The effect of brace treatment on pulmonary functions in adolescent idiopathic scoliosis: An 8-month follow-up study

2021 ◽  
pp. 1-7
Author(s):  
Yasin Yurt ◽  
İlker Yatar ◽  
Mehtap Malkoç ◽  
Yavuz Yakut ◽  
Serpil Mıhçıoğlu ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Pulmonary Functions ◽  
Measurement Results ◽  
Forced Expiratory Flow ◽  
Permanent Effect ◽  
Expiratory Flow

BACKGROUND: The instant effect of a brace on pulmonary functions of patients with adolescent idiopathic scoliosis (AIS) is known. However, the permanent effects of its regular use are still unclear. OBJECTIVE: This study aimed to determine whether a brace in patients with AIS had a permanent effect on respiratory functions. METHODS: Fifteen patients with a mean age of 13.2 ± 1.6 years, and a major Cobb angle of 25.8∘± 7.7∘ participated in this study. Lung volumes and respiratory muscle strength were measured with and without thoracolumbosacral brace, at the end of first month and follow-up period after the patients started using the brace for 23 hours daily. RESULTS: When the brace was on, the forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), ratio of FEV1/FVC, peak expiratory flow, and forced expiratory flow between 25% and 75% of vital capacity values were found to be lower at both first month and follow-up. After the follow-up, the measurement results did not differ from the results of the first month. CONCLUSIONS: The brace had a momentary restrictive effect on patients with AIS. However, it did not cause a permanent change in pulmonary functions after the 8-month follow-up.

In-brace alterations of pulmonary functions in adolescents wearing a brace for idiopathic scoliosis

2019 ◽  
Vol 43 (4) ◽  
pp. 434-439 ◽  
Author(s):  
Gozde Yagci ◽  
Gokhan Demirkiran ◽  
Yavuz Yakut
Keyword(s):  
Idiopathic Scoliosis ◽  
Pulmonary Function ◽  
Peak Expiratory Flow ◽  
Forced Vital Capacity ◽  
Respiratory Muscle ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Pulmonary Functions ◽  
Significant Difference ◽  
Expiratory Flow

Background:Despite the common use of braces to prevent curve progression in idiopathic scoliosis, their functional effects on respiratory mechanics have not been widely studied.Objective:The objective was to determine the effects of bracing on pulmonary function in idiopathic scoliosis.Methods:A total of 27 adolescents with a mean age of 14.5 ± 1.5 years and idiopathic scoliosis were included in the study. Pulmonary function evaluation included vital capacity, forced expiratory volume, forced vital capacity, maximum ventilator volume, peak expiratory flow, and respiratory muscle strengths, measured with a spirometer, and patient-reported degree of dyspnea. The tests were performed once prior to bracing and at 1 month after bracing (while the patients wore the brace).Results:Compared with the unbraced condition, vital capacity, forced expiratory volume, forced vital capacity, maximum ventilator volume, and peak expiratory flow values decreased and dyspnea increased in the braced condition. Respiratory muscle strength was under the norm in both unbraced and braced conditions, while no significant difference was found for these parameters between the two conditions.Conclusion:The spinal brace for idiopathic scoliosis tended to reduce pulmonary functions and increase dyspnea symptoms (when wearing a brace) in this study. Special attention should be paid in-brace effects on pulmonary functions in idiopathic scoliosis.Clinical relevanceBracing seems to mimic restrictive pulmonary disease, although there is no actual disease when the brace is removed. This study suggests that bracing may result in a deterioration of pulmonary function when adolescents with idiopathic scoliosis are wearing a brace.

scholarly journals Small Airway Dysfunction in Cough Variant Asthma: Prevalence, Clinical, and Pathophysiological Features

2022 ◽  
Vol 12 ◽  
Author(s):  
Fang Yi ◽  
Ziyu Jiang ◽  
Hu Li ◽  
Chunxing Guo ◽  
Hankun Lu ◽  
...  
Keyword(s):  
Airway Inflammation ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Small Airway ◽  
Asthma Prevalence ◽  
Cough Variant Asthma ◽  
Forced Expiratory Flow ◽  
Sputum Eosinophils ◽  
Expiratory Flow

