Chest Wall Mobility Is Related to Respiratory Muscle Strength and Lung Volumes in Healthy Subjects.

Chest wall mobility is related to respiratory muscle strength and lung volumes in healthy subjects.

Respir Care. 2013 May 14;
Lanza FD, de Camargo A, Archija LR, Selman JP, Malaguti C, Dal Corso S

Background:chest wall mobility is often used in clinical practice, but is not determined it’s correlation with respiratory muscle strength and lung volumes.Objective:to investigate the association between chest wall mobility, axilary (Cax) and thoracic cirtometry (Cthor), respiratory muscle strength (maximal inspiratory pressure – PImax, maximal expiratory pressure – PEmax) and lung volumes (expiratory reserve volume – ERV, forced expiratory volume in the first second – FEV1, inspiratory capacity – IC, forced vital capacity – FVC), and secondarily to investigate the determinants of chest mobility in healthy subjects.Methods:64 healthy volunteers; spirometry was performed to determine: IC, FVC, FEV1 and ERV. PImax and PEmax were evaluated using a manometer to measure pressure at the mouth. Chest wall mobility was performed at axillary and thoracic levels using a measuring tape. Linear regression analysis was used to evaluate the influence of some variables on chest wall mobility.Result:the volunteers were 24 ± 3 years old, Cax was 6.3 ± 2.0 cm, Cthor was 7.5 ± 2.3 cm. Respiratory pressures were PImax: -90.4±10.6% pred; PEmax: +92.8±13.5% pred. Lung function IC: 99.7 ± 8.6% pred, FVC: 101.9 ± 10.6% pred, FEV1: 98.2 ± 10.3% pred; ERV: 90.9 ± 19.9% pred. There was significant correlation between Cax and FVC, FEV1, PImax, PEmax, IC (r: 0.32, r: 0.30, r: 0.48, r: 0.25, r: 0.24, respectively) and between Cthor and FVC, FEV1, PImax, PEmax, IC, ERV (r: 0.50, r: 0.48, r: 0.46, r: 0.37, r: 0.39, r: 0.47, respectively). In multiple regression analysis the variable that best explained the Cax variation was PImax (R2: 0.23), and for Cthor was FVC and PImax (R2: 0.32).Conclusions:chest mobility in healthy subjects is related to respiratory muscle strength and lung function, thus the higher the Cax and Cthor greater PImax, PEmax, and lung volumes in healthy subjects. HubMed – rehab

 

Retrieval practice is a robust memory aid for memory-impaired patients with MS.

Mult Scler. 2013 May 14;
Sumowski JF, Leavitt VM, Cohen A, Paxton J, Chiaravalloti ND, Deluca J

Memory impairment is prevalent in multiple sclerosis (MS). Retrieval practice is a powerful memory technique whereby retrieving information (quizzing oneself) leads to better memory than restudying. In a within-subjects experiment, 12 memory-impaired MS patients encoded verbal paired associates (VPAs) through massed restudy (MR), spaced restudy (SR), or retrieval practice (RP). Half of VPAs were tested after short delay (30 minutes) and half after long delay (one week). RP robustly improved memory more than restudy. Short delay: MR=15.6%, SR=27.1%, RP=72.9%. Long delay: MR=1.0%, SR=4.2%, RP=24.0%. RP was the best memory technique for nearly all patients after both short and long delays. HubMed – rehab

 

The 6-minute walk test and other clinical endpoints in Duchenne muscular dystrophy: Reliability, concurrent validity, and minimal clinically important differences from a multicenter study.

Muscle Nerve. 2013 May 14;
McDonald CM, Henricson EK, Abresch RT, Florence J, Eagle M, Gappmaier E, Glanzman AM, , Spiegel R, Barth J, Elfring G, Reha A, Peltz SW

Introduction: An international clinical trial enrolled 174 ambulatory males ?5 years old with nonsense mutation Duchenne muscular dystrophy (nmDMD). Pre-treatment data provide insight into reliability, concurrent validity, and minimal clinically important differences (MCID) of the 6-minute walk test (6MWT) and other endpoints. Methods: Screening and baseline evaluations included the 6-minute walk distance (6MWD), timed function tests (TFTs), quantitative strength by myometry, the PedsQL(TM) , heart rate determined energy expenditure index, and other exploratory endpoints. Results: The 6MWT proved feasible and reliable in a multicenter context. Concurrent validity with other endpoints was excellent. The MCID for 6MWD was 28.5 and 31.7 meters based on 2 statistical distribution methods. Discussion: The ratio of MCID to baseline mean is lower for 6MWD than for other endpoints. The 6MWD is an optimal primary endpoint for Duchenne muscular dystrophy (DMD) clinical trials that are focused therapeutically on preservation of ambulation and slowing of disease progression. © 2013 Wiley Periodicals, Inc. HubMed – rehab