Measurement of Cough Aerodynamics in Healthy Adults

Importance: Cough is a critical human reflex and also among the most frequent symptoms in medicine. Despite the prevalence of disordered cough in laryngeal pathologies, comprehensive and quantitative evaluation of cough in these patients is lacking. Objective: Herein we seek to establish normative values for cough aerodynamics to provide a population standard for reference in future studies. Design, Setting, and Participants: Healthy subjects were recruited from an outpatient clinic to perform voluntary cough. Subjects were instructed on the technique for maximal voluntary cough production with measurements recorded on pneumotachograph. Fifty-two subjects were studied, including 29 women and 23 men with a mean age of 51.6 and 52.3 years, respectively. Main Outcomes and Measures: Cough peak airflow, peak pressure, and expiratory rise time. Results were stratified by age, gender, and height. Results: Peak airflow demonstrated significant differences across age, gender, and height, with flow increasing according to increasing height. Peak cough pressure also increased with height and was significantly greater in males versus females. Expiratory rise time, the time from glottal opening to peak airflow, did not vary with age or height but was statistically significantly longer in women. Conclusions: Cough aerodynamics can be readily measured objectively in the outpatient setting. Expiratory rise time, peak flow, and peak pressure are important aspects of each cough epoch. Normative data provided herein can be used for future studies of patients with laryngotracheal disorders, and these cough parameters may prove to be simple, accessible, and repeatable outcome measures.

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The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS): Validation in Arabic and Lebanese Normative Values

Journal of the International Neuropsychological Society ◽

10.1017/s1355617721000102 ◽

2021 ◽

pp. 1-10

Author(s):

Hala Darwish ◽

Pia Zeinoun ◽

Natali Farran ◽

Husam Ghusn ◽

Bassem Yamout ◽

...

Keyword(s):

Multiple Sclerosis ◽

Psychometric Properties ◽

Cognitive Assessment ◽

Healthy Subjects ◽

Good Evidence ◽

Normative Values ◽

Arabic Version ◽

Retest Reliability ◽

Test Retest Reliability ◽

Healthy Participants

Abstract Objective: Multiple sclerosis (MS) is often associated with cognitive deficits. Accurate evaluation of the MS patients’ cognitive performance is essential for diagnosis and treatment recommendation. The Brief International Cognitive Assessment in Multiple Sclerosis (BICAMS), widely used cognitive testing battery, examines processing speed, verbal and visuospatial learning, and memory. Our study aims to examine the psychometric properties of an Arabic version of the BICAMS and to provide normative values in a Lebanese sample. Method: The BICAMS, comprised of the Symbol Digit Modalities Test (SDMT), Brief Visuospatial Memory Test-Revised (BVMT-R), and a newly developed verbal learning/memory test, the Verbal Memory Arabic Test (VMAT), were administered on healthy subjects and MS patients. The sample consisted of 180 healthy individuals, of whom 63 were retested after 2–3 weeks. Forty-three MS patients matched with 43 healthy subjects based on age, sex, and years of education were assessed. A sample of 10 MS patients was also examined on two occasions. Test–retest reliability and criterion-related validity were examined, and regression-based norms were derived. Results: The test–retest correlations showed good evidence of reliability with coefficients ranging between 0.64 and 0.73 in the healthy sample, and between 0.43 and 0.92 in the MS sample. The BICAMS was able to discriminate between MS patients and matched healthy participants on the SDMT and BVMT-R. Normative data were comparable to other studies. Conclusions: This new Arabic version of the BICAMS shows initial good psychometric properties. While good evidence of VMAT’s reliability was shown in the healthy participants, less test–retest reliability in this tool was seen in the MS group, and partial criterion-related validity was evident. This renders further examination of the VMAT. We provide regression-based norms for a Lebanese sample and encourage the use of this battery in both research and clinical settings.

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Normative data for parameters of sagittal spinal alignment in healthy subjects: an analysis of gender specific differences and changes with aging in 626 asymptomatic individuals

European Spine Journal ◽

10.1007/s00586-016-4807-7 ◽

2016 ◽

Vol 27 (2) ◽

pp. 426-432 ◽

Cited By ~ 32

Author(s):

Yasutsugu Yukawa ◽

Fumihiko Kato ◽

Kota Suda ◽

Masatsune Yamagata ◽

Takayoshi Ueta ◽

...

