Quiet Breathing Research Articles

Smart Mattress Based on Multipoint Fiber Bragg Gratings for Respiratory Rate Monitoring

Long-term monitoring of respiratory rate (RR) is of great importance in people suffering from sleep-related breathing disorders (SBDs). Instrumented mattresses are gaining the attention of several research groups to monitor this vital sign. Among the existing sensing techniques, fiber Bragg grating sensors (FBGs) show promise in this arena. In this article, we presented a novel FBG-based smart mattress to monitor RR over time. The proposed measuring system consisted of 13 sensing elements (SEs) based on FBGs encapsulated in soft biocompatible rubber, totally embedded in multiple silicone layers. Compactness, robustness, and user comfort are the main advantages of our solution. The mattress size and the arrangement of the 13 SEs were chosen to allow monitoring subjects with different anthropometric parameters and taking up different sleeping postures. Before the overall system integration, each SE was subjected to static and dynamic metrological characterization, a process often overlooked in fiber-optic-based mattresses. Results showed a mean sensitivity to force equal to 14 pm <inline-formula xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink"> <tex-math notation="LaTeX">$\cdot \,\,\text{N}^{-1}$ </tex-math></inline-formula> and a mean percentage hysteresis error always lower than 18%. The feasibility assessment of the system in RR monitoring was carried out on five healthy volunteers taking up common sleeping postures (i.e., supine -S-, right side -RS-, left side -LS-, and prone -P-) under two breathing conditions (i.e., quiet breathing -QB-, and tachypnea -T-). RR estimation showed a mean absolute error (MAE) always lower than 0.65 breaths/min. The promising findings proved the capability of our smart mattress in monitoring RR over time, encouraging the investigation of its performance in real-world scenarios.

Relationships between parameters of respiratory muscle activity measured by ultrasonography and magnetic resonance imaging

This study aimed to clarify the correlations between values of diaphragmatic movement as respiratory muscle activity measured by ultrasonography (US) and magnetic resonance imaging (MRI) under quiet breathing (QB) and forced abdominal breathing (FAB) to select the optimal evaluation method according to the purpose of physical therapy, such as breathing instruction.

딥벨트의 가로막 수축압력과 초음파영상의 가로막 움직임 및 폐활량과의 상관성

Purpose: This study was designed to determine the correlation between the diaphragmatic contraction pressure using diaphragmatic pressure belt (DiP Belt) and the ultrasound imaging of diaphragmatic motion and forced vital capacity. This study was conducted to confirm the usefulness of assessing the diaphragmatic function using the DiP Belt.&#x0D; Methods: This study included 41 healthy subjects (13 males and 28 females). The diaphragmatic motion was measured using sonography, and the forced vital capacity (FVC) was measured using a portable digital spirometer device. After 2 weeks, the diaphragmatic contraction pressure was measured during maximal inspiration using the DiP Belt.&#x0D; Results: The mean diaphragmatic contraction pressure (MDCP) and peak diaphragmatic contraction pressure (PMCP) using the DiP Belt were not significantly correlated with sonography imaging of diaphragmatic motion during quiet breathing but were significantly positively correlated with the diaphragmatic motion during deep breathing. Both the MDCP and PMCP were significantly positively correlated with FVC, forced expiratory volume in 1 second (FEV1), and peak expiratory flow (PEF). However, diaphragmatic motion was significantly positively correlated with FVC, FEV1, and PEF in only deep breathing.&#x0D; Conclusion: The Dip Belt can provide valuable information about the diaphragmatic function, particularly ultrasound imaging of diaphragmatic motion and lung capacity.

Effect of the respiratory motion of pulmonary nodules on CT-guided percutaneous transthoracic needle biopsy.

Computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) is highly affected by respiratory motion; however, respiratory motion of target nodule during the PTNB and its effect on CT-guided lung biopsy have not been studied. To investigate the effect of the respiratory motion of pulmonary nodules on CT-guided PTNB. We retrospectively reviewed the procedural CT scans of 426 pulmonary nodules that underwent PTNB during quiet breathing. Maximal and average respiratory motions were measured using the difference of table position of the targeted nodule between multiple procedural scans. Diagnostic performance, complications, and technical factors of PTNB in nodules with large motion (maximal motion >1 cm) were compared with those in nodules with small motion (≤1 cm). The mean maximal and average respiratory motions between tidal volume breathing were 5.4 ± 4.4 and 2.7 ± 2.6 mm, respectively. Sensitivity and accuracy were 93.1% and 96.1% in nodules with large motion, compared with 94.7% and 95.9% in nodules with small motion, respectively. Respiratory targeting (P < 0.001), needle modulation (P < 0.001), motion artifact of target (P < 0.001), target disappearance from scans (P < 0.001), and number of performed CT scans (P < 0.001) were significantly higher in the large motion group, with no significant difference in radiation dose and complications between the groups. The respiratory motion of pulmonary nodules during CT-guided PTNB may cause technical difficulties but does not affect diagnostic performance nor complications associated with PTNB.

Characteristics of Diaphragmatic and Chest Wall Motion in People with Normal Pulmonary Function: A Study with Free-Breathing Dynamic MRI.

We aimed to quantitatively study the characteristic of diaphragm and chest wall motion using free-breathing dynamic magnetic resonance imaging (D-MRI) in Chinese people with normal lung function. 74 male subjects (mean age, 37 ± 11 years old) were prospectively enrolled, and they underwent high-resolution CT(HRCT), pulmonary functional tests (PFTs), and D-MRI in the same day. D-MRI was acquired with a gradient-echo sequence during the quiet and deep breathing. The motion of the diaphragm and chest wall were respectively assessed by measuring thoracic anteroposterior diameter (AP), left-right diameter (LR), cranial-caudal diameter (CC), and thoracic area ratios between end-inspiration and end-expiration. The effect of age, body mass index (BMI), and smoking on respiratory muscle function was also analyzed. The mean ratio of right and left AP was greater than that of LR on three transversal planes during both quiet and deep breathing. The mean ratio at the anterior diaphragm (AND, Quiet: 1.04 ± 0.03; Deep: 1.15 ± 0.09) was weaker than that of the apex (vs. APD, Quiet: 1.08 ± 0.05, p &lt; 0.001; Deep: 1.29 ± 0.12, p &lt; 0.001) and posterior diaphragm (vs. POD, Quiet: 1.09 ± 0.04, p &lt; 0.001; Deep: 1.30 ± 0.12, p &lt; 0.001) both in quiet and deep breathing. Compared with non-smokers, the left AP and thoracic area ratios in smokers were significantly decreased (p &lt; 0.05). However, the ratios of AP, LR, CC, and thoracic area on each plane were similar among groups in different age and BMI. During both quiet and deep breathing, the chest wall motion is prominent in the anteroposterior direction. The motions of diaphragm apex and posterior diaphragm were more prominent than that of the anterior diaphragm. Smoking may affect the respiratory muscle mobility. Dynamic MRI can quantitatively evaluate the motion of respiratory muscles.

Cross-System Integration of Respiration and Deglutition: Function, Treatment, and Future Directions.

Swallowing occurs preferentially in the expiratory phase of the quiet breathing cycle and at mid-to-low tidal volume. This coordinative pattern imparts important biomechanical advantages to swallowing and airway protection and facilitate laryngeal elevation, laryngeal vestibular and vocal fold closure, and cricopharyngeal sphincter opening. This preferred coordinative relationship between breathing and swallowing is impaired in a variety of patient populations, including head and neck cancer survivors with dysphagia. We developed a training protocol to re-establish more optimal phasing of swallowing with breathing in these patients with striking outcomes, including reduced swallowing physiological impairments and improved airway protection. This motivated us to continue to refine and expand this training protocol and develop new assistive technologies for swallowing monitoring outside of the lab. In this review, we highlight the origins of our optimal respiratory-swallowing coordination hypothesis, describe the biomechanical advantages it provides, carefully describe our training protocol and findings, and chart a course for the next phase of this work. Our overall goal is to harness technology combined with carefully constructed learning paradigms to improve the lives of patients with impaired respiratory-swallowing coordination consequent to a variety of pathologies including head and neck cancer and degenerative neurological conditions such as Parkinson's disease.

