Banca de QUALIFICAÇÃO: LAILANE SATURNINO DA SILVA
Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.STUDENT : LAILANE SATURNINO DA SILVA
DATE: 22/11/2024
TIME: 10:00
LOCAL: Remoto
TITLE:
Introduction: The influence of body position on ventilation has been
studied for decades, both in healthy individuals and in patients with various
respiratory conditions. The neuromuscular system’s ability to generate
force is influenced by numerous factors, and changes in posture have the
potential to alter the length and position of the respiratory muscles,
affecting their function, tension-generating capacity, and overall force
production. In Duchenne Muscular Dystrophy (DMD), disease progression
leads to respiratory muscle weakness. Based on this, the study aimed to
evaluate the influence and electrical activity of respiratory muscles on peak
pressure values during Sniff Nasal Inspiratory Pressure (SNIP) and Sniff
Nasal Expiratory Pressure (SNEP) in seated and 45° supine positions in
subjects with DMD versus matched healthy controls. Additionally, the study
assessed Maximal Inspiratory Pressure (MIP) and Maximal Expiratory
Pressure (MEP), as well as SNIP and SNEP in seated, 45° supine, and
fully supine positions in healthy individuals.
Methods: The activation of respiratory muscles—including the
sternocleidomastoid (SCM), scalene (SCA), rectus abdominis (RA),
external oblique (EO), and intercostals (IT)—was assessed using surface
electromyography (sEMG) during SNIP, SNEP, MIP, and MEP maneuvers.
The evaluation was conducted in seated and 45° supine positions for
individuals with DMD (Duchenne group, DG) and matched healthy controls
(control group, CG), as well as in seated, 45° supine, and fully supine
positions in healthy subjects.
Results: A total of 15 individuals with DMD were initially assessed (4 were
excluded), leaving 11 subjects in the DG, who were matched with 11
healthy controls. DG participants showed lower SNIP and SNEP values
compared to the CG. Additionally, the DG presented lower pressure values
in the 45° supine position compared to the seated position. sEMG activity
during the maneuvers was lower in the DG compared to the CG across all muscles evaluated. In the group of 10 healthy individuals (5 males and 5
females), SNIP and SNEP values were significantly higher in the seated
position compared to the fully supine position. Intercostal muscle activity
was greater during MIP, MEP, and SNEP maneuvers in the seated position
(p < 0.05). Furthermore, the rectus abdominis muscle showed increased
activity in this position during MIP and SNEP maneuvers.
Conclusion: Our results demonstrate that, in both individuals with DMD
and healthy subjects, the pressures generated during SNIP and SNEP
maneuvers, as well as sEMG activity in all maneuvers, are optimized when
the trunk is in a more upright position.
KEY WORDS:
Duchenne Muscular Dystrophy. Respiratory Muscles, Maximum
respiratory pressures; Electromyography; Posture.
PAGES: 50
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:
Introduction: The influence of body position on ventilation has been
studied for decades, both in healthy individuals and in patients with various
respiratory conditions. The neuromuscular system’s ability to generate
force is influenced by numerous factors, and changes in posture have the
potential to alter the length and position of the respiratory muscles,
affecting their function, tension-generating capacity, and overall force
production. In Duchenne Muscular Dystrophy (DMD), disease progression
leads to respiratory muscle weakness. Based on this, the study aimed to
evaluate the influence and electrical activity of respiratory muscles on peak
pressure values during Sniff Nasal Inspiratory Pressure (SNIP) and Sniff
Nasal Expiratory Pressure (SNEP) in seated and 45° supine positions in
subjects with DMD versus matched healthy controls. Additionally, the study
assessed Maximal Inspiratory Pressure (MIP) and Maximal Expiratory
Pressure (MEP), as well as SNIP and SNEP in seated, 45° supine, and
fully supine positions in healthy individuals.
Methods: The activation of respiratory muscles—including the
sternocleidomastoid (SCM), scalene (SCA), rectus abdominis (RA),
external oblique (EO), and intercostals (IT)—was assessed using surface
electromyography (sEMG) during SNIP, SNEP, MIP, and MEP maneuvers.
The evaluation was conducted in seated and 45° supine positions for
individuals with DMD (Duchenne group, DG) and matched healthy controls
(control group, CG), as well as in seated, 45° supine, and fully supine
positions in healthy subjects.
Results: A total of 15 individuals with DMD were initially assessed (4 were
excluded), leaving 11 subjects in the DG, who were matched with 11
healthy controls. DG participants showed lower SNIP and SNEP values
compared to the CG. Additionally, the DG presented lower pressure values
in the 45° supine position compared to the seated position. sEMG activity
during the maneuvers was lower in the DG compared to the CG across all muscles evaluated. In the group of 10 healthy individuals (5 males and 5
females), SNIP and SNEP values were significantly higher in the seated
position compared to the fully supine position. Intercostal muscle activity
was greater during MIP, MEP, and SNEP maneuvers in the seated position
(p < 0.05). Furthermore, the rectus abdominis muscle showed increased
activity in this position during MIP and SNEP maneuvers.
Conclusion: Our results demonstrate that, in both individuals with DMD
and healthy subjects, the pressures generated during SNIP and SNEP
maneuvers, as well as sEMG activity in all maneuvers, are optimized when
the trunk is in a more upright position.
COMMITTEE MEMBERS:
Presidente - 1545315 - GUILHERME AUGUSTO DE FREITAS FREGONEZI
Interna - 3358154 - GIANE AMORIM RIBEIRO SAMORA
Externa à Instituição - JESSICA DANIELLE MEDEIROS DA FONSECA - EBSERH