Keyword(s):

Healthy Subjects ◽

Normative Data ◽

Spinal Alignment ◽

Sagittal Spinal Alignment ◽

Gender Specific Differences ◽

Asymptomatic Individuals ◽

Gender Specific

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Accuracy of Anthropometric Measurements: Past, Present, and Future

The Cleft Palate-Craniofacial Journal ◽

10.1597/1545-1569_1996_033_0010_aoampp_2.3.co_2 ◽

1996 ◽

Vol 33 (1) ◽

pp. 10-22 ◽

Cited By ~ 26

Author(s):

Leslie G. Farkas

Keyword(s):

Clinical Practice ◽

Healthy Subjects ◽

Normative Data ◽

Population Sample ◽

Anthropometric Measurements ◽

Anthropometric Measurement ◽

Cross Sectional ◽

Relative Validity ◽

Factors Influencing ◽

Cross Sectional Studies

Experience, based on anthropometric examination of over 1000 children with facial syndromes and more than 2400 healthy subjects of both sexes and various ages, has led me to diverge in some points from the more usual views found in the physical anthropologic literature. The purpose of this paper is to discuss the major controversial topics associated with anthropometric measurement. These include the problems associated with formation of a representative population sample, the relative validity of longitudinal and cross-sectional studies, the interpretation of intraobserver and interobserver testings, and the questionable judgments of mensurative skill in clinical practice. The factors influencing the accuracy of anthropometric measurements, definitions of both the consistent and less reliable measurements, and the duration of validity of anthropometric normative data are also discussed.

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Time sequential prediction of ventricular-vascular interactions

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.1986.251.6.h1341 ◽

1986 ◽

Vol 251 (6) ◽

pp. H1341-H1353 ◽

Cited By ~ 1

Author(s):

T. W. Latson ◽

W. C. Hunter ◽

D. Burkhoff ◽

K. Sagawa

Keyword(s):

Peak Pressure ◽

Peak Flow ◽

Impulse Response Function ◽

Internal Resistance ◽

Arterial System ◽

Analytical Technique ◽

Sequential Prediction ◽

Loading Effects ◽

Instantaneous Pressure

A new analytical method (sequential convolution) for describing ventricular-vascular interactions was used to predict instantaneous pressure and flow in four isolated canine left ventricles ejecting into a computer-simulated arterial system. Ventricular pumping ability was described by a load-independent elastance, [E*(t)] combined with a ventricular internal resistance. “Arterial” properties were characterized using a time-based impulse response function that is derived from impedance measurements. Sequential convolution was then used to couple these independent descriptions of ventricular and vascular properties. Predicted pressure-volume trajectories, as well as instantaneous pressures and flows, closely matched the experimental data. Stroke volume, peak pressure, and peak flow were typically within 5% of measured values. This method provides a powerful analytical technique for examining ventricular-vascular interactions and has potential application in evaluating the ventricular-loading effects of more complex in vivo vascular properties.

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Detection of Pepsin in Oral Secretions of Infants with and without Laryngomalacia

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489419884332 ◽

2019 ◽

Vol 129 (3) ◽

pp. 224-229 ◽

Cited By ~ 1

Author(s):

Miles J. Klimara ◽

Tina L. Samuels ◽

Nikki Johnston ◽

Robert H. Chun ◽

Michael E. McCormick

Keyword(s):