The (human) respiratory rate at rest

All schoolchildren know how often they breathe, but even experts don’t know exactly why. The aim of this publication is to develop a model of the resting spontaneous breathing rate using physiological, physical and mathematical methods with the aid of the principle that evolution pushes physiology in a direction that is as economical as possible. The respiratory rate then follows from an equation with the parameters hbox {CO}_{2}-production rate of the organism, resistance, static compliance and dead space of the lungs, the inspiration duration: expiration duration - ratio and the end-expiratory hbox {CO}_{2} fraction. The derivation requires exclusively secondary school mathematics. Using the example of an adult human or a newborn child, data from the literature then result in normal values for their breathing rate at rest. The reason for the higher respiratory rate of a newborn human compared to an adult is the relatively high hbox {CO}_{2}-production rate together with the comparatively low compliance of the lungs. A side result is the fact that the common alveolar pressure throughout the lungs and the common time constant is a consequence of the economical principle as well. Since the above parameters are not human-specific, there is no reason to assume that the above equation could not also be applicable to many animals breathing through lungs within a thorax, especially mammals. Not only physiology and biology, but also medicine, could benefit: Applicability is being discussed in pulmonary function diagnostics, including pathophysiology. However, the present publication only claims to be a theoretical concept of the spontaneous quiet breathing rate. In the absence of comparable animal data, this publication is intended to encourage further scientific tests.

Quantification of diaphragmatic dynamic dysfunction in septic patients by bedside ultrasound

Although diaphragmatic dysfunction is an important indicator of severity of illness and poor prognosis in ICU patients, there is no convenient and practical method to monitor diaphragmatic function. This study was designed to analyze diaphragmatic dynamic dysfunction by bedside ultrasound in septic patients and provide quantitative evidence to assess diaphragm function systematically. This prospective observational study was conducted from October 2019 to January 2021 in the Department of Respiratory and Critical Care Medicine. 74 patients suffered from sepsis were recruited and divided into two groups, sepsis group 1 (2 ≤ SOFA ≤ 5, n = 41) and sepsis group 2 (SOFA > 5, n = 33). 107 healthy volunteers were randomly recruited as the control group. In all participants, the diaphragmatic thickness and excursion were measured directly and the dynamic parameters including thickening fraction (TF), EQB/EDB, Contractile velocity, and area under diaphragmatic movement curve (AUDMC) were calculated by bedside ultrasound during quiet breathing (QB) and deep breathing (DB). Each parameter among three groups was analyzed separately by covariance analysis, which was adjusted by age, sex, body mass index, MAP, hypertension, and diabetes. First, contractile dysfunction occurred before diaphragmatic atrophy both in sepsis group 1 and sepsis group 2. Second, compared with the control group, the dynamic parameters showed significant decrease in sepsis group 1 and more obvious change in sepsis group 2, including TF, EQB/EDB. Third, the maximum contractile velocity decreased in sepsis group 1, reflecting the damage of intrinsic contraction efficiency accurately. Finally, per breathing AUDMC in two septic groups were lower than those in control group. However, per minute AUDMC was compensated by increasing respiratory rate in sepsis group 1, whereas it failed to be compensated which indicated gradual failure of diaphragm in sepsis group 2. Diaphragmatic ultrasound can be used to quantitatively evaluate the severity of sepsis patients whose contractile dysfunction occurred before diaphragmatic atrophy. As dynamic parameters, TF and EQB/EDB are early indicator associated with diaphragmatic injury. Furthermore, maximum contractile velocity can reflect intrinsic contraction efficiency accurately. AUDMC can evaluate diaphragmatic breathing effort and endurance to overcome resistance loads effectively.