Introduction: Small airway dysfunction (SAD) commonly presents in patients with classic asthma, which is associated with airway inflammation, disease severity, and asthma control. However, the prevalence of SAD, its relationship with cough severity and airway inflammation, and its development after antiasthmatic treatment in patients with cough variant asthma (CVA) need to be clarified. This study aimed to investigate the prevalence of SAD and its relationship with clinical and pathophysiological characteristics in patients with CVA and the change in small airway function after antiasthmatic treatment.Methods: We retrospectively analyzed 120 corticosteroid-naïve patients with CVA who had finished a standard questionnaire and relevant tests in a specialist cough clinic, such as cough visual analog scale (VAS), differential cells in induced sputum, fractional exhaled nitric oxide (FeNO) measurement, spirometry, and airway hyper-responsiveness. Information of 1-year follow-up was recorded in a part of patients who received complete cough relief after 2 months of treatment. SAD was defined as any two parameters of maximal mid-expiratory flow (MMEF)% pred, forced expiratory flow at 50% of forced vital capacity (FEF50%) pred, and forced expiratory flow at 75% of forced vital capacity (FEF75%) pred measuring <65%.Results: SAD occurred in 73 (60.8%) patients with CVA before treatment. The patients with SAD showed a significantly longer cough duration (24.0 vs. 6.0, p = 0.031), a higher proportion of women (78.1 vs. 59.6%, p = 0.029), older mean age (41.9 vs. 35.4, p = 0.005), and significantly lower forced expiratory volume in 1 s (FEV1%) pred, FEV1/FVC, MMEF% pred, FEF50% pred, FEF75% pred, PEF% pred, and PD20 (all p < 0.01) as compared with patients without SAD. There were no significant differences in cough VAS, sputum eosinophils count, FeNO, and TIgE level between patients with SAD and those without SAD. Among 105 patients who completed 2 months of antiasthmatic treatment and repeatedly experienced spirometry measurement, 57 (54.3%) patients still had SAD, despite a significant improvement in cough VAS, sputum eosinophils, FeNO, FEF50% pred, and PEF% pred (all p < 0.01). As compared with patients without SAD, patients with SAD showed no significant differences in the relapse rate (50.0 vs. 41.9%, p = 0.483) and wheeze development rate (10.4 vs. 0%, p = 0.063) during the follow-up.Conclusions: Small airway dysfunction occurred in over half of patients with CVA and persisted after short-term antiasthmatic treatment, which showed distinctive clinical and pathophysiological features.

Relationship of ventilatory capacity to hyperbaric exposure in divers

1984 ◽  
Vol 56 (6) ◽  
pp. 1655-1658 ◽  
Author(s):  
I. S. Davey ◽  
J. E. Cotes ◽  
J. W. Reed
Keyword(s):  
Flow Rate ◽  
Vital Capacity ◽  
Positive Association ◽  
Forced Expiratory Volume ◽  
Elastic Tissue ◽  
Significant Positive Association ◽  
Cross Sectional ◽  
Maximal Depth ◽  
Forced Expiratory Flow ◽  
Expiratory Flow

The results of divers' annual medical examinations were used to assess the effects of diving exposure independent of age, stature, and smoking on forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1). Cross-sectional analysis of records for 858 men showed a significant positive association between the maximal depth that subjects had experienced and FVC but not FEV1. There was a significant negative association for FEV1/FVC%, and this index was also positively correlated with years of diving exposure. Among a subsample of 81 men the forced expiratory flow rate at low lung volume was reduced relative to that of control subjects similarly assessed; the extent of the reduction from the reference value was significantly correlated with the diving exposure. Longitudinal analysis of results for 255 men over a minimum of 5 yr showed that the change in FVC per annum (positive or negative) was correlated with the change in maximal depth; there were no similar associations for FEV1 or FEV1/FVC%. Thus diving exposure affects the vital capacity and the forced expiratory flow rate at small lung volumes. The latter is evidence for narrowing of airways that might be secondary to diving-induced loss of lung elastic tissue; this hypothesis merits further investigation.