Surgical Management ◽

Laryngopharyngeal Reflux ◽

Operative Management ◽

Outpatient Setting ◽

Oral Secretion ◽

Oral Secretions ◽

Common Cause ◽

Future Studies ◽

Flexible Laryngoscopy ◽

Noninvasive Marker

Objectives: Laryngomalacia is a common cause of stridor in infants and is associated with laryngopharyngeal reflux (LPR). Although pepsin in operative supraglottic lavage specimens is associated with severe laryngomalacia, detection of pepsin in oral secretions has not been demonstrated in an outpatient setting. Methods: Children <2 years old with laryngomalacia diagnosed by flexible laryngoscopy and children without stridor were selected. Oral secretion samples were obtained in clinic from all subjects. Pepsin, IL-1β, and IL-8 enzyme-linked immunosorbent assays were performed to determine presence of LPR. Results: Sixteen laryngomalacia and sixteen controls were enrolled. Pepsin was detected more frequently in oral secretions of patients with laryngomalacia (13/16) than in controls (2/16; P < .001). Four patients with laryngomalacia developed symptoms requiring supraglottoplasty. Presence and level of salivary pepsin was not significantly associated with need for surgical management, nor were the levels or presence of IL-1β or IL-8 significantly associated with presence or level of pepsin, diagnosis of laryngomalacia, or need for operative management. Conclusion: Pepsin in saliva appears to be associated with laryngomalacia, suggesting a role for salivary pepsin as a noninvasive marker of LPR in patients with laryngomalacia. Future studies will determine the utility of this test in laryngomalacia.

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Measures of dynamic balance during level walking in healthy adult subjects: Relationship with age, anthropometry and spatio-temporal gait parameters

Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine ◽

10.1177/0954411919889237 ◽

2019 ◽

Vol 234 (2) ◽

pp. 131-140 ◽

Cited By ~ 1

Author(s):

Tiziana Lencioni ◽

Ilaria Carpinella ◽

Marco Rabuffetti ◽

Davide Cattaneo ◽

Maurizio Ferrarin

Keyword(s):

Motor Control ◽

Body Mass ◽

Healthy Subjects ◽

Normative Data ◽

Dynamic Balance ◽

Frontal Plane ◽

The Body ◽

Heel Strike ◽

Gait Parameters ◽

Spatio Temporal

The maintenance of balance in dynamic conditions (e.g. during walking) is a necessary requirement that motor control must reach to avoid falls. However, this is a challenging situation, since to ensure the forward progression of the body, the center of mass must stay outside the base of support in the sagittal plane, and simultaneously remain inside the lateral borders in the frontal plane. Deviation from normative data of healthy subjects in dynamic balance could be used to quantify gait stability, fall risk and to provide hints for rehabilitation. However, normative data can be influenced by age, sex, anthropometry and spatio-temporal gait parameters, and such differences among subjects and leg side can hamper accurate assessment. The aims of this study were to investigate, in a group of healthy subjects: (1) possible asymmetry in dynamic balance maintenance strategies between leg sides, (2) the influence of age, sex and anthropometry on stability and (3) its dependence by spatio-temporal gait parameters. A total of 34 healthy subjects aged between 21 and 71 years, and ranging from 50.1 to 101.6 kg of body mass and from 155.0 to 188.9 cm of height were assessed on spatio-temporal and dynamic balance parameters (Foot Placement Estimator at heel strike and Margin of Stability at mid-stance) during self-selected gait. No parameter showed differences between legs. Dynamic balance parameters were influenced by sex, age, body mass and height mainly in the frontal plane. These measures were also correlated with gait speed and stride length both in the antero-posterior and medio-lateral directions. In addition also cadence and step width influenced the stability in the sagittal and frontal planes, respectively. The findings of this study confirm the symmetry in motor control of dynamic balance during self-selected gait in healthy subjects. Sex, anthropometry and spatio-temporal gait parameters have a significant effect on stability parameters, and this should be taken into account in dynamic balance studies.

