023; 23:118. [PMID: 36959618 PMCID: PMC10035150 DOI: 10.1186/s12883-023-03136-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/24/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Spinal Muscular Atrophy (SMA) is characterized by progressive and predominantly proximal and axial muscle atrophy and weakness. Respiratory muscle weakness results in impaired cough with recurrent respiratory tract infections, nocturnal hypoventilation, and may ultimately lead to fatal respiratory failure in the most severely affected patients. Treatment strategies to either slow down the decline or improve respiratory muscle function are wanting. OBJECTIVE The aim of this study is to assess the feasibility and efficacy of respiratory muscle training (RMT) in patients with SMA and respiratory muscle weakness. METHODS The effect of RMT in patients with SMA, aged ≥ 8 years with respiratory muscle weakness (maximum inspiratory mouth pressure [PImax] ≤ 80 Centimeters of Water Column [cmH2O]), will be investigated with a single blinded randomized sham-controlled trial consisting of a 4-month training period followed by an 8-month open label extension phase. INTERVENTION The RMT program will consist of a home-based, individualized training program involving 30-breathing cycles through an inspiratory and expiratory muscle training device. Patients will be instructed to perform 10 training sessions over 5-7 days per week. In the active training group, the inspiratory and expiratory threshold will be adjusted to perceived exertion (measured on a Borg scale). The sham-control group will initially receive RMT at the same frequency but against a constant, non-therapeutic resistance. After four months the sham-control group will undergo the same intervention as the active training group (i.e., delayed intervention). Individual adherence to the RMT protocol will be reviewed every two weeks by telephone/video call with a physiotherapist. MAIN STUDY PARAMETERS/ENDPOINTS We hypothesize that the RMT program will be feasible (good adherence and good acceptability) and improve inspiratory muscle strength (primary outcome measure) and expiratory muscle strength (key secondary outcome measure) as well as lung function, patient reported breathing difficulties, respiratory infections, and health related quality of life (additional secondary outcome measures, respectively) in patients with SMA. DISCUSSION RMT is expected to have positive effects on respiratory muscle strength in patients with SMA. Integrating RMT with recently introduced genetic therapies for SMA may improve respiratory muscle strength in this patient population. TRIAL REGISTRATION Retrospectively registered at clinicaltrial.gov: NCT05632666.
Collapse
Affiliation(s)
- Kim Kant-Smits
- Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Lundlaan 6, PO Box 85090, 3508 AB, Utrecht, The Netherlands
| | - Bart Bartels
- Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Lundlaan 6, PO Box 85090, 3508 AB, Utrecht, The Netherlands
| | - Fay-Lynn Asselman
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Esther S Veldhoen
- Department of Pediatric Intensive Care, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Ruben P A van Eijk
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Biostatistics & Research Support, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - W Ludo van der Pol
- Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Erik H J Hulzebos
- Child Development and Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Lundlaan 6, PO Box 85090, 3508 AB, Utrecht, The Netherlands.
| |
Collapse
|
4
|
Vedrenne-Cloquet M, Khirani S, Khemani R, Lesage F, Oualha M, Renolleau S, Chiumello D, Demoule A, Fauroux B. Pleural and transpulmonary pressures to tailor protective ventilation in children. Thorax 2023; 78:97-105. [PMID: 35803726 DOI: 10.1136/thorax-2021-218538] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 06/12/2022] [Indexed: 02/07/2023]
Abstract
This review aims to: (1) describe the rationale of pleural (PPL) and transpulmonary (PL) pressure measurements in children during mechanical ventilation (MV); (2) discuss its usefulness and limitations as a guide for protective MV; (3) propose future directions for paediatric research. We conducted a scoping review on PL in critically ill children using PubMed and Embase search engines. We included peer-reviewed studies using oesophageal (PES) and PL measurements in the paediatric intensive care unit (PICU) published until September 2021, and excluded studies in neonates and patients treated with non-invasive ventilation. PL corresponds to the difference between airway pressure and PPL Oesophageal manometry allows measurement of PES, a good surrogate of PPL, to estimate PL directly at the bedside. Lung stress is the PL, while strain corresponds to the lung deformation induced by the changing volume during insufflation. Lung stress and strain are the main determinants of MV-related injuries with PL and PPL being key components. PL-targeted therapies allow tailoring of MV: (1) Positive end-expiratory pressure (PEEP) titration based on end-expiratory PL (direct measurement) may be used to avoid lung collapse in the lung surrounding the oesophagus. The clinical benefit of such strategy has not been demonstrated yet. This approach should consider