title: Short-term effect of volume recruitment-derecruitment manoeuvre on chest-wall motion in Duchenne muscular dystrophy.
abstract: Because progressive respiratory muscle weakness leads to decreased chest-wall motion with eventual ribcage stiffening, the purpose was to compare vital capacity (VC) and contributions of chest-wall compartments before and after volume recruitment-derecruitment manoeuvres (VRDM) in Duchenne muscular dystrophy (DMD). We studied nine patients with DMD and VC lower than 30% of predicted. VRDM was performed using 15 insufflations-exsufflations of +30 to -30 cmH2O. VC and three-dimensional chest-wall motion were measured, as well as oxygen saturation, transcutaneous partial pressure of carbon dioxide and the rapid shallow breathing index (respiratory rate/tidal volume) before (baseline) and immediately and 1 hour after VRDM. VC increased significantly immediately after VRDM (108% ± 7% of baseline, p = 0.018) but returned to baseline within 1 hour, and the rapid shallow breathing index increased significantly. The non-dominant side systematically increased immediately after VRDM ( p = 0.0077), and in the six patients with abnormal breathing asymmetry (difference >10% of VC) at baseline, this asymmetry was corrected immediately and/or 1 hour after VRDM. VRDM improved VC and reduced chest-wall motion asymmetry, but this beneficial effect waned rapidly with respiratory muscle fatigue, suggesting that VRDM may need to be repeated during the day to produce lasting benefits.
authors.affiliation: 1 Physiology, Functional Testing Department and Technological Innovations Centre, Raymond Poincaré Teaching Hospital, Garches, France.|2 UMR Inserm 1179, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France.|3 Laboratoire Européen Performance Santé Altitude (LEPSA: EA4604), Université de Perpignan Via Dominitia (UPVD), Font Romeu, France.
authors.forename: Henri
authors.initials: H
authors.lastname: Meric
authors.affiliation: 1 Physiology, Functional Testing Department and Technological Innovations Centre, Raymond Poincaré Teaching Hospital, Garches, France.|2 UMR Inserm 1179, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France.
authors.forename: Line
authors.initials: L
authors.lastname: Falaize
authors.affiliation: 1 Physiology, Functional Testing Department and Technological Innovations Centre, Raymond Poincaré Teaching Hospital, Garches, France.|2 UMR Inserm 1179, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Pradon
authors.affiliation: 1 Physiology, Functional Testing Department and Technological Innovations Centre, Raymond Poincaré Teaching Hospital, Garches, France.|2 UMR Inserm 1179, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Lacombe
authors.affiliation: 1 Physiology, Functional Testing Department and Technological Innovations Centre, Raymond Poincaré Teaching Hospital, Garches, France.|2 UMR Inserm 1179, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Petitjean
authors.affiliation: 1 Physiology, Functional Testing Department and Technological Innovations Centre, Raymond Poincaré Teaching Hospital, Garches, France.|2 UMR Inserm 1179, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France.
authors.forename: David
authors.initials: D
authors.lastname: Orlikowski
authors.affiliation: 1 Physiology, Functional Testing Department and Technological Innovations Centre, Raymond Poincaré Teaching Hospital, Garches, France.|2 UMR Inserm 1179, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Prigent
authors.affiliation: 1 Physiology, Functional Testing Department and Technological Innovations Centre, Raymond Poincaré Teaching Hospital, Garches, France.|2 UMR Inserm 1179, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Lofaso
mesh_terms: D000293:Adolescent; D000328:Adult; D006801:Humans; D018908:Muscle Weakness / Q000503:physiopathology; D020388:Muscular Dystrophy, Duchenne / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D010991:Plethysmography; D012121:Respiration, Artificial / Q000379:methods*; D012131:Respiratory Insufficiency / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D015656:Respiratory Mechanics; D012132:Respiratory Muscles / Q000503:physiopathology; D056152:Respiratory Rate; D035441:Thoracic Wall / Q000503:physiopathology; D013997:Time Factors; D014797:Vital Capacity; D055815:Young Adult
keywords: Duchenne muscular dystrophy; lung function; mechanical insufflation–exsufflation; physiotherapy; respiratory mechanics