An assessment of forced expiratory volumes and flow rates in the detection of early ventilatory impairment in RN submariners

1985 ◽  
Vol 71 (3) ◽  
pp. 167-170
Author(s):  
R. Herrmann ◽  
G. M. Clifford ◽  
D. J. Smith ◽  
Caroline S. M. Searing
Keyword(s):  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Linear Regression Analysis ◽  
Smoking Habit ◽  
Multiple Linear Regression Analysis ◽  
Forced Expiratory Volume ◽  
Single Breath ◽  
Forced Expiratory Flow ◽  
Expiratory Flow ◽  
Highly Correlated

AbstractA prospective study of an early diagnostic test of small airway dysfunction, the forced expiratory flow between 75 and 85% of the forced vital capacity, was carried out in 230 RN submariners. All the subjects were male caucasians, of whom 105 were smokers and 125 non-smokers. Measurements were performed using a single breath wedge spirometer (Vitalograph®) and forced vital capacity (FVC), forced expiratory volume in one second (FEV1), ratio of the FEV1 to the FVC (FEV1/FVC%) and the forced expiratory flow between 75 and 85% of the forced vital capacity (FEF75–85) obtained from the tracings in accordance with the recommendations of the American Thoracic Society. Multiple linear regression analysis of these four measurements together with height, age and smoking habit showed age to be the most significant factor for FEF75–85, followed by height Height was the most significant factor for FVC and FEV1 followed by age. Age was the only significant factor for FEV1/FVC%. FEF75-85 was highly correlated with FEV1/FVC% (r = 0.72) and to a lesser extent with FEV1 and FVC (r = 0.70 and 0.37 respectively). In the presence of age and height no significant effect of smoking habit on FEF75–85 could be demonstrated. However when the FEV1/FYC%, age and smoking habit were examined, there was found to be a significantly greater decrease in FEV1/FYC% with age in the smokers. It would appear that in this study FEV1/FVC% is a more sensitive index of early obstructive changes induced by smoking than measurement of flow at low lung volumes.

Effects of aerosol methacholine and histamine on airways and lung parenchyma in healthy humans

1993 ◽  
Vol 74 (6) ◽  
pp. 2681-2686 ◽  
Author(s):  
R. Pellegrino ◽  
B. Violante ◽  
E. Crimi ◽  
V. Brusasco
Keyword(s):  
Vital Capacity ◽  
Transpulmonary Pressure ◽  
Lung Parenchyma ◽  
Forced Expiratory Volume ◽  
Flow Volume ◽  
Tissue Properties ◽  
Bronchodilator Effect ◽  
Healthy Humans ◽  
Forced Expiratory Flow ◽  
Expiratory Flow

To investigate whether histamine (His) and methacholine (MCh) have different effects on airways and lung parenchyma, 11 healthy subjects were given aerosol MCh until a response plateau was obtained and then two doses of His. At the plateau, forced expiratory volume in 1 s and forced expiratory flow at 40% of vital capacity from partial flow-volume curves were reduced by 19 +/- 3 (SE) and 80 +/- 4%, respectively. Aerosol His decreased forced expiratory volume in 1 s by an additional 12 +/- 1% but left partial forced expiratory flow unchanged. The bronchodilator effect of deep inhalation, as inferred from the ratio of forced expiratory flow from maximal to that from partial flow-volume curves, increased after MCh and plateaued but decreased after His. Quasi-static transpulmonary pressure-volume area determined in seven subjects was unchanged after MCh but was increased by 57 +/- 10% after His. We conclude that adding His after the response to MCh plateaued does not increase the maximal degree of bronchoconstriction but may increase parenchymal hysteresis, thus blunting the bronchodilator effect of deep inhalation. These results suggest that His and MCh have similar effects on airway smooth muscle but different effects on lung tissue properties.

scholarly journals Postoperative translation of the upper instrumented vertebra in thoracic adolescent idiopathic scoliosis