the degree of recruitable lung, and may be limited to patients in which PEEP is set to achieve an end-expiratory PL value close to zero; (2) Protective ventilation based on end-inspiratory PL (derived from the ratio of lung and respiratory system elastances), might be used to limit overdistention and volutrauma by targeting lung stress values < 20-25 cmH2O; (3) PPL may be set to target a physiological respiratory effort in order to avoid both self-induced lung injury and ventilator-induced diaphragm dysfunction; (4) PPL or PL measurements may contribute to a better understanding of cardiopulmonary interactions. The growing cardiorespiratory system makes children theoretically more susceptible to atelectrauma, myotrauma and right ventricle failure. In children with acute respiratory distress, PPL and PL measurements may help to characterise how changes in PEEP affect PPL and potentially haemodynamics. In the PICU, PPL measurement to estimate respiratory effort is useful during weaning and ventilator liberation. Finally, the use of PPL tracings may improve the detection of patient ventilator asynchronies, which are frequent in children. Despite these numerous theoritcal benefits in children, PES measurement is rarely performed in routine paediatric practice. While the lack of robust clincal data partially explains this observation, important limitations of the existing methods to estimate PPL in children, such as their invasiveness and technical limitations, associated with the lack of reference values for lung and chest wall elastances may also play a role. PPL and PL monitoring have numerous potential clinical applications in the PICU to tailor protective MV, but its usefulness is counterbalanced by technical limitations. Paediatric evidence seems currently too weak to consider oesophageal manometry as a routine respiratory monitoring. The development and validation of a noninvasive estimation of PL and multimodal respiratory monitoring may be worth to be evaluated in the future.
Collapse
Affiliation(s)
- Meryl Vedrenne-Cloquet
- Pediatric intensive care unit, Necker-Enfants Malades Hospitals, Paris, France .,Université de Paris Cité, VIFASOM, Paris, France.,Pediatric Non Invasive Ventilation Unit, Necker-Enfants Malades Hospitals, Paris, France
| | - Sonia Khirani
- Pediatric Non Invasive Ventilation Unit, Necker-Enfants Malades Hospitals, Paris, France.,ASV Santé, Genevilliers, France
| | - Robinder Khemani
- Children's Hospital Los Angeles, University of Southern California, Los Angeles, California, USA
| | - Fabrice Lesage
- Pediatric intensive care unit, Necker-Enfants Malades Hospitals, Paris, France
| | - Mehdi Oualha
- Pediatric intensive care unit, Necker-Enfants Malades Hospitals, Paris, France
| | - Sylvain Renolleau
- Pediatric intensive care unit, Necker-Enfants Malades Hospitals, Paris, France
| | - Davide Chiumello
- Dipartimento di Anestesia, Rianimazione e Terapia del Dolore, Fondazione, IRCCS Ca' Granda - Ospedale Maggiore Policlinico, Milan, Italy
| | - Alexandre Demoule
- Service de Médecine Intensive et Réanimation (Département R3S), AP-HP, Groupe Hospitalier Universitaire APHP-Sorbonne Université, site Pitié-Salpêtrière, Paris, France.,UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, F-75005 Paris, Sorbonne Université, INSERM, Paris, France
| | - Brigitte Fauroux
- Université de Paris Cité, VIFASOM, Paris, France.,Pediatric Non Invasive Ventilation Unit, Necker-Enfants Malades Hospitals, Paris, France
| |
Collapse
|
5
|
Lin CH, Lee CW, Huang CH. Inspiratory Muscle Training Improves Aerobic Fitness in Active Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14722. [PMID: 36429439 PMCID: PMC9690705 DOI: 10.3390/ijerph192214722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 06/16/2023]
Abstract
Research on the effect of inspiratory muscle training (IMT) on exercise performance is inconsistent. IMT has not been applied to fit child athletes, who are more likely to develop inspiratory muscle fatigue, and, consequently, to benefit from IMT. Methods: Thirty children (mean age: 10.7 ± 1.2 years) were recruited and randomly assigned to a high-intensity (HG), a low-intensity (LG), or a control group (CG). For both training groups, a double-blind procedure was applied. In the HG, 80% of maximal inspiratory pressure (MIP) was used as the level of training intensity. The LG used 30% MIP. Training groups were trained at 6 breaths a set, 4 sets a day, totaling 24 breaths a day for 6 weeks. Exercise capacity outcomes include maximal and submaximal aerobic capacity, as measured as VO2max and distance from six-minute walk test (6MWD). Results show improvement in MIP, VO2max, and 6MWD only in the HG. MIP in the HG significantly increases from 108.7 (100.8-143.3) to 144.4 (130.0-175.6) cmH2O. VO2max in the HG increases from 43.0 (40.5-45) to 53.0 (46-63) mL·kg-1·min-1. The 6MWD increases from 792.0 (737.5-818.0) to 862.0 (798.5-953.5) m. Data are presented as median (interquartile range). No difference is found in the LG or CG. Conclusion: high-intensity IMT increases MIP, maximal, and submaximal exercise capacity in the HG, but no difference is found in the LG or CG. Therefore, high-intensity type of IMT improves aerobic fitness in fit children by appropriately applying inspiratory muscle strength training.