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Maximum Performance Tests of Speech Production

Journal of Speech and Hearing Disorders ◽

10.1044/jshd.5204.367 ◽

1987 ◽

Vol 52 (4) ◽

pp. 367-387 ◽

Cited By ~ 219

Author(s):

Ray D. Kent ◽

Jane F. Kent ◽

John C. Rosenbek

Keyword(s):

Speech Production ◽

Normative Data ◽

Normative Values ◽

Clinical Neurology ◽

Performance Tests ◽

Maximum Performance ◽

Assessment Protocol ◽

Maximum Duration ◽

Upper Limits ◽

Maximum Expiratory Pressure

The maximum performance tests of speech production are those tests that examine the upper limits of performance for selected speech tasks. Among the most commonly used maximum performance tests are the following: maximum duration of phonation, maximum fricative duration, maximum phonation volume, maximum expiratory pressure, fundamental frequency range, maximum sound pressure level, maximum occluding force of the articulators, and diadochokinetic (maximum repetition) rate. Many clinicians use at least some of these tasks as part of an assessment protocol. These tests are analogous to strength, range, or speed tests in clinical neurology. Given the widespread use of these tests and a rather scattered literature on normative values obtained for them, a survey of the data base seemed in order. This paper summarizes the published normative data, discusses the adequacy of these data for clinical application, and recommends interpretive guidelines to enhance the usefulness of maximum performance tests.

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Day-to-Day Consistency of Lower Extremity Kinematics during Walking and Running

Journal of Applied Biomechanics ◽

10.1123/jab.25.4.369 ◽

2009 ◽

Vol 25 (4) ◽

pp. 369-376 ◽

Cited By ~ 16

Author(s):

Peter Wolf ◽

Renate List ◽

Thomas Ukelo ◽

Christian Maiwald ◽

Alex Stacoff

Keyword(s):

Lower Extremity ◽

Gait Analysis ◽

Healthy Subjects ◽

Human Gait ◽

Future Studies ◽

Almost All

Before conclusions can be drawn with respect to the quality of adaptations in human gait, the day-to-day consistency of the variables of interest must be known. The present study estimated the day-to-day consistency of kinematic variables collected during barefoot walking and running. Sixteen healthy subjects performed two gait analysis sessions based on skin markers. Test sessions were at least 1 week apart. In total, 48 ranges of motion were monitored for the hip, knee, ankle, and midfoot joint. Based on differences between the repeated gait analysis sessions, the day-to-day consistency was estimated. It was found that the day-to-day consistency was of the magnitude of 3 to 4 degrees for almost all ranges of motion independently of the test condition, the investigated joints, or the cardinal body plane. It was concluded that future studies on effects of interventions or on the characterization of pathological versus normative gait should consider the provided values of day-to-day consistency to improve their interpretation and conclusions.

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Clinical and immunological analysis of measles patients admitted to a Beijing hospital in 2014 during an outbreak in China

Epidemiology and Infection ◽

10.1017/s0950268816001114 ◽

2016 ◽

Vol 144 (12) ◽

pp. 2613-2620 ◽

Cited By ~ 3

Author(s):

B. TU ◽

J.-J. ZHAO ◽

Y. HU ◽

J.-L. FU ◽

H-H. HUANG ◽

...

Keyword(s):

Liver Injury ◽

Healthy Subjects ◽

Measles Virus ◽

Military Hospital ◽

Future Studies ◽

Immunological Markers ◽

Age Related ◽

Significant Independent Risk Factor ◽

Measles Outbreak ◽

Related Distribution

SUMMARYAt the end of 2013, China reported a countrywide outbreak of measles. From January to May 2014, we investigated the clinical and immunological features of the cases of the outbreak admitted to our hospital. In this study, all 112 inpatients with clinically diagnosed measles were recruited from the 302 Military Hospital of China. The virus was isolated from throat swabs from these patients, and cytokine profiles were examined. By detecting the measles virus of 30 of the 112 patients, we found that this measles outbreak was of the H1 genotype, which is the major strain in China. The rates of complications, specifically pneumonia and liver injury, differed significantly in patients aged <8 months, 8 months to 18 years, and >18 years: pneumonia was more common in children, while liver injury was more common in adults. Pneumonia was a significant independent risk factor affecting measles duration. Compared to healthy subjects, measles patients had fewer CD4+IL-17+, CD4+IFN-γ+, and CD8+IFN-γ+ cells in both the acute and recovery phases. In contrast, measles patients in the acute phase had more CD8+IL-22+ cells than those in recovery or healthy subjects. We recommend that future studies focus on the age-related distribution of pneumonia and liver injury as measles-related complications as well as the association between immunological markers and measles prognosis.

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