Abstract
Analysis of autonomic modulation after postural change may inform the prognosis and guide treatment in different populations. However, this has been insufficiently explored among adolescents with Duchenne muscular dystrophy (DMD). To investigate autonomic modulation at rest and in response to an active sitting test (AST) among adolescents with DMD. Fifty-nine adolescents were included in the study and divided into two groups: 1) DMD group: adolescents diagnosed with DMD; 2) control group (CG): healthy adolescents. Participants' weight and height were assessed. Lower limb function, motor limitations and functional abilities of the participants in the DMD group were classified using the Vignos scale, Egen classification and motor function measurement, respectively. The following variables were assessed before, during and after AST: systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (f), oxygen saturation and heart rate (HR). To analyze the autonomic modulation, the HR was recorded beat-by-beat. Heart rate variability (HRV) indices were calculated in the time and frequency domains. Differences in relation to groups were observed for all HRV indices, except LF/HF, oxygen saturation, HR and f (p < 0.05). Differences in relation to time and the interaction effect between group and time were observed for RMSSD, SD1, SD2, SD1/SD2, LFms2 and LFnu, HFun, SBP and DBP (p < 0.05). Differences in relation to time were also observed for the indice SDNN, FC and f (p < 0.05). Performing the AST promoted reduced autonomic modulation and increased SBP, DBP and HR in adolescents with DMD.
Highlights
METHODSDuchenne muscular dystrophy (DMD) is a progressive neuromuscular disease affecting approximately 1 in 3500 newborn males[1,2]
Lower-limb function and functional ability of the adolescents with DMD included in this study, the average score calculated from the EK scale was relatively low (9.3 out of 30), indicating lower motor limitations
It is important to highlight that 14 adolescents in the DMD group were using a wheelchair (82%)
Summary
METHODSDuchenne muscular dystrophy (DMD) is a progressive neuromuscular disease affecting approximately 1 in 3500 newborn males[1,2]. These disorders are reflected in poor prognoses and increased mortality rates in this population[7]. Autonomic nervous system (ANS) dysfunction is observed in individuals with DMD It can be assessed using heart rate variability (HRV), a noninvasive method in which the ANS is assessed based on fluctuations in the time intervals between consecutive heartbeats (RR intervals)8,9”. Analysis of autonomic modulation after postural change may inform the prognosis and guide treatment in different populations This has been insufficiently explored among adolescents with Duchenne muscular dystrophy (DMD). Conclusions: Performing the AST promoted reduced autonomic modulation and increased SBP, DBP and HR in adolescents with DMD
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