Collapse
Affiliation(s)
- Ching-Hsin Lin
- Division of Rehabilitation Technology, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan
| | - Chih-Wei Lee
- Department of Physical Therapy, Tzu Chi University, Hualien 970374, Taiwan
| | - Chien-Hui Huang
- Department of Physical Therapy, Tzu Chi University, Hualien 970374, Taiwan
| |
Collapse
|
6
|
Miller K, Mayer OH. Pulmonary function testing in patients with neuromuscular disease. Pediatr Pulmonol 2021; 56:693-699. [PMID: 33290643 DOI: 10.1002/ppul.25182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/05/2020] [Accepted: 11/06/2020] [Indexed: 11/11/2022]
Abstract
Progressive neuromuscular disease leads to muscle weakness or failure that produces loss of pulmonary function and clinical respiratory morbidity. Tracking pulmonary function in a practical and effective way is very important because it can help identify a stage of disease when a morbidity, such as inadequate airway clearance or respiratory failure, may be present. There are four general categories of pulmonary function outcome measures such as volume, flow, pressure, and gas exchange. These outcome measures have variable precision and accuracy in predicting clinical change, and practicality in performing them relative to age and condition. It is widely recommended to follow multiple measurements longitudinally and create an accurate and timely clinical picture. This manuscript will review the most commonly used and most practical measures for use in clinical practice and how they can help to assess morbidity, disease state, and help optimize patient management.
Collapse
Affiliation(s)
- Kristen Miller
- Division of Pulmonology, The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Oscar H Mayer
- Division of Pulmonology, The Children's Hospital of Philadelphia, The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| |
Collapse
|
7
|
Abstract
OBJECTIVES This review discusses the different techniques used at the bedside to assess respiratory muscle function in critically ill children and their clinical applications. DATA SOURCES A scoping review of the medical literature on respiratory muscle function assessment in critically ill children was conducted using the PubMed search engine. STUDY SELECTION We included all scientific, peer-reviewed studies about respiratory muscle function assessment in critically ill children, as well as some key adult studies. DATA EXTRACTION Data extracted included findings or comments about techniques used to assess respiratory muscle function. DATA SYNTHESIS Various promising physiologic techniques are available to assess respiratory muscle function at the bedside of critically ill children throughout the disease process. During the acute phase, this assessment allows a better understanding of the pathophysiological mechanisms of the disease and an optimization of the ventilatory support to increase its effectiveness and limit its potential complications. During the weaning process, these physiologic techniques may help predict extubation success and therefore optimize ventilator weaning. CONCLUSIONS Physiologic techniques are useful to precisely assess respiratory muscle function and to individualize and optimize the management of mechanical ventilation in children. Among all the available techniques, the measurements of esophageal pressure and electrical activity of the diaphragm appear particularly helpful in the era of individualized ventilatory management.
Collapse
|
8
|
Dassios T, Dimitriou G. Determinants of inspiratory muscle function in healthy children. JOURNAL OF SPORT AND HEALTH SCIENCE 2019; 8:183-188. [PMID: 30997265 PMCID: PMC6451049 DOI: 10.1016/j.jshs.2016.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/08/2016] [Revised: 05/24/2016] [Accepted: 07/05/2016] [Indexed: 06/09/2023]
Abstract
BACKGROUND Children are affected by disorders that have an impact on the respiratory muscles. Inspiratory muscle function can be assessed by means of the noninvasive tension-time index of the inspiratory muscles (TTImus). Our objectives were to identify the determinants of TTImus in healthy children and to report normal values of TTImus in this population. METHODS We measured weight, height, upper arm muscle area (UAMA), and TTImus in 96 children aged 6-18 years. The level and frequency of aerobic activity was assessed by questionnaire. RESULTS TTImus was significantly lower in male subjects (0.095 ± 0.038, mean ± SD) compared with female subjects (0.126 ± 0.056) (p = 0.002). TTImus was significantly lower in regularly exercising (0.093 ± 0.040) compared with nonexercising subjects (0.130 ± 0.053) (p < 0.001). TTImus was significantly negatively related to age (r = -0.239, p = 0.019), weight (r = -0.214, p = 0.037), height (r = -0.355, p < 0.001), and UAMA (r = -0.222, p = 0.030). Multivariate logistic regression analysis revealed that height and aerobic exercise were significantly related to TTImus independently of age, weight, and UAMA. The predictive regression equation for TTImus in male subjects was TTImus = 0.228 - 0.001 × height (cm), and in female subjects it was TTImus = 0.320 - 0.001 × height (cm) . CONCLUSION Gender, age, anthropometry, skeletal muscularity, and aerobic exercise are significantly associated with indices of inspiratory muscle function in children. Normal values of TTImus in healthy children are reported.