Technical standards for pulmonary function tests: impulse oscillometry

Impulse oscillometry (IOS) is a method for measuring respiratory impedance based on the forced oscillation technique (FOT). The IOS measurement requires only quiet tidal breathing, which is simple, suitable for a wide range of people and provides various respiratory physiological parameters. For promoting the standardization and clinical application of IOS measurement in China, based on the relevant research evidence and the updated technical standards by European Respiratory Society, this article provided a brief introduction to the background of IOS technique and the current situation of its clinical application in China, as well as the recommendations and interpretations on the indications and contraindications, device calibration, testing protocols, quality control requirements including acceptability and repeatability criteria, measurement parameters and graphs, testing results interpretation, references values and normal limits, report template, clinical application including assessment of airway patency, airway reversibility and responsiveness, small airway function and so on. It also offered recommendations on the relevant thresholds of diagnosis and evaluation.

Breathing patterns and CO2 production in adult spiny mice (Acomys cahirinus)

The spiny mouse (Acomys) is a precocial mammal with unique regenerative abilities. We used whole-body plethysmography to describe the breathing patterns and CO2 production (VCO2) of adult spiny mice (n = 10 male, 10 female) and C57BL/6 mice (n = 9 male, 11 female). During quiet breathing, female but not male spiny mice had lower tidal volumes and CO2 production vs. C57BL/6 mice. During extended hypoxia (30 min), male and female spiny mice decreased VCO2 and tidal volume to a greater degree than C57BL/6 mice. During an acute hypoxic-hypercapnic respiratory challenge (10% O2, 7% CO2), male and female spiny mice had blunted ventilatory responses as compared to C57BL/6 mice, primarily from a diminished increase in respiratory rate. These data establish a baseline for studies of respiratory physiology and neurobiology in spiny mice in the context of their remarkable regenerative capacity and their unique background of a desert dwelling species.

Chest Drainage Therapy: What Comes out of Pandora's Box Can Affect Patient Outcomes.

Background: Over the last 100 years, the original three-bottle chest drainage system has been variously engineered into compact disposables and electronic units. Clinicians are now surrounded by a plethora of different types of systems, but little is known about the way that they work and perform. Thus, we sought to test the performance of the most commonly used chest drainage units under conditions that are relevant to clinical practice. Methods: A pleural space environment simulator was built. Thirty-two units were tested under four clinical scenarios: air leak interpretation during quiet breathing and after obstructed inspiration (−5 to −150 cmH2O), a buildup of negative pressure (−100 cmH2O), a bronchopleural fistula (10 L/min) and the need for effective external suction in the presence of air leakage. Twenty-five units were “traditional” thoracic drainages, five were “digital” low-flow/low-vacuum pumps and two were hybrids (a combination of the two). According to the design of the seal and of the suction control, the units were classified as wet-wet, wet-dry and dry-dry. Results: All wet units showed reverse air flow, with the potential to mimic an air leak when there was none. Ten wet units showed no automatic negative pressure relief features, while five dry-dry did but were slow to react. Ten wet and five dry-dry units showed no capability to handle a 10 L/min leak, as they were restrictive to flow (peak pressure up to 55 cmH2O). Only seven dry-suction units were able to maintain the set suction at high airflow rates (>20 L/min). Conclusions: Different chest drainage unit designs lead to different performances, some of which may negatively impact patient outcomes. This sounds the call to tailor our clinical practice for the individual patient. A paradigm shift to better understand all components of pleural physiology post-surgical intervention on this relatively neglected topic is needed to improve our daily practice.

Respiratory-Induced Amplitude Modulation of Forcecardiography Signals.

