Comparison of physical properties of voluntary coughing, huffing and swallowing in healthy subjects.

Akiko Yawata,Ryosuke Takeishi,Li Yu,Jin Magara,Takanori Tsujimura,Makoto Inoue,Shane Patman

doi:10.1371/journal.pone.0242810

Akiko Yawata, Ryosuke Takeishi + Show 5 more

Open Access

https://doi.org/10.1371/journal.pone.0242810

Copy DOI

Journal: PloS one	Publication Date: Dec 3, 2020
Citations: 1	License type: CC BY 4.0

Affiliation: Niigata University, Tongji University, Tongji Hospital

Abstract

Coughing, huffing and swallowing protect the airway from aspiration. This study was conducted to compare the physical properties of voluntary coughing, huffing and swallowing in healthy subjects. Ten healthy men were asked to huff, cough and swallow repeatedly. Electromyograms (EMGs) were recorded from the left side of the external oblique (EO), sternocleidomastoid, suprahyoid (SH) and thyrohyoid muscles. Airflow was recorded using a face mask with two-way non-rebreathing valves. The expiratory velocity of huffing and coughing and the SH EMG of all actions presented high intraclass correlation coefficients (> 0.8). The inspiratory and expiratory velocities did not differ significantly between coughing and huffing. The expiratory acceleration of coughing was significantly higher than that of huffing, whereas the expiratory volume of coughing was significantly smaller than that of huffing. The EO EMG of coughing and huffing were significantly larger than that of swallowing. The EO EMG activity during the expiratory phase was significantly higher than that of the other phases of both coughing and huffing. The SH EMG of coughing and huffing were significantly smaller than that of swallowing. Correlation analysis revealed that the expiratory velocity of coughing was strongly positively correlated with that of huffing. The expiratory volume of huffing was significantly positively correlated with hand grip strength. These results suggest that EO and SH muscle activities during huffing or coughing differ those during swallowing, and huffing and coughing may work similarly in expiratory function.

Highlights

Severe pneumonia is a life-threatening pulmonary disease classified by the site of incidence as either community-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP)
Physical properties of coughing, huffing and swallowing pneumonia for CAP and HAP were reported to exceed 60% and 80%, respectively, in patients hospitalized for pneumonia, and the ratios of aspiration pneumonia increased with age [3]
Deep inspiration occurred with SCM EMG activity, followed by a sharp expiration with external oblique (EO), SCM and TH EMG burst

Summary

Introduction

Severe pneumonia is a life-threatening pulmonary disease classified by the site of incidence as either community-acquired pneumonia (CAP) or hospital-acquired pneumonia (HAP). In Japan, pneumonia became the third leading cause of death in 2011, and approximately 96% of patients who died from pneumonia were aged 65 years or older [1]. Marik et al demonstrated that 5%–15% of CAP cases are aspiration pneumonia [2]. Physical properties of coughing, huffing and swallowing pneumonia for CAP and HAP were reported to exceed 60% and 80%, respectively, in patients hospitalized for pneumonia, and the ratios of aspiration pneumonia increased with age [3]. Aspiration pneumonia is caused by impaired swallowing and coughing, which are referred to as dysphagia and dystussia, respectively [4]. Avoiding aspiration pneumonia is an urgent and important issue

Methods

Results

Conclusion