2018 ◽  
Vol 22 (6) ◽  
pp. 694-700 ◽  
Author(s):  
Katsuhisa Yamada ◽  
Hideki Sudo ◽  
Kiyoshi Kaneda ◽  
Yasuhiro Shono ◽  
Yuichiro Abe ◽  
...  
Keyword(s):  
Adolescent Idiopathic Scoliosis ◽  
Idiopathic Scoliosis ◽  
Pulmonary Function ◽  
Research Society ◽  
Forced Expiratory Volume ◽  
Postoperative Results ◽  
Scoliosis Research Society ◽  
Correction Rate ◽  
Upper Instrumented Vertebra

OBJECTIVEThe aim of this retrospective study was to analyze the influence of upper instrumented vertebra (UIV) translation from the C7 plumb line (C7PL) on the long-term postoperative results of patients with main thoracic (MT) adolescent idiopathic scoliosis (AIS).METHODSTwenty-five patients had been treated surgically for AIS with a Lenke type 1 curve and had been followed up for a mean period of 18.2 years. Radiographic parameters, pulmonary function measurements, and clinical outcomes were compared between the patients (n = 15) with UIV translation < 20 mm and those (n = 10) with UIV translation ≥ 20 mm at the final follow-up. Correlations between UIV translation and radiographic or pulmonary function parameters were analyzed.RESULTSPatients with ≥ 20 mm UIV translation at the final follow-up had a significantly larger preoperative UIV translation than that in the patients with < 20 mm UIV translation at follow-up. The former group also had a significantly lower correction rate of the MT curve, higher chest cage ratio, and lower radiographic shoulder height (p = 0.01, 0.005, and 0.025, respectively) at the final follow-up. The Scoliosis Research Society (SRS)–30 Questionnaire scores were equivalent between the two groups. Correlation analysis showed that the following parameters were significantly associated with UIV translation: MT curve correction rate (r = -0.481, p = 0.015), chest cage ratio (r = 0.673, p < 0.001), and percent-predicted forced expiratory volume in 1 second (r = -0.455, p = 0.033).CONCLUSIONSThe UIV translation should be considered an important factor that influences postoperative results. In MT AIS patients whose preoperative upper end vertebra (UEV) is distant from the C7PL, the UIV should be selected above the UEV to prevent large UIV translation at the postoperative follow-up.

An Evaluation of the Initial Treatment of Acute Asthma

PEDIATRICS ◽  
1982 ◽  
Vol 70 (3) ◽  
pp. 348-353
Author(s):  
Zvi Ben-Zvi ◽  
Carin Lam ◽  
Jane Hoffman ◽  
Katherine C. Teets-Grimm ◽  
Meyer Kattan
Keyword(s):  
Initial Treatment ◽  
Vital Capacity ◽  
Acute Asthma ◽  
Clinical Score ◽  
Forced Expiratory Volume ◽  
Treatment Regimens ◽  
Forced Expiratory Flow ◽  
Expiratory Flow ◽  
The One ◽  
Β2 Agonist

Two treatment regimens for the initial treatment of acute asthma in 50 patients between the ages of 12 and 20 years seen in the emergency room were evalvated. The treatments were randomized such that 26 patients received 2.5 mg of the β2-agonist fenoterol by nebulizer and 24 patients received 0.3 mg of epinephrine followed by 0.75 mg of Sus-Phrine. Clinical assessment and spirometry were performed over a two-hour period. Both groups responded within ten minutes and peak improvement was reached within one hour. Peak expiratory flow and clinical score were better following fenoterol treatment in the first hour (P &lt; .05). The one-second forced expiratory volume and the forced expiratory flow in the middle half of the vital capacity were greater at 20 minutes with fenoterol (P &lt; .05). Those with more severe obstruction (forced expiratory volume &lt; 30%) receiving aerosol therapy also had significantly greater improvement in the first 20 minutes compared with those who received injections. Four patients failed to respond to epinephrine whereas all patients showed improvement with fenoterol (P &lt; .05). These results demonstrated that an inhaled β2-agonist is effective in the initial treatment of acute asthma in children, regardless of severity, and avoids the need for injections.

