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Neck and abdominal muscle activity in patients with severe thoracic scoliosis

Marc Estenne, Eric Derom UGent and André De Troyer (1998) AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE. 158(2). p.452-457
abstract
Patients with severe chronic obstructive pulmonary disease (COPD) do not use the sternocleidomastoid muscles when breathing at rest, but have a greater than normal neural drive to the rib-cage inspiratory muscles, the abdominal muscles, and the diaphragm. Yet the increased activation of the abdominal muscles and diaphragm in such patients has only limited mechanical effects, and this has led to the suggestion that the overall increase in neural drive is simply an automatic response of the respiratory system to a greater than resting stimulation. To test this hypothesis, we examined the pattern of respiratory-muscle activation in eight patients with severe thoracic scoliosis (Cobb angle between 100 degrees and 136 degrees). We recorded electromyograms of the sternocleidomastoid, scalene, rectus abdominis, external oblique, and transversus abdominis muscles; esophageal (Pes) and gastric (Pga) pressures; and the anteroposterior (AP) diameter of the abdomen during resting breathing in the seated posture. All patients had invariable phasic inspiratory activity in the scalenes; and five patients had invariable phasic expiratory activity in the transversus; intermittent expiratory activity in the transversus was also recorded in three patients. In contrast, only one patient had invariable phasic inspiratory activity in the sternocleidomastoid, and only one patient had invariable phasic expiratory activity in the external oblique. The decrease in abdominal AP diameter during expiration was commonly associated with a rise in Pga. These observations therefore indicate that the pattern of respiratory-muscle activation in patients with severe thoracic scoliosis is essentially similar to that seen in patients with severe COPD. This supports the concept that the order of recruitment of the respiratory muscles during breathing is an automatic response of the central controller.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
KYPHOSCOLIOSIS, OBSTRUCTIVE PULMONARY-DISEASE, DIAPHRAGM, HUMANS, COPD
journal title
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE
Am. J. Respir. Crit. Care Med.
volume
158
issue
2
pages
452 - 457
Web of Science type
Article
Web of Science id
000075387700016
ISSN
1073-449X
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
179433
handle
http://hdl.handle.net/1854/LU-179433
alternative location
http://ajrccm.atsjournals.org/cgi/content/abstract/158/2/452
date created
2004-01-14 13:41:00
date last changed
2016-12-19 15:38:24
@article{179433,
  abstract     = {Patients with severe chronic obstructive pulmonary disease (COPD) do not use the sternocleidomastoid muscles when breathing at rest, but have a greater than normal neural drive to the rib-cage inspiratory muscles, the abdominal muscles, and the diaphragm. Yet the increased activation of the abdominal muscles and diaphragm in such patients has only limited mechanical effects, and this has led to the suggestion that the overall increase in neural drive is simply an automatic response of the respiratory system to a greater than resting stimulation. To test this hypothesis, we examined the pattern of respiratory-muscle activation in eight patients with severe thoracic scoliosis (Cobb angle between 100 degrees and 136 degrees). We recorded electromyograms of the sternocleidomastoid, scalene, rectus abdominis, external oblique, and transversus abdominis muscles; esophageal (Pes) and gastric (Pga) pressures; and the anteroposterior (AP) diameter of the abdomen during resting breathing in the seated posture. All patients had invariable phasic inspiratory activity in the scalenes; and five patients had invariable phasic expiratory activity in the transversus; intermittent expiratory activity in the transversus was also recorded in three patients. In contrast, only one patient had invariable phasic inspiratory activity in the sternocleidomastoid, and only one patient had invariable phasic expiratory activity in the external oblique. The decrease in abdominal AP diameter during expiration was commonly associated with a rise in Pga. These observations therefore indicate that the pattern of respiratory-muscle activation in patients with severe thoracic scoliosis is essentially similar to that seen in patients with severe COPD. This supports the concept that the order of recruitment of the respiratory muscles during breathing is an automatic response of the central controller.},
  author       = {Estenne, Marc and Derom, Eric and De Troyer, Andr{\'e}},
  issn         = {1073-449X},
  journal      = {AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE},
  keyword      = {KYPHOSCOLIOSIS,OBSTRUCTIVE PULMONARY-DISEASE,DIAPHRAGM,HUMANS,COPD},
  language     = {eng},
  number       = {2},
  pages        = {452--457},
  title        = {Neck and abdominal muscle activity in patients with severe thoracic scoliosis},
  url          = {http://ajrccm.atsjournals.org/cgi/content/abstract/158/2/452},
  volume       = {158},
  year         = {1998},
}

Chicago
Estenne, Marc, Eric Derom, and André De Troyer. 1998. “Neck and Abdominal Muscle Activity in Patients with Severe Thoracic Scoliosis.” American Journal of Respiratory and Critical Care Medicine 158 (2): 452–457.
APA
Estenne, M., Derom, E., & De Troyer, A. (1998). Neck and abdominal muscle activity in patients with severe thoracic scoliosis. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 158(2), 452–457.
Vancouver
1.
Estenne M, Derom E, De Troyer A. Neck and abdominal muscle activity in patients with severe thoracic scoliosis. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE. 1998;158(2):452–7.
MLA
Estenne, Marc, Eric Derom, and André De Troyer. “Neck and Abdominal Muscle Activity in Patients with Severe Thoracic Scoliosis.” AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE 158.2 (1998): 452–457. Print.