Chest
Control of Breathing and Respiratory Muscle Strength in Patients With Multiple Sclerosis
Section snippets
METHODS
Eleven patients, 10 of whom were female (mean age, 44.1±12.0 years) with stable MS, lasting 11.2±7.3 years, were studied when they were inpatients enrolled in a neuromuscular rehabilitation program, together with a group of 10 control subjects, age (36.8 ± 6.2 years) and sex matched. The neurologic impairment was scored from 0 to 10, according to the expanded disability status scale (EDSS)8 by the neurologists involved in the study. The mean EDSS was 6.7 ± 1.2, ranging from 5 to 9.5. In the
RESULTS
Lung volumes, usual parameters derived from the flow-volume curves, and maximal inspiratory and expiratory pressures are listed in Table 2 for each patient as individual data and for both patients and control subjects as percent predicted.
Results of lung function tests were essentially normal in the MS group. However, despite normal FRC (89 percent of predicted), patient 2 had greatly reduced VC (27 percent of predicted) and markedly increased RV (157 percent of predicted).
The MVV was on the
DISCUSSION
First of all, the results of this study indicate that patients with moderately severe MS (ambulatory with assistance and wheelchair bound), in stable condition, exhibit on average a 40 percent and 60 percent reduction of Pimax and PEmax, respectively. In these patients, however, this level of respiratory muscle dysfunction does not appear severe enough to induce significant restrictive changes in lung volumes.
In other neuromuscular diseases,5 the decline of Pimax and PEmax precedes changes in
ACKNOWLEDGMENTS
The authors wish to thank Rita Fraboni for her valuable technical assistance.
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Effect of eight weeks respiratory muscle training on respiratory capacity, functional capacity and quality of life on subjects with mild to moderate relapsing-remitting multiple sclerosis: A single-blinded randomized controlled trial
2022, Multiple Sclerosis and Related DisordersCitation Excerpt :In addition, if the rehabilitation period was more than eight weeks, the performance test results could be significant. Limited studies have been performed to investigate the relationship between fatigue and respiratory muscle strength in MS patients, and their results are inconsistent (Gosselink et al., 2000; Ray et al., 2015; Tantucci et al., 1994; Krupp et al., 1989; Balkan and Salci, 2020). Balkan et al. showed that inspiratory training in patients with mild to moderate MS did not affect their improving fatigue (Balkan and Salci, 2020).
Effects of 12-week inspiratory muscle training with low resistance in patients with multiple sclerosis: A non-randomised, double-blind, controlled trial
2020, Multiple Sclerosis and Related DisordersEvolving relationship between respiratory functions & impairment in sleep and cognition in patients with multiple sclerosis
2020, Multiple Sclerosis and Related DisordersCitation Excerpt :Pulmonary manifestations of MS consist primarily of respiratory muscle weakness that leads to impaired ventilation and poor cough (Gosselink et al., 1999; Smeltzer et al., 1988). Several reports have suggested that the expiratory muscles are preferentially involved (Tantucci et al., 1994). The clinical examination may reveal paradoxical inward abdominal movement during inspiration (Fromageot et al., 2001), “respiratory pulse” during inspiration where there is visible contraction of scalene muscles and/or rapid shallow breathing; this breathing pattern reduces inspiratory time and transdiaphragmatic pressure which limits alveolar ventilation, thereby contributing to the development of chronic respiratory failure (Misuri et al., 2000).
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Supported by a grant from the Ministero dell'Universitá e della Ricerca Scientifica e Tecnologica of Italy.
Presented in abstract form at the ATS International Conference, Miami Beach, May 17-20, 1992.