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Sheers NL, Andersen T, Chatwin M. Airway Clearance in Neuromuscular Disease. Sleep Med Clin 2024; 19:485-496. [PMID: 39095145 DOI: 10.1016/j.jsmc.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
High-quality respiratory care and airway clearance is essential for people with neuromuscular disease (pwNMD) as respiratory tract infections are a major cause of morbidity and mortality. This review expands on published guidelines by highlighting the role of cough peak flow along with other options for cough evaluation, and discusses recent key research findings which have influenced the practice of respiratory therapy for pwNMD.
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Affiliation(s)
- Nicole L Sheers
- Department of Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Victoria, Australia; The Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia.
| | - Tiina Andersen
- The Department of Health and Functioning, Western Norway University of Applied Science, Postboks 7030, 5020 Bergen, Norway; Thoracic Department, Haukeland University Hospital, Postboks 1400, 5021 Bergen, Norway
| | - Michelle Chatwin
- NMCC, The National Hospital for Neurology and Neurosurgery, University College London Hospitals Foundation Trust, London WC1N 3BG, UK; Clinical and Academic Department of Sleep and Breathing, Royal Brompton Hospital, Part of Guys and St Thomas' NHS Foundation Trust, London SW3 6NP, UK
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2
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Ge J, Niu G, Li Q, Li Y, Yang B, Guo H, Wang J, Zhang B, Zhang C, Zhou T, Zhao Z, Jiang H. Cough flows as a criterion for decannulation of autonomously breathing patients with tracheostomy tubes. Respir Res 2024; 25:128. [PMID: 38500141 PMCID: PMC10949589 DOI: 10.1186/s12931-024-02762-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 03/08/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Adequate cough or exsufflation flow can indicate an option for safe tracheostomy decannulation to noninvasive management. Cough peak flow via the upper airways with the tube capped is an outcome predictor for decannulation readiness in patients with neuromuscular impairment. However, this threshold value is typically measured with tracheotomy tube removed, which is not acceptable culturally in China. The aim of this study was to assess the feasibility and safety of using cough flow measured with tracheostomy tube and speaking valve (CFSV) > 100 L/min as a cutoff value for decannulation. STUDY DESIGN Prospective observational study conducted between January 2019 and September 2022 in a tertiary rehabilitation hospital. METHODS Patients with prolonged tracheostomy tube placement were referred for screening. Each patient was assessed using a standardized tracheostomy decannulation protocol, in which CFSV greater than 100 L/min indicated that the patients' cough ability was sufficient for decannulation. Patients whose CFSV matched the threshold value and other protocol criteria were decannulated, and the reintubation and mortality rates were followed-up for 6 months. RESULTS A total of 218 patients were screened and 193 patients were included. A total of 105 patients underwent decannulation, 103 patients were decannulated successfully, and 2 patients decannulated failure, required reinsertion of the tracheostomy tube within 48 h (failure rate 1.9%). Three patients required reinsertion or translaryngeal intubation within 6 months. CONCLUSIONS CFSV greater than 100 L/min could be a reliable threshold value for successful decannulation in patients with various primary diseases with a tracheostomy tube. TRIAL REGISTRATION This observational study was not registered online.
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Affiliation(s)
- Jingyi Ge
- Department of Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Guangyu Niu
- Department of Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Qing Li
- Department of Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Yi Li
- Department of Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Bo Yang
- Department of Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Haiming Guo
- Department of Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Jianjun Wang
- Department of Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Bin Zhang
- Department of Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Chenxi Zhang
- Department of Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Ting Zhou
- Department of Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China
| | - Zhanqi Zhao
- School of Biomedical Engineering, Guangzhou Medical University, Guangzhou, China
- Institute of Technical Medicine, Furtwangen University, Villingen-Schwenningen, Germany
| | - Hongying Jiang
- Department of Respiratory Rehabilitation Center, Beijing Rehabilitation Hospital of Capital Medical University, Beijing, China.
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Geronimo A. Turning up the volume on neuromuscular cough medicine. Muscle Nerve 2024; 69:129-130. [PMID: 38037436 DOI: 10.1002/mus.28016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/02/2023]
Abstract
See article on pages 213–217 in this issue.
