title: Respiratory muscular strength decrease in children with myelomeningocele.
abstract: METHODS
  Case-control study.
  
  
  OBJECTIVE
  To evaluate respiratory muscle force in children with myelomeningocele.
  
  
  BACKGROUND
  Myelomeningocele is a common spinal cord malformation with limitations linked to central nervous system lesions and abnormalities in respiratory movements. Despite this, little attention has been given to evaluating respiratory muscle force in these patients.
  
  
  METHODS
  Children with myelomeningocele aged between 4 and 14 years (myelomeningocele group; MG, n = 20) were studied and compared with healthy children (control group; CG, n = 20) matched for age and gender. Respiratory muscular force was evaluated by maximum inspiratory (Pimax) and expiratory (Pemax) pressures.
  
  
  RESULTS
  Groups were similar for age [CG = 8 (6-13) x MG = 8 (4-14), P > 0.05]; gender, and body mass index [CG = 17.4 (14.1-24.7) x MG = 19.2 (12.6-31.9), P > 0.05]. The lumbosacral region was predominantly affected (45%). Maximum respiratory pressures were significantly higher in CG than MG (Pimax = CG: -83 +/- 21.75 > MG: -54.1 +/- 23.66; P < 0.001 and Pemax = CG: +87.4 +/- 26.28 > MG: +64.6 +/- 26.97; P = 0.01). Patients with upper spinal lesion (UL) had lower maximum respiratory pressure values than those with lower spinal lesion (LL), [Pimax (UL = -38.33 +/- 11.20 cm H2O x LL = -60.85 +/- 24.62 cm H2O), P < 0.041 and Pemax (UL = +48 +/- 20.82 cm H2O x LL + 71.71 +/- 26.73 cm H2O), P = 0.067]).
  
  
  CONCLUSIONS
  Children with myelomeningocele at the ages studied presented reduced respiratory muscle force with more compromise in upper spinal lesion.
authors.affiliation: Physiotherapy and Rehabilitation Section, University Hospital of Botucatu Medical School, Sao Paulo State University-UNESP, Brazil.
authors.forename: Carlos Fernando
authors.initials: CF
authors.lastname: Ronchi
authors.forename: Leticia Cláudia de Oliveira
authors.initials: LC
authors.lastname: Antunes
authors.forename: Jose Roberto
authors.initials: JR
authors.lastname: Fioretto
mesh_terms: D000293:Adolescent; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D045853:Exhalation / Q000502:physiology; D005260:Female; D006801:Humans; D001239:Inhalation / Q000502:physiology; D008297:Male; D008591:Meningomyelocele / Q000150:complications* / Q000503:physiopathology*; D009123:Muscle Hypotonia / Q000209:etiology* / Q000503:physiopathology*; D053580:Muscle Strength / Q000502:physiology; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000502:physiology*