Collapse
Affiliation(s)
- Theodore Dassios
- Department of Child Health, King's College Hospital, Denmark Hill, London, SE5 9RS, UK
- Department of Paediatrics, University of Patras Medical School, Patras, Rio 26504, Greece
| | - Gabriel Dimitriou
- Department of Paediatrics, University of Patras Medical School, Patras, Rio 26504, Greece
| |
Collapse
|
9
|
Cossio-Bolaños MA, Andruske C, Arruda M, Sulla-Torres J, Pacheco-Carrillo J, Urra-Albornoz C, Gomez-Campos R. Reference norms for evaluating maximum expiratory flow of children and adolescents of the Maule Region in Chile. PeerJ 2018; 6:e5157. [PMID: 30038857 PMCID: PMC6052850 DOI: 10.7717/peerj.5157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 06/13/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND The norms for evaluating the maximum expiratory flow (MEF) usually are developed according to chronological age and height. However, to date, little research has been conducted using reference values that take into account the temporal changes of biological maturation. The objectives of this study were to (a) compare the MEF with those of other international studies, (b) align the MEF values with chronological and biological age, and (c) propose reference standards for children and adolescents. METHODS The sample studied consisted of 3,566 students of both sexes (1,933 males and 1,633 females) ranging in age from 5.0 to 17.9 years old. Weight, standing height, and sitting height were measured. Body mass index was calculated. Biological maturation was predicted by using age of peak height velocity growth (APHV). MEF (L/min) was obtained by using a forced expiratory manoeuvre. Percentiles were calculated using the LMS method. RESULTS AND DISCUSSION Predicted APHV was at age 14.77 ± 0.78 years for males and for females at age 12.74 ± 1.0 years. Biological age was more useful than chronological age for assessing MEF in both sexes. Based on these findings, regional percentiles were created to diagnose and monitor the risk of asthma and the general expiratory status of paediatric populations.
Collapse
Affiliation(s)
- Marco Antonio Cossio-Bolaños
- Departamento de Ciencias de la Actividad Física, Universidad Católica del Maule, Talca, Chile
- Faculty of Physical Education, State University of Campinas, Campinas, São Paulo, Brazil
- Universidad Nacional de San Agustin, Arequipa, Perú
| | - Cynthia Andruske
- Centro de Investigación Especializado en Ciencias de la Educación, Salud y Deporte, CINEMAROS, Arequipa, Perú
| | - Miguel Arruda
- Faculty of Physical Education, State University of Campinas, Campinas, São Paulo, Brazil
| | | | | | - Camilo Urra-Albornoz
- Facultad de Salud, Carrera de Kinesiología, Universidad Santo Tomás, Talca, Chile
| | | |
Collapse
|
10
|
Hulzebos E, Takken T, Reijneveld EA, Mulder MMG, Bongers BC. Reference Values for Respiratory Muscle Strength in Children and Adolescents. Respiration 2018; 95:235-243. [PMID: 29342462 DOI: 10.1159/000485464] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 11/17/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Measurement of respiratory muscle function is important in the diagnosis of respiratory muscle disease, respiratory failure, to assess the impact of chronic diseases, and/or to evaluate respiratory muscle function after treatment. OBJECTIVES To establish reference values for maximal inspiratory and expiratory pressure, and the tension-time index at rest in healthy children and adolescents aged 8-19 years, as well as to present sex- and age-related reference centiles normalized for demographic and anthropometric determinants. METHODS In this cross-sectional observational study, demographic, anthropometric, and spirometric data were assessed, as well as data on respiratory muscle strength (PImax and PEmax) and work of breathing at rest (TT0.1), in a total of 251 children (117 boys and 134 girls; mean age 13.4 ± 2.9 years). Reference values are presented as reference centiles developed by use of the lambda, mu, sigma method. RESULTS Boys had significantly higher PImax and PEmax values. Next to sex and age, fat-free mass appeared to be an important predictor of respiratory muscle strength. Reference centiles demonstrated a slight, almost linear increase in PImax with age in boys, and a less steep increase with age in girls. TT0.1 values did not differ between boys and girls and decreased linearly with age. CONCLUSION This study provides reference values for respiratory muscle strength and work of breathing at rest. In addition to sex and age, fat-free mass was found to be an important predictor of respiratory muscle strength in boys and girls.