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Affiliation(s)
- Andrew Geronimo
- Neurology, Penn State College of Medicine, Hershey, Pennsylvania, USA
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Recasens BB, Balañá Corberó A, Llorens JMM, Guillen-Sola A, Moreno MV, Escobar GG, Umayahara Y, Soh Z, Tsuji T, Rubio MÁ. Sound-based cough peak flow estimation in patients with neuromuscular disorders. Muscle Nerve 2024; 69:213-217. [PMID: 37860934 DOI: 10.1002/mus.27987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 10/01/2023] [Accepted: 10/04/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION/AIMS Cough impairment is common in individuals with neuromuscular disorders and is associated with respiratory infections and shorter survival. Cough strength is assessed by measuring cough peak flow (CPF) using a flow meter, but this method requires a complex device setup and trained staff. The aim of the study is to evaluate the reliability of a smartphone app to estimate CPF based on cough sounds in a cohort of individuals with neuromuscular disorders. METHODS Individuals with neuromuscular disorders underwent CPF measurement with a flow meter and a smartphone app. A CPF <270 L/min was considered abnormal. RESULTS Of the 50 patients studied, 26 had amyotrophic lateral sclerosis (52%), 15 had hereditary myopathies (30%), and 9 had myasthenia gravis (18%). The intraclass correlation coefficient (ICC) between the CPF measured with a flow meter and CPF estimated with cough sounds was 0.774 (p < .001) even if the patients had orofacial weakness (ICC = 0.806, p < .001). The smartphone app had 94.4% sensitivity and 100% specificity to detect patients with CPF of less than 270 L/min. DISCUSSION Our findings suggest that sounds measured with a smartphone app provide a reliable estimate of CPF in patients with neuromuscular disorders, even in the presence of with orofacial weakness. This may be a convenient way to monitor respiratory involvement in patients with neuromuscular disorders, but larger studies of more diverse patient cohorts are needed.
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Affiliation(s)
| | - Ana Balañá Corberó
- ALS/Motor Neuron Diseases Unit, Pneumology Department, Hospital del Mar, Barcelona, Spain
| | - Juana María Martínez Llorens
- ALS/Motor Neuron Diseases Unit, Pneumology Department, Hospital del Mar, Barcelona, Spain
- Hospital del Mar - Medical Research Institute (IMIM), Barcelona, Spain
- Universitat Pompeu Fabra, Barcelona, Spain
- CIBER de Enfermedades Respiratorias (CIBERES), ISC III, Madrid, Spain
| | - Anna Guillen-Sola
- ALS/Motor Neuron Diseases Unit, Physical Medicine and Rehabilitation Department, Hospital del Mar, Barcelona, Spain
- Rehabilitation Research Group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | | | - Greta García Escobar
- ALS/Motor Neuron Diseases Unit, Neurology Department, Hospital del Mar, Barcelona, Spain
| | - Yasutaka Umayahara
- Graduate School of Health Sciences, Hiroshima Cosmopolitan University, Hiroshima, Japan
| | - Zu Soh
- Graduate School of Advanced Science and Engineering, Hiroshima University, Hiroshima, Japan
| | - Toshio Tsuji
- Graduate School of Advanced Science and Engineering, Hiroshima University, Hiroshima, Japan
| | - Miguel Ángel Rubio
- ALS/Motor Neuron Diseases Unit, Neurology Department, Hospital del Mar, Barcelona, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Instituto de Salud Carlos III, Bellaterra, Spain
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Mootassim-Billah S, Schoentgen J, De Bodt M, Roper N, Digonnet A, Le Tensorer M, Van Nuffelen G, Van Gestel D. Acoustic Analysis of Voluntary Coughs, Throat Clearings, and Induced Reflexive Coughs in a Healthy Population. Dysphagia 2023; 38:1467-1486. [PMID: 37245187 PMCID: PMC10225042 DOI: 10.1007/s00455-023-10574-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 03/31/2023] [Indexed: 05/29/2023]
Abstract
Cough efficacy is considered a reliable predictor of the aspiration risk in head and neck cancer patients with radiation-associated dysphagia. Currently, coughing is assessed perceptually or aerodynamically. The goal of our research is to develop methods of acoustic cough analysis. In this study, we examined in a healthy population the acoustical differences between three protective maneuvers: voluntary cough, voluntary throat clearing, and induced reflexive cough. Forty healthy participants were included in this study. Voluntary cough, voluntary throat clearing, and reflexive cough samples were recorded and analyzed acoustically. Temporal acoustic features were the following: the slope and curvature of the amplitude contour, as well as the average, slope, and curvature of the sample entropy and kurtosis contours of the recorded signal. Spectral features were the relative energy in the frequency bands (0-400 Hz, 400-800 Hz, 800-1600 Hz, 1600 Hz-3200 Hz, > 3200 Hz) as well as the weighted spectral energy. Results showed that, compared to a voluntary cough, a throat clearing starts with a weaker onset pulse and involves oscillations from the onset to the offset (concave curvature of the amplitude contour, p < 0.05), lower average (p < 0.05), and slope (p < 0.05) as well as lower convex curvature (p < 0.05) of the kurtosis contour. An induced reflexive cough starts with a higher and briefer onset burst and includes higher frication noise (larger convexity of the curvature of the amplitude and kurtosis contours (p < 0.05)) compared to a voluntary cough. The conclusion is that voluntary coughs are acoustically significantly different from voluntary throat clearings and induced reflexive coughs.