Acute and Chronic Theophylline Therapy in Exercise-Induced Bronchospasm

PEDIATRICS ◽  
1977 ◽  
Vol 60 (6) ◽  
pp. 845-849
Author(s):  
C. Warren Bierman ◽  
Gail G. Shapiro ◽  
William E. Pierson ◽  
Carol S. Dorsett
Keyword(s):  
Exercise Test ◽  
Vital Capacity ◽  
Forced Expiratory Volume ◽  
Repeated Testing ◽  
Before And After ◽  
Control Asthma ◽  
Forced Expiratory Flow ◽  
Treatment Changes ◽  
Expiratory Flow ◽  
Exercise Induced

This study examined the effectiveness of theophylline therapy in modifying exercise-induced bronchospasm (EIB) in children with perennial asthma and evaluated whether tolerance to theophylline developed with prolonged use. Twenty-one children between 7 and 16 years of age were studied by a standardized treadmill exercise test carried out before administration of theophylline, 90 minutes after administration of theophylline, and again after three weeks of round-the-clock theophylline treatment. Changes in forced expiratory volume at one second, forced expiratory flow between 25% and 75% of vital capacity, and peak expiratory flow rate were measured before and after each exercise test. Theophylline inhibited EIB in 20 of 21 subjects. There was considerable intersubject variation in the response to theophylline, however, ranging from complete inhibition in five subjects to no inhibition at all in one subject, even though theophylline controlled perennial asthma in all subjects, and all but one had theophylline levels between 10 and 22 µg/ml when tested. On repeated testing after three weeks of therapy, no tolerance developed to theophylline. These findings suggest that EIB and perennial asthma may result from different causes and that theophylline's ability to control asthma will not predict its effect on EIB. Subjects who have severe EIB should be retested after theophylline pretreatment to evaluate the effectiveness of therapy.

scholarly journals Upper airway obstruction in patients with endothoracic goiter enlargement: no relationship between flow-volume loops and radiological tests

2010 ◽  
Vol 163 (4) ◽  
pp. 665-669 ◽  
Author(s):  
M Albareda ◽  
J Viguera ◽  
C Santiveri ◽  
P Lozano ◽  
A Mestrón ◽  
...  
Keyword(s):  
Airway Obstruction ◽  
Vital Capacity ◽  
Visual Analysis ◽  
Upper Airway ◽  
Forced Expiratory Volume ◽  
Upper Airway Obstruction ◽  
Flow Volume ◽  
Flow Parameters ◽  
Forced Expiratory Flow ◽  
Expiratory Flow

BackgroundIn about 16–85% of subjects with goiter, upper airway obstruction (UAO) is observed. This percentage is higher in patients affected by goiter with endothoracic enlargement. UAO is an indication for surgery. Visual analysis of flow-volume loops (FVL) are the best indicators for UAO, although various studies using clinical and radiological parameters have observed no correlation.ObjectiveTo evaluate the presence of UAO in patients with endothoracic goiter enlargement and the relationship between the FVL with the observed symptoms and the measurements obtained by computed tomography (CT).SubjectsSubjects with endothoracic goiter enlargement participated in the study.Designi) Symptom questionnaire (dysphagia, dyspnea, cough, oppression, dysphonia, and worsened symptoms when prone); ii) analysis: TSH and free thyroxine; iii) cervical ultrasound; iv) cervical-thoracic CT (measurements of area and diameter in the area of maximum stenosis and at 2 cm from the carina); v) chest radiography and vi) forced spirometry: visual analysis of FVL morphology and the maximum forced expiratory volume in 1 s (FEV1), forced expiratory flow at 50% vital capacity/forced inspiratory flow at 50% vital capacity and FEV1/peak expiratory flow parameters.ResultsFifty subjects participated in the study: 11 men/39 women, median age 73.8 years (43.76–88.43). UAO was diagnosed in 13 cases (26%, confidence interval: 14.6–40.3%) and 27 subjects (54%) presented symptoms suggesting goiter compression. No clinical or radiological variables showed the presence of UAO.ConclusionsThe frequency of UAO in subjects affected by goiter with endothoracic enlargement was lower than that described for goiter patients, and there were no clinical or radiological indicators to establish its presence.

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