Banca de DEFESA: LAILANE SATURNINO DA SILVA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : LAILANE SATURNINO DA SILVA
DATE: 23/12/2024
TIME: 14:30
LOCAL: Remoto
TITLE:

ACUTE EFFECTS OF DIFFERENT BODY POSITIONS ON RESPITARORY
PRESSURE MEASUREMENTS AND ELECTROMYOGRAPHIC ACTIVATION OF
RESPIRATORY MUSCLES IN INDIVIDUALS WITH DUCHENNE MUSCULAR DYSTROPHY AND HEALTHY CONTROLS

KEY WORDS:

Duchenne Muscular Dystrophy. Respiratory Muscles, Maximum
respiratory pressures; Electromyography; Posture. 

 

PAGES: 70
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
affected by several factors, and postural changes have the potential to modify the
length and position of respiratory muscles, thereby impacting their function and their
ability to generate tension and force. In Duchenne Muscular Dystrophy (DMD),
disease progression leads to respiratory muscle weakness. Based on this, the study
aimed to evaluate the influence of body positions and the electrical activity of
respiratory muscles during nasal inspiratory (SNIP) and expiratory (SNEP) pressure
measurements in individuals with DMD versus healthy matched controls, and during
Maximal Inspiratory Pressure (MIP), Maximal Expiratory Pressure (MEP), as well as
SNIP and SNEP measurements in healthy subjects.

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: 1) A total of 15 individuals with Duchenne Muscular Dystrophy
(DMD) were initially assessed (with 4 excluded), leaving 11 subjects who formed
the Duchenne Group (DG) paired with 11 healthy subjects. The DG showed lower
SNIP and SNEP values compared to the Control Group (CG) (P<0.05).Electromyographic activity in the Sternocleidomastoid (SCM), Scalene (ESC), and
Rectus Abdominis (RA) muscles during maneuvers was lower in the DG versus CG
in the seated position, and lower in the RA muscle in the 45° supine position when
comparing the same groups (P<0.05). In intragroup analyses, electromyographic
activation in the SCM, ESC, and RA muscles was higher in the seated position than
in the 45° supine position within the DG (P<0.05). In the CG, electromyographic
activation in the SCM was greater in the seated position than in the 45° supine
position (P<0.05).

2) Ten healthy individuals were also assessed, equally divided between
five males and five females. In this group, SNIP and SNEP values were significantly
higher in the seated position compared to the supine position (P<0.05). Intercostal
muscle activity was higher during Maximal Inspiratory Pressure (MIP), Maximal
Expiratory Pressure (MEP), and SNEP maneuvers in the seated position (P<0.05).
Additionally, RA muscle activity was higher in this position during MIP and SNEP
maneuvers (P<0.05).

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:
Externa ao Programa - 2212172 - CATHARINNE ANGELICA CARVALHO DE FARIAS - nullInterna - 3358154 - GIANE AMORIM RIBEIRO SAMORA
Presidente - 1545315 - GUILHERME AUGUSTO DE FREITAS FREGONEZI
Externa à Instituição - JESSICA DANIELLE MEDEIROS DA FONSECA - EBSERH
Externo à Instituição - RENCIO BENTO FLORENCIO - UFG