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Affiliation(s)
- Sofiana Mootassim-Billah
- Department of Radiation Oncology, Speech Therapy, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium.
| | - Jean Schoentgen
- Department of Biomechatronics, Université Libre de Bruxelles, Brussels, Belgium
| | - Marc De Bodt
- Department of Otolaryngology and Head and Neck Surgery, University Rehabilitation Center for Communication Disorders, Antwerp University Hospital, Antwerp, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Logopaedics and Audiological Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Nicolas Roper
- Department of Oto-Rhino-Laryngology and Head & Neck Surgery, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - Antoine Digonnet
- Department of Surgical Oncology, Head and Neck Surgery Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
| | - Mathilde Le Tensorer
- Speech Therapy Unit, Institut Jules Bordet, Hôpital Universitaire de Bruxelles, Université Libre de Bruxelles, Brussels, Belgium
| | - Gwen Van Nuffelen
- Department of Otolaryngology and Head and Neck Surgery, University Rehabilitation Center for Communication Disorders, Antwerp University Hospital, Antwerp, Belgium
- Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Logopaedics and Audiological Sciences, Faculty of Medicine and Health Sciences, University of Ghent, Ghent, Belgium
| | - Dirk Van Gestel
- Department of Radiation Oncology, Head and Neck Unit, Institut Jules Bordet, Université Libre de Bruxelles, Brussels, Belgium
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Umayahara Y, Soh Z, Furui A, Sekikawa K, Imura T, Otsuka A, Tsuji T. Cough sound-based estimation of vital capacity via cough peak flow using artificial neural network analysis. Sci Rep 2023; 13:8461. [PMID: 37231138 DOI: 10.1038/s41598-023-35544-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Accepted: 05/19/2023] [Indexed: 05/27/2023] Open
Abstract
This study presents a novel approach for estimating vital capacity using cough sounds and proposes a neural network-based model that utilizes the reference vital capacity computed using the lambda-mu-sigma method, a conventional approach, and the cough peak flow computed based on the cough sound pressure level as inputs. Additionally, a simplified cough sound input model is developed, with the cough sound pressure level used directly as the input instead of the computed cough peak flow. A total of 56 samples of cough sounds and vital capacities were collected from 31 young and 25 elderly participants. Model performance was evaluated using squared errors, and statistical tests including the Friedman and Holm tests were conducted to compare the squared errors of the different models. The proposed model achieved a significantly smaller squared error (0.052 L2, p < 0.001) than the other models. Subsequently, the proposed model and the cough sound-based estimation model were used to detect whether a participant's vital capacity was lower than the typical lower limit. The proposed model demonstrated a significantly higher area under the receiver operating characteristic curve (0.831, p < 0.001) than the other models. These results highlight the effectiveness of the proposed model for screening decreased vital capacity.
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Affiliation(s)
- Yasutaka Umayahara
- Graduate School of Health Sciences, Hiroshima Cosmopolitan University, 3-2-1 Otsukahigashi, Asaminami-ku, Hiroshima, Japan.
| | - Zu Soh
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, Japan
| | - Akira Furui
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, Japan
| | - Kiyokazu Sekikawa
- Graduate School of Biomedical and Health Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan
| | - Takeshi Imura
- Graduate School of Health Sciences, Hiroshima Cosmopolitan University, 3-2-1 Otsukahigashi, Asaminami-ku, Hiroshima, Japan
| | - Akira Otsuka
- Graduate School of Health Sciences, Hiroshima Cosmopolitan University, 3-2-1 Otsukahigashi, Asaminami-ku, Hiroshima, Japan
| | - Toshio Tsuji
- Graduate School of Advanced Science and Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima, Japan.