Collapse
Affiliation(s)
- Erik Hulzebos
- Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Tim Takken
- Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Elja A Reijneveld
- Physical Therapy Science, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Mark M G Mulder
- Child Development & Exercise Center, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Bart C Bongers
- Department of Epidemiology, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, the Netherlands.,SOMT University of Physiotherapy, Amersfoort, the Netherlands
| |
Collapse
|
11
|
Friedrich FO, Heinzmann-Filho JP, Birck MA, Pinto LA, Vidal PCV. Frequência de sucesso de pré-escolares e escolares com e sem sintomas respiratórios nos testes de função pulmonar. FISIOTERAPIA E PESQUISA 2016. [DOI: 10.1590/1809-2950/15015623022016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO O objetivo deste estudo foi avaliar a frequência de sucesso de pré-escolares e escolares com e sem sintomas respiratórios nos testes de função pulmonar. Foram incluídas crianças e adolescentes com idade entre quatro e 12 anos com e sem sintomas respiratórios, baseados no questionário de doenças respiratórias. Os participantes foram recrutados em duas escolas e classificados, de acordo com sua faixa etária, em pré-escolares (4-6 anos) e escolares (7-12 anos). Foram coletados dados demográficos e antropométricos, além das variáveis dos testes de manovacuometria (PIMAX e PEMAX) e de espirometria (VEF1, CVF, VEF1/CVF e FEF25-75%). Os testes de função pulmonar foram considerados bem-sucedidos quando os participantes preenchiam os critérios de aceitabilidade e reprodutibilidade das diretrizes nacionais e internacionais. Para fins estatísticos, utilizou-se o teste de qui-quadrado e correlação de Pearson. Foram incluídos 148 participantes, com média de idade de 8,1±1,7 anos, sendo 51,4% do sexo feminino e 85,1% saudáveis. A taxa de sucesso no teste de manovacuometria e de espirometria foi de 91,9% e 91,2%, respectivamente. Houve uma taxa de sucesso significativamente menor no grupo de pré-escolares em comparação aos escolares, tanto para o teste de manovacuometria (p=0,044) como para o exame espirométrico (p=0,015). As correlações entre as variáveis do teste de manovacuometria e do exame espirométrico mostraram-se positivas e moderadas entre a PIMAX e a CVF, e a PEMAX e o VEF1 e FEF25-75%. Os achados demonstram uma frequência de sucesso significativamente menor no grupo etário pré-escolar em comparação com os sujeitos escolares em ambos os testes de função pulmonar avaliados.
Collapse
|
12
|
[Respiratory muscle strength test: is it realistic in young children?]. REVISTA PAULISTA DE PEDIATRIA 2015; 33:275-80. [PMID: 26137867 PMCID: PMC4620953 DOI: 10.1016/j.rpped.2015.01.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 01/13/2015] [Accepted: 01/18/2015] [Indexed: 11/20/2022]
Abstract
Objective: To determine the success rate of the manovacuometry test in children between 4 and
12 years of age. Methods: Cross-sectional study involving children and adolescents from 4 to 12 years of
age, enrolled in three basic education schools. All subjects had the
anthropometric and respiratory muscle strength (maximum inspiratory pressure and
maximum expiratory pressure) data measured. Students whose parents did not
authorize participation or who did not want to undergo the test were excluded. The
test was considered successful when the subject reached acceptability (no air
leaks) and reproducibility (variation <10% between the two major maneuvers)
criteria established by guidelines. Failure was defined when subjects did not meet
the above criteria. Data were expressed as mean and standard deviation and the
categorical variables in absolute and relative frequency. The comparison between
proportions was performed using the chi-square test. Results: We included 196 children and adolescents, mean age of 8.4±2.5 years, 53.1% female.
The success rate of the manovacuometry test in children and adolescents evaluated
was 92.3%. When comparing the differences between the success rates of preschool
children with those children and adolescents of school age, there was a
significantly lower success rate in the pre-school (85.1%) group compared to the
school group (94.6%) (p=0.032). However, no significant
differences (p=0.575) were found when gender comparisons were
performed. Conclusions: The manovacuometry test showed a high success rate in both preschool and school
population assessed. Furthermore, the rate of success appears to be related to
aging.
Collapse
|