Chest wall volume and asynchrony in stroke and Parkinson’s disease subjects: A case-control study
Open accessAbstract
BACKGROUND: The expansion of the rib cage and abdomen occurs in a synchronic way during a coordinated contraction of the diaphragm and the abdominal and intercostal muscles under normal conditions and healthy. The presence of restrictive respiratory disease may lead to uncoordinated action of the respiratory muscles which affects breathing pattern and chest wall volumes. The aim of this study was to evaluate chest wall volumes, chest wall asynchrony and inspiratory paradoxical movement of breathing, as well as the influence of the time of disease diagnosis in subjects with Parkinson's disease and post-Stroke in comparison to healthy individuals. METHODS: Total and compartmental chest wall volumes, chest wall asynchrony and paradoxical movement were measured at rest in a seated position by Optoelectronic Plethysmography in 76 individuals (29 healthy individuals, 20 post-Stroke and 27 Parkinson's disease subjects). Post-stroke and Parkinson's disease subjects were also grouped according to the length of diagnosis. RESULTS: In both groups with restrictive respiratory disease we observed that pulmonary rib cage compartment (VRCp) volume is reduced when compared to healthy subjects (p <0.05). This same pattern was observed when analyzing post-stroke subjects with more than three years of diagnosis and Parkinson's subjects with less than three years of diagnosis (p<0.05). Furthermore, post-stroke subjects with inspiratory paradoxical movement showed decreased total and compartmental chest wall volumes (p<0.05), while individuals with Parkinson's disease with inspiratory paradoxical movement only presented a decrease in pulmonary rib cage compartment volume (p<0.05). CONCLUSION: Our study presents new findings for better understanding of chest wall volumes and chest wall asynchrony in post-stroke and Parkinson's disease individuals. Half of the subjects with post-Stroke and Parkinson's disease presented inspiratory paradox movement, but changes in breathing pattern was especially observed in post-stroke subjects with more than three years of diagnosis.
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Thoraco-abdominal asynchrony has been extensively reported in studies of persons with PD.
“Thoraco-abdominal asynchrony has been extensively reported in studies of persons with PD (Florêncio et al., 2019; Huber et al., 2003; Solomon & Hixon, 1993), but the effect of voice intervention on RC–abdominal coupling remains unknown.”
From Respiratory Responses to Two Voice Interventions for Parkinson's Disease (2022) · cites this paper as Florêncio et al., 2019
The Discussion reports inspiratory paradoxical movement in 55.5% of the Parkinson’s disease subjects, supporting the citation as an example of a study examining thoraco-abdominal coupling in PD. But the Results say the PD group’s phase angles were close to healthy controls, and the Introduction says this phenomenon had not previously been studied in detail in these populations. This paper therefore does not support the claim that asynchrony has been extensively reported across studies of PD. (LLM, conf=0.86)
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- Authors
- Florêncio, R. B., da Nobrega, A. J. S., Lima, Í. N. D. F., Gualdi, L. P., Cabral, E. E., Fagundes, M. L. L. C., Aliverti, A., Resqueti, V. R., & Fregonezi, G. A. D. F.
- Affiliations
- Universidade Federal do Rio Grande do Norte (BR)
- Corresponding author
- Fregonezi, Guilherme Augusto de Freitas
- ORCID
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2019-05-16
- Volume
- 14
- Issue
- 5
- Pages
- e0216641
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC6522099
- OpenAlex
- W2946029153
- Cited by
- 19
- References
- 43
- Citations by year
- 2026: 6 · 2025: 1 · 2023: 2 · 2022: 4 · 2021: 2 · 2020: 3 · 2019: 1
- FWCI
- 1.84
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Virtual Community of Pathological Anatomy (University of Castilla La Mancha) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Programa Geral de Cooperação Internacional - PGCI - 23038.007514/2014-78)
- Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Programa Nacional de Cooperação Acadêmica (88881.068409/2014-0)
- Conselho Nacional de Desenvolvimento Científico e Tecnológico (PQ II - 307353/2015-0, DT II - 310091/2015-2)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Health Professions › Speech and Hearing › Dysphagia Assessment and Management
- Keywords
- chest wall volume, Parkinson's disease, stroke, breathing pattern, disease duration
- MeSH terms
- Aged, Female, Humans, Lung, Male, Middle Aged, Organ Size, Parkinson Disease, Respiratory Muscles, Respiratory Mechanics, Case-Control Studies, Stroke, Thoracic Wall
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