Forcecardiography (FCG) is a novel technique that records the weak forces induced on the chest wall by cardio-respiratory activity, by using specific force sensors. FCG sensors feature a wide frequency band, which allows us to capture respiration, heart wall motion, heart valves opening and closing (similar to the Seismocardiogram, SCG) and heart sounds, all simultaneously from a single contact point on the chest. As a result, the raw FCG sensors signals exhibit a large component related to the respiratory activity, referred to as a Forcerespirogram (FRG), with a much smaller, superimposed component related to the cardiac activity (the actual FCG) that contains both infrasonic vibrations, referred to as LF-FCG and HF-FCG, and heart sounds. Although respiration can be readily monitored by extracting the very low-frequency component of the raw FCG signal (FRG), it has been observed that the respiratory activity also influences other FCG components, particularly causing amplitude modulations (AM). This preliminary study aimed to assess the consistency of the amplitude modulations of the LF-FCG and HF-FCG signals within the respiratory cycle. A retrospective analysis was performed on the FCG signals acquired in a previous study on six healthy subjects at rest, during quiet breathing. To this aim, the AM of LF-FCG and HF-FCG were first extracted via a linear envelope (LE) operation, consisting of rectification followed by low-pass filtering; then, the inspiratory peaks were located both in the LE of LF-FCG and HF-FCG, and in the reference respiratory signal (FRG). Finally, the inter-breath intervals were extracted from the obtained inspiratory peaks, and further analyzed via statistical analyses. The AM of HF-FCG exhibited higher consistency within the respiratory cycle, as compared to the LF-FCG. Indeed, the inspiratory peaks were recognized with a sensitivity and positive predictive value (PPV) in excess of 99% in the LE of HF-FCG, and with a sensitivity and PPV of 96.7% and 92.6%, respectively, in the LE of LF-FCG. In addition, the inter-breath intervals estimated from the HF-FCG scored a higher R2 value (0.95 vs. 0.86) and lower limits of agreement (± 0.710 s vs. ±1.34 s) as compared to LF-FCG, by considering those extracted from the FRG as the reference. The obtained results are consistent with those observed in previous studies on SCG. A possible explanation of these results was discussed. However, the preliminary results obtained in this study must be confirmed on a larger cohort of subjects and in different experimental conditions.

An alternative method for measuring total respiratory resistance during quiet breathing: a feasibility and validation study.

Determining the respiratory system's mechanical properties with minimal patient effort has been an important field of investigation addressing patients unable to perform pulmonary function testing and in light of the preventive measures due to the recent pandemic. The current study aimed to present an alternative method for total respiratory resistance measurement during tidal breathing, compare it with airway resistance (Raw), measured by body plethysmography, and validate the procedure in three groups of subjects with normal, constrictive and obstructive respiratory patterns in spirometry. We developed an alternative method of assessing total respiratory resistance during quiet breathing. After manufacturing the appropriate hardware apparatus, we applied a steady extrinsic resistance (ΔR) for 100-200 m/s during tidal breathing. Α theoretical mathematical model allowed measurement of total respiratory resistance (Rtot) during inspiration (Rin) and expiration (Rex). To validate the method, 15 individuals were enrolled and assigned to the normal, obstructive and restrictive groups based on their spirometry patterns. All groups participated in two sets of measurements, the plethysmographic and novel method. Finally, respiratory resistance measurements were compared between groups and methods. The method was successfully developed, and Rtot measurements were recorded in five normal subjects and in five obstructive and restrictive subjects. Mean Rin and mean Rex were 4.99 cm H2O/L/sec and 4.42 cm H2O/L/sec in the healthy, 4.87 cm H2O/L/sec, and 6.63 cm H2O/L/sec in the obstructive and 5.97 cm H2O/L/sec and 4.12 cm H2O/L/sec in the restrictive group, respectively. Rex was notably higher than Rin in the obstructive group and was positively correlated with Raw (p<0.005, r=0.47). This method provides the theoretical background for a plausible alternative tool for accessing a mechanical parameter of the respiratory system, which is easy to perform and requires only passive patient cooperation while enabling rough differentiation between obstructive and restrictive disorders. The model's feasibility potential in a real-life setting was studied in a small sample, and additional implementation and validation of the method in a larger population are guaranteed.