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Rameau A, Andreadis K, German A, Lachs MS, Rosen TE, Pitzrick MS, Symes LB, Klinck H. Changes in Cough Airflow and Acoustics After Injection Laryngoplasty. Laryngoscope 2023; 133 Suppl 3:S1-S14. [PMID: 35723533 PMCID: PMC9763552 DOI: 10.1002/lary.30255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/05/2022] [Accepted: 06/01/2022] [Indexed: 11/10/2022]
Abstract
OBJECTIVE/HYPOTHESIS We explored the following hypotheses in a cohort of patients undergoing injection laryngoplasty: (1) glottic insufficiency affects voluntary cough airflow dynamics and restoring glottic competence may improve parameters of cough strength, (2) cough strength can be inferred from cough acoustic signal, and (3) glottic competence changes cough sounds and correlates with spectrogram morphology. STUDY TYPE/DESIGN Prospective interventional study. METHODS Subjects with glottic insufficiency secondary to unilateral vocal fold paresis, paralysis, or atrophy, and scheduled for injection laryngoplasty completed an instrumental assessment of voluntary cough airflow using a pneumotachometer and a protocolized voluntary cough sound recording. A Wilcoxon signed-rank test was used to compare the differences between pre- and post-injection laryngoplasty in airflow and acoustic measures. A Spearman rank-order correlation was used to evaluate the association between airflow and acoustic cough measures. RESULTS Twenty-five patients (13F:12M, mean age 68.8) completed voluntary cough airflow measurements and 22 completed cough sound recordings. Following injection laryngoplasty, patients had a statistically significant decreased peak expiratory flow rise time (PEFRT) (mean change: -0.03 s, SD: 0.06, p = 0.04) and increased cough volume acceleration (mean change: 13.1 L/s2 , SD: 33.9, p = 0.03), suggesting improved cough effectiveness. Correlation of cough acoustic measures with airflow measures showed a weak relationship between PEFRT and acoustic energy (coefficient: -0.31, p = 0.04) and peak power density (coefficient: -0.35, p = 0.02). CONCLUSIONS Our study thus indicates that injection laryngoplasty may help avert aspiration in patients with glottic insufficiency by improving cough effectiveness and that improved cough airflow measures may be tracked with cough sounds. LEVEL OF EVIDENCE 3 Laryngoscope, 133:S1-S14, 2023.
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Affiliation(s)
- Anaïs Rameau
- Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, New York, U.S.A
| | - Katerina Andreadis
- Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, New York, U.S.A
| | - Alexander German
- Sean Parker Institute for the Voice, Department of Otolaryngology-Head and Neck Surgery, Weill Cornell Medicine, New York, New York, U.S.A
| | - Mark S Lachs
- Division of Geriatrics and Palliative Medicine, Department of Medicine, Weill Cornell Medicine, New York, New York, U.S.A
| | - Tony E Rosen
- Department of Emergency Medicine, Weill Cornell Medicine, New York, New York, U.S.A
| | - Michael S. Pitzrick
- K. Lisa Yang Center for Conservation Bioacoustics, Cornell University, Ithaca, New York, U.S.A
| | - Laurel Braden Symes
- K. Lisa Yang Center for Conservation Bioacoustics, Cornell University, Ithaca, New York, U.S.A
| | - Holger Klinck
- K. Lisa Yang Center for Conservation Bioacoustics, Cornell University, Ithaca, New York, U.S.A
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Seeking Inspiration: Examining the Validity and Reliability of a New Smartphone Respiratory Therapy Exergame App. SENSORS 2021; 21:s21196472. [PMID: 34640793 PMCID: PMC8513019 DOI: 10.3390/s21196472] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 09/17/2021] [Accepted: 09/25/2021] [Indexed: 12/23/2022]
Abstract
Background: Clinically valid and reliable simulated inspiratory sounds were required for the development and evaluation of a new therapeutic respiratory exergame application (i.e., QUT Inspire). This smartphone application virtualises incentive spirometry, a longstanding respiratory therapy technique. Objectives: Inspiratory flows were simulated using a 3 litre calibration syringe and validated using clinical reference devices. Syringe flow nozzles of decreasing diameter were applied to model the influence of mouth shape on audible sound levels generated. Methods: A library of calibrated audio inspiratory sounds was created to determine the reliability and range of inspiratory sound detection at increasing distances separating the sound source and smartphones running the app. Results: Simulated inspiratory sounds were reliably detected by the new application at higher air inflows (high, medium), using smaller mouth diameters (<25 mm) and where smartphones were held proximal (≤5 cm) to the mouth (or at distances up to 50 cm for higher airflows). Performance was comparable for popular smartphone types and using different phone orientations (i.e., held horizontally, at 45° or 90°). Conclusions: These observations inform future application refinements, including prompts to reduce mouth diameter, increase inspiratory flow and maintain proximity to the phone to optimise sound detection. This library of calibrated inspiratory sounds offers reproducible non-human reference data suitable for development, evaluation and regression testing of a therapeutic respiratory exergame application for smartphones.
