Abstract
Neuromuscular disorders (NMD) lead to the progressive loss of motor and respiratory functions and a decline in daily activities and participation. We aimed to evaluate respiratory changes and functional outcomes in children attending an aquatic therapy program. Eleven patients diagnosed with NMD (4–18 years, Vignos scale 1–9) were involved in a 10-week aquatic exercise program. The ventilation variables were: peak cough flow, volumes (forced expiratory volume in one second-FEV1 and inspiratory volume) and respiratory pressures to evaluate strength and oxygen saturation (O2 sat). Functional skills were measured in the aquatic environment (Water Orientation Test Alyn 1) and on dry land, (Pediatric Evaluation of Disability Inventory), together with quality of life (Pediatric Quality of Life Inventory). Our evaluation included several 2 × 6 mixed-model repeated measures analysis of covariance (ANCOVA) with time (baseline, post 1 session, pre-post at five weeks and pre-post at 10 weeks). Important improvements in functional skills were observed in and out of the water and children under the age of 11 displayed a significant difference for inspirational volume (p = 0.002) and O2 sat (p = 0.029). Clinical, statistically insignificant changes were found for peak cough flow and expiratory pressures values after aquatic exercise. These results may support a relationship between aquatic exercise in NMD, respiratory outcomes and functional activities in water and on land.
Highlights
Neuromuscular disorders (NMD) constitute a wide group of pathologies that lead to an alteration of the peripheral nervous system, which can occur in cells of the anterior horn, peripheral nerves, neuromuscular junction and muscle [1,2]
The present research was carried out to evaluate the changes that may occur in respiratory function in children with NMD, after intervention based on aquatic exercise and its influence on subsequent functional abilities, both in the aquatic environment and on dry land and the impact of this intervention on quality of life
Improvements in the performance of functional mobility tasks in and out of the water were found, together with improvements in inspiratory and expiratory volumes, which could indicate a possible relationship between aquatic exercise in NMD and respiratory functions related to functional participation
Summary
Neuromuscular disorders (NMD) constitute a wide group of pathologies that lead to an alteration of the peripheral nervous system, which can occur in cells of the anterior horn, peripheral nerves, neuromuscular junction and muscle [1,2]. They may begin in childhood or, in adulthood and life expectancy is conditioned by the type of specific disease and degree of involvement [2,3]. Brain Sci. 2020, 10, 458 alteration of respiratory function) are produced by muscle weakness [4,5,6], which impacts on the control of static and dynamic postural balance [7]. Thoracic and oropharyngeal muscle weakness makes it difficult to eliminate secretions due to difficulty in coughing
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