Quantification of Respirable Aerosol Particles from Speech and Language Therapy Exercises

Voice assessment and treatment involve the manipulation of all the subsystems of voice production, and may lead to production of respirable aerosol particles that pose a greater risk of potential viral transmission via inhalation of respirable pathogens (eg, SARS-CoV-2) than quiet breathing or conversational speech. To characterise the production of respirable aerosol particles during a selection of voice assessment therapy tasks. We recruited 23 healthy adult participants (12 males, 11 females), 11 of whom were speech-language pathologists specialising in voice disorders. We used an aerodynamic and an optical particle sizer to measure the number concentration and particle size distributions of respirable aerosols generated during a variety of voice assessment and therapy tasks. The measurements were carried out in a laminar flow operating theatre, with a near-zero background aerosol concentration, allowing us to quantify the number concentration and size distributions of respirable aerosol particles produced from assessment/therapy tasks studied. Aerosol number concentrations generated while performing assessment/therapy tasks were log-normally distributed among individuals with no significant differences between professionals (speech-language pathologists) and non-professionals or between males and females. Activities produced up to 32 times the aerosol number concentration of breathing and 24 times that of speech at 70-80 dBA. In terms of aerosol mass, activities produced up to 163 times the mass concentration of breathing and up to 36 times the mass concentration of speech. Voicing was a significant factor in aerosol production; aerosol number/mass concentrations generated during the voiced activities were 1.1-5 times higher than their unvoiced counterpart activities. Additionally, voiced activities produced bigger respirable aerosol particles than their unvoiced variants except the trills. Humming generated higher aerosol concentrations than sustained /a/, fricatives, speaking (70-80 dBA), and breathing. Oscillatory semi-occluded vocal tract exercises (SOVTEs) generated higher aerosol number/mass concentrations than the activities without oscillation. Water resistance therapy (WRT) generated the most aerosol of all activities, ∼10 times higher than speaking at 70-80 dBA and >30 times higher than breathing. All activities generated more aerosol than breathing, although a sizeable minority were no different to speaking. Larger number concentrations and larger particle sizes appear to be generated by activities with higher suspected airflows, with the greatest involving intraoral pressure oscillation and/or an oscillating oral articulation (WRT or trilling).

Relationships between diaphragm ultrasound, spirometry, and respiratory mouth pressures in children

Diaphragm ultrasound (DUS) is a noninvasive method of evaluating the diaphragm’s structure and function. This study explored the relationships between DUS, spirometry, and respiratory mouth pressures in 10 healthy children (median age: 11 [range: 7–14 years]; 5 females, 5 males). Thickening fraction correlated with maximal inspiratory pressure (MIP) (Spearman’s rho [rs] = 0.64, p = 0.05). During quiet breaths, excursion time correlated with MIP (rs = 0.78, p = 0.01) while velocity correlated with maximal expiratory pressure (rs = −0.82, p = 0.01). During deep breaths, MIP correlated with excursion (rs = 0.64, p = 0.05) and time (rs = 0.87, p = 0.01). Excursion time during deep breaths also correlated with forced vital capacity (rs = 0.65, p = 0.04). Our findings suggest that DUS parameters are closely related to spirometry and respiratory mouth pressures in healthy children and further support the use of DUS as a noninvasive method of respiratory assessment.

Assessment of Diaphragm in Hemiplegic Patients after Stroke with Ultrasound and Its Correlation of Extremity Motor and Balance Function.