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Non-Contact Measurements of Electrocardiogram and Cough-Associated Electromyogram from the Neck Using In-Pillow Common Cloth Electrodes: A Proof-of-Concept Study. SENSORS 2021; 21:s21030812. [PMID: 33530394 PMCID: PMC7930970 DOI: 10.3390/s21030812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/14/2021] [Accepted: 01/22/2021] [Indexed: 11/30/2022]
Abstract
Asthma and chronic obstructive pulmonary disease are associated with nocturnal cough and changes in heart rate. In this work, the authors propose a proof-of-concept non-contact system for performing capacitive electrocardiogram (cECG) and cough-associated capacitive electromyogram (cEMG) measurements using cloth electrodes under a pillowcase. Two electrodes were located along with the approximate vector of lead II ECG and were used for both cECG and cEMG measurements. A signature voltage follower was introduced after each electrode to detect biopotentials with amplitudes of approximately 100 µV. A bootstrapping technique and nonlinear electrical component were combined and implemented in the voltage follower to attain a high input impedance and rapid static discharge. The measurement system was evaluated in a laboratory experiment for seven adult males and one female (average age: 22.5 ± 1.3 yr). The accuracy of R-wave detection for 2-min resting periods was 100% in six subjects, with an overall average of 87.5% ± 30.0%. Clearly visible cEMGs were obtained for each cough motion for all subjects, synchronized with reference EMGs from submental muscle. Although there remains room for improvement in practical use, the proposed system is promising for unobtrusive detection of heart rate and cough over a prolonged period of time.
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Umayahara Y, Soh Z, Sekikawa K, Kawae T, Otsuka A, Tsuji T. A Mobile Cough Strength Evaluation Device Using Cough Sounds. SENSORS (BASEL, SWITZERLAND) 2018; 18:E3810. [PMID: 30405015 PMCID: PMC6263407 DOI: 10.3390/s18113810] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 10/31/2018] [Accepted: 11/05/2018] [Indexed: 12/11/2022]
Abstract
Although cough peak flow (CPF) is an important measurement for evaluating the risk of cough dysfunction, some patients cannot use conventional measurement instruments, such as spirometers, because of the configurational burden of the instruments. Therefore, we previously developed a cough strength estimation method using cough sounds based on a simple acoustic and aerodynamic model. However, the previous model did not consider age or have a user interface for practical application. This study clarifies the cough strength prediction accuracy using an improved model in young and elderly participants. Additionally, a user interface for mobile devices was developed to record cough sounds and estimate cough strength using the proposed method. We then performed experiments on 33 young participants (21.3 ± 0.4 years) and 25 elderly participants (80.4 ± 6.1 years) to test the effect of age on the CPF estimation accuracy. The percentage error between the measured and estimated CPFs was approximately 6.19%. In addition, among the elderly participants, the current model improved the estimation accuracy of the previous model by a percentage error of approximately 6.5% (p < 0.001). Furthermore, Bland-Altman analysis demonstrated no systematic error between the measured and estimated CPFs. These results suggest that the developed device can be applied for daily CPF measurements in clinical practice.
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Affiliation(s)
- Yasutaka Umayahara
- Department of System Cybernetics, Institute of Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima 739-8527, Japan.
- Department of Rehabilitation, Faculty of Health Sciences, Hiroshima Cosmopolitan University, Hiroshima 731-3166, Japan.
| | - Zu Soh
- Department of System Cybernetics, Institute of Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima 739-8527, Japan.
| | - Kiyokazu Sekikawa
- Division of Physical Analysis and Therapeutic Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8553, Japan.
| | - Toshihiro Kawae
- Division of Rehabilitation, Department of Clinical Support, Hiroshima University Hospital, Hiroshima 734-8551, Japan.
| | - Akira Otsuka
- Department of Rehabilitation, Faculty of Health Sciences, Hiroshima Cosmopolitan University, Hiroshima 731-3166, Japan.
| | - Toshio Tsuji
- Department of System Cybernetics, Institute of Engineering, Hiroshima University, 1-4-1 Kagamiyama, Higashi-Hiroshima, Hiroshima 739-8527, Japan.
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