Kinesiological evaluation of respiration in patients with Parkinson’s disease using optoelectronic plethysmography
Kinesiological evaluation of respiration in patients with Parkinson’s disease using optoelectronic plethysmography
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使用光电体积描记法对帕金森病患者呼吸进行运动学评估
DOI：
10.11482/kmj-e202248119
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Masaki HYODO
中科院分区：
文献类型：
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作者：
Masashi YASUNAGA;Kozo HANAYAMA;Hiromichi METANI;Masaki HYODO
吸入性肺炎是帕金森病（PD）患者死亡的常见原因，除吞咽困难外，还与咳嗽能力受损相关。据报道，脊柱后凸、运动迟缓和肌肉僵硬可能与咳嗽能力下降有关;然而，具体情况尚不清楚。本研究旨在通过三维运动分析和表面肌电图的呼吸模式和呼吸肌活动来研究导致PD患者咳嗽能力下降的呼吸功能障碍。参与者是7名没有呼吸系统或脊柱疾病史的PD患者，以及7名年龄和体重指数匹配的健康男性。使用光电体积描记法，将参与者置于坐姿，并以与测量肺活量相同的方式测量安静呼吸期间和深呼吸期间的上下胸部和腹部的体积变化。记录第二肋间肌、腹直肌和腹外斜肌的表面肌电图（EMG）。将标准化的EMG数据分为吸气和呼气时间，并将吸气和呼气时间随时间分为四等份，以检查深呼吸期间肌肉活动的变化趋势。在相对晚期PD患者中，深呼吸时脊柱角度的变化量、深呼吸时胸壁各室的比例与对照组无显著差异，而PD患者在安静呼吸时以腹腔室为主，胸和腹之间的呼吸量无显著差异。PD组在吸气和呼气结束时未表现出呼吸肌活动增加，这在对照组中观察到。虽然疾病尚未相对进展的PD组的胸部和腹部的呼吸模式与对照组的呼吸模式没有差异，但在EMG上观察到显著差异，并且可能从早期阶段就无法根据吸气和呼气条件有效地利用呼吸肌。doi：10.11482/KMJ-E202248119（2022年10月3日受理）
Aspiration pneumonia, a common cause of mortality in patients with Parkinson’s disease (PD), is associated with impaired coughing ability in addition to dysphagia. Kyphosis, bradykinesia, and muscle rigidity reportedly may be involved in the decline of coughing ability; however, the details are unknown. This study aimed to investigate the respiratory impairment that causes the decreased coughing ability in patients with PD using a three-dimensional motion analysis and surface electromyography in terms of respiratory pattern and respiratory muscle activity. The participants were seven patients with PD without history of respiratory or spinal diseases, and seven healthy men of age and matched for body mass index. Using optoelectronic plethysmography, the participants were placed in a sitting posture, and the volume changes of the upper and lower thorax and abdomen were measured during quiet breathing and during deep breathing in the same manner as in the measurement of lung capacity. Surface electromyograms (EMG) were recorded from the second intercostal muscle, the rectus abdominis muscle, and the external oblique abdominal muscle. The normalized EMG data were divided into inspiratory and expiratory times, and the inspiratory and expiratory times were divided into four equal parts over time to examine the trend of changes in muscle activity during deep breathing. In the patients with relatively unadvanced PD, no significant differences from the control in the amount of change in the angle of the spinal column during deep breathing, ratio of each compartment of the chest wall during deep breathing, whereas abdominal compartment was dominant in patients with PD during quiet breathing, and no significant difference in asynchrony between the chest and abdomen was observed. The PD group did not demonstrate increased respiratory muscle activity toward the end of inspiration and expiration, which was observed in the control group. Although the respiratory patterns of the thorax and abdomen in the PD group, whose disease has not relatively progressed, are not different from those of the control group, a significant difference was observed on the EMG, and it is possible that the respiratory muscles could not be effectively utilized according to the inspiratory and expiratory conditions from an early stage. doi: 10.11482/KMJ-E202248119 (Accepted on October 3, 2022)