Background: A variety of functional disorders can be caused after stroke, among which impairment of respiratory function is a frequent and serious complication of stroke patients. The aim of this study was to examine diaphragmatic function after stroke by diaphragm ultrasonography and then to apply to explore its correlation with extremity motor function and balance function of the hemiplegia patients. Methods: This cross-sectional observational study recruited 48 hemiplegic patients after stroke and 20 matched healthy participants. The data of demographic and ultrasonographic assessment of all healthy subjects were recorded, and 45 patients successfully underwent baseline data assessment in the first 48 h following admission, including post-stroke duration, stroke type, hemiplegia side, pipeline feeding, pulmonary infection, ultrasonographic assessment for diaphragm, Fugl–Meyer Motor Function Assessment Scale (FMA Scale), and Berg Balance Scale assessment. Ultrasonographic assessment parameters included diaphragm mobility under quiet and deep breathing, diaphragm thickness at end-inspiratory and end-expiratory, and calculated thickening fraction of the diaphragm. The aim was to analyze the diaphragm function of hemiplegic patients after stroke and to explore its correlation with extremity motor function and balance function. Results: The incidence of diaphragmatic dysfunction under deep breath was 46.67% in 45 hemiplegia patients after stroke at the convalescent phase. The paralyzed hemidiaphragm had major impairments, and the mobility of the hemiplegic diaphragm was significantly reduced during deep breathing (p < 0.05). Moreover, the thickness fraction of hemiplegic side was extremely diminished when contrasted with the healthy control and non-hemiplegic side (p < 0.05). We respectively compared the diaphragm mobility under deep breath on the hemiplegic and non-hemiplegic side of patients with left and right hemiplegia and found there was no significant difference between the hemiplegic side of right and left hemiplegia (p > 0.05), but the non-hemiplegic side of right hemiplegia was significantly weaker than that of left hemiplegia patients (p < 0.05). The diaphragm mobility of stroke patients under quiet breath was positively correlated with age and FMA Scale score (R2 = 0.296, p < 0.05), and significant positive correlations were found between the diaphragm mobility under deep breath and Berg Balance Scale score (R2 = 0.11, p < 0.05), diaphragm thickness at end-inspiratory and FMA Scale score (R2 = 0.152, p < 0.05), and end-expiratory thickness and FMA Scale score (R2 = 0.204, p < 0.05). Conclusions: The mobility and thickness fraction of the hemiplegic diaphragm after stroke by diaphragm ultrasonography were significantly reduced during deep breathing. Diaphragm mobility on bilateral sides of the right hemiplegia patients were reduced during deep breathing. Moreover, the hemiplegic diaphragmatic function was positively correlated with extremity motor and balance function of the hemiplegia patients.

Combined head accelerometry and EEG improves the detection of respiratory-related cortical activity during inspiratory loading in healthy participants.

Mechanical ventilation is a highly utilized life‐saving tool, particularly in the current era. The use of EEG in a brain–ventilator interface (BVI) to detect respiratory discomfort (due to sub‐optimal ventilator settings) would improve treatment in mechanically ventilated patients. This concept has been realized via development of an EEG covariance‐based classifier that detects respiratory‐related cortical activity associated with respiratory discomfort. The aim of this study was to determine if head movement, detected by an accelerometer, can detect and/or improve the detection of respiratory‐related cortical activity compared to EEG alone. In 25 healthy participants, EEG and acceleration of the head were recorded during loaded and quiet breathing in the seated and lying postures. Detection of respiratory‐related cortical activity using an EEG covariance‐based classifier was improved by inclusion of data from an Accelerometer‐based classifier, i.e. classifier ‘Fusion’. In addition, ‘smoothed’ data over 50s, rather than one 5 s window of EEG/Accelerometer signals, improved detection. Waveform averages of EEG and head acceleration showed the incidence of pre‐inspiratory potentials did not differ between loaded and quiet breathing, but head movement was greater in loaded breathing. This study confirms that compared to event‐related analysis with >5 min of signal acquisition, an EEG‐based classifier is a clinically valuable tool with rapid processing, detection times, and accuracy. Data smoothing would introduce a small delay (<1 min) but improves detection results. As head acceleration improved detection compared to EEG alone, the number of EEG signals required to detect respiratory discomfort with future BVIs could be reduced if head acceleration is included.

Functional state of the diaphragm in patients with cervical spinal cord injury at the stages of respiratory support

Objective. To analyze the role of the functional state of the diaphragm in patients with cervical spinal cord injury at the stages of respiratory support and to substantiate additional criteria for their readiness to transfer to spontaneous breathing.Material and Methods. The state of the diaphragm was assessed by ultrasound in 24 patients with spinal cord injury. The excursion of the diaphragm during quiet breathing, the excursion and thickness of the diaphragm during forced breathing, and the change in forced expiratory volume from the moment of admission till the end of mechanical ventilation were analyzed.Results. On the first day, on the background of mechanical ventilation, there was a significant decrease in the excursion and thickness of the diaphragm during forced breathing (p = 0.002; p = 0.008) which persisted up to 3 days (p &lt; 0.001; p &lt; 0.001); by the fifth day of mechanical ventilation, the indicators increased to the initial levels (p = 0.112; p = 0.433); and by the 10th day they exceeded the initial values (p &lt; 0.001). When comparing the excursion and thickness of the diaphragm during the transfer of patients to spontaneous breathing with the data on their admission, a significant difference was obtained (p &lt; 0.001; p &lt; 0.001). The dynamics of forced expiratory volume indicators was similar to those of diaphragm excursion during forced breathing.Conclusion. A peculiarity of the functional state of the diaphragm in patients with cervical spinal cord injury in the acute period was a significant decrease in diaphragm excursion and the development of ventilator-induced diaphragm dysfunction (VIDD) associated with mechanical ventilation in replacement modes. The tactics of early tracheostomy and the use of auxiliary ventilation modes determined the absence of progression of VIDD during prolonged mechanical ventilation. The presence of a strong correlation between the diaphragm excursion during forced breathing and the forced expiratory volume allows concluding that these indicators can be additional objective criteria for the readiness of patients with cervical SC injury to transfer to spontaneous breathing, since they reflect not only the functional state of the diaphragm, but also the state of the lung tissue.

Volumes da parede torácica, mobilidade diafragmática e capacidade funcional em pacientes com mucopolissacaridoses

Purpose We investigated respiratory muscle strength, diaphragm mobility, lung function, functional capacity, quality of life, body composition, breathing pattern, and chest wall (V T,CW) and compartmental volumes of Mucopolysaccharidosis (MPS) patients and compared these variables with matched healthy individuals. Methods A cross-sectional study with data analyzed separately according to age group. A total of 68 individuals (34 MPS and 34 matched-healthy subjects) were included. Six-minute walking test assessed functional capacity and ultrasound assessed diaphragm mobility during quiet spontaneous breathing (QB). Optoelectronic plethysmography assessed V T,CW and breathing pattern during QB in two different positions: seated and supine (45° trunk inclination). Results Body composition, lung function, respiratory muscle strength, and functional capacity were reduced in MPS (all p < 0.01). Diaphragm mobility was only reduced in adolescents (p = 0.01) and correlated with body composition and breathing pattern. Upper chest wall compartmental volumes were significantly lower in MPS, while abdominal volume only differed significantly in adolescents. Percentage contribution (%) of upper ribcage compartments to tidal volume was reduced in MPS children, whereas %AB was significantly increased compared with healthy subjects. Conclusion Lung function, respiratory muscle strength, functional capacity, diaphragm mobility, and quality of life are reduced in MPS compared with matched healthy subjects. V T,CW was mainly reduced due to pulmonary and abdominal ribcage impairment. Implications for Rehabilitation Reduction in respiratory muscle strength, functional capacity, diaphragm excursion and low lung volumes were found in individuals with Mucopolysaccharidoses (MPS). Chest wall volumes and the upper chest wall compartmental volumes during quiet spontaneous breathing are reduced in MPS. Assessment and monitoring of the respiratory system for individuals with MPS should be performed periodically through standardized assessments to enable identification of changes and early intervention by rehabilitation protocols. This study may provide the necessary basis for carrying out respiratoty rehabilitation protocols that can improving chest wall mechanics with breathing exercise in this group.

Bilateral analysis of pranayama and meditation on selected psychological variable among working men

The purpose of the present study was to investigate the combined quiet breathing pranayama and meditation practices on self confidence among working men. To achieve the purpose of the study thirty working men were selected from Karaikudi, Tamilnadu, India during the year 2022. The subject’s age ranges from 35 to 45 years. The selected subjects were randomly divided into two equal groups consists of 15 men each namely experimental group and control group. The experimental group underwent a combined quiet breathing pranayama and meditation practices programme for six weeks. The control group was not taking part in any training during the course of the study. Self confidence was taken as criterion variable in this study. The selected subjects were tested on Self confidence was measured through Vealy’s trait sports confidence inventory (TSCI) assessment. Pre-test was taken before the training period and post- test was measured immediately after the six week training period. Statistical technique ‘t’ ratio was used to analyse the means of the pre-test and post test data of experimental group and control group. The results revealed that there was a significant difference found on the criterion variable.