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Comparison of the Ratio of Upper to Lower Chest Wall in Children with Spastic Quadriplegic Cerebral Palsy and Normally Developed Children

박정현|박찬우|나동욱|박은숙|박창일
연세대학교의과대학 (Yonsei University College of Medicine)|2006.04|Yonsei Medical Journal|제47권 제2호|pp. 237-242

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초록

The upper chest wall does not grow properly in children with spinal muscular atrophy (SMA) with paradoxical breathing. This suggests that long-term inability to take a deep breath in developing children may result in underdevelopment of the upper chest wall. In addition, a rapid and paradoxical breathing pattern is frequently observed in children with severe cerebral palsy (CP), which often corresponds to the underdevelopment of the upper chest wall. The present study is designed to evaluate the ratio of the upper to lower chest wall in children with severe spastic quadriplegic CP, compared with normal children. We compared normal children with children that had spastic quadriplegic CP who did not have kyphosis or scoliosis. Test subjects were matched in terms of age, height, and weight. The diameters of upper chest (Dapex) and of lower chest (Dbase) were measured on the anteroposterior (AP) view of a chest X-ray and the Dapex to Dbase ratio was calculated. In selected cases the forced vital capacity (FVC) was measured using a Wright Respirometer. The Dapex to Dbase ratio was significantly lower in the CP group than in the control group (p<0.001). The ratio increased linearly with age (p<0.001) in both CP (R=0.372) and control groups (R= 0.477). The FVC/preFVC showed significant correlation with the Dapex to Dbase ratio (R=0.542, p<0.01). The results of this study suggest a deviation of optimal chest wall structure in children with spastic quadriplegic CP.

Abstract

The upper chest wall does not grow properly in children with spinal muscular atrophy (SMA) with paradoxical breathing. This suggests that long-term inability to take a deep breath in developing children may result in underdevelopment of the upper chest wall. In addition, a rapid and paradoxical breathing pattern is frequently observed in children with severe cerebral palsy (CP), which often corresponds to the underdevelopment of the upper chest wall. The present study is designed to evaluate the ratio of the upper to lower chest wall in children with severe spastic quadriplegic CP, compared with normal children. We compared normal children with children that had spastic quadriplegic CP who did not have kyphosis or scoliosis. Test subjects were matched in terms of age, height, and weight. The diameters of upper chest (Dapex) and of lower chest (Dbase) were measured on the anteroposterior (AP) view of a chest X-ray and the Dapex to Dbase ratio was calculated. In selected cases the forced vital capacity (FVC) was measured using a Wright Respirometer. The Dapex to Dbase ratio was significantly lower in the CP group than in the control group (p<0.001). The ratio increased linearly with age (p<0.001) in both CP (R=0.372) and control groups (R= 0.477). The FVC/preFVC showed significant correlation with the Dapex to Dbase ratio (R=0.542, p<0.01). The results of this study suggest a deviation of optimal chest wall structure in children with spastic quadriplegic CP.

참고문헌 (23)

  1. "Causes of excess mortality in cerebral palsy", 41, pp.580~585 (1999)
  2. "Respiratory problems in children with neurological impairment", 88, pp.75~78 (2003)
  3. "Respiration and speech in the cerebral palsied child", pp.48~53
  4. "Lung function of athetoid and spastic quadriplegic children", pp.378~88
  5. "Dynamic and static lung volumes of school children with cerebral palsy", pp.35~41
  6. "Abnormal postural reflex activity and voice usage deviations in cerebral palsy", pp.1358~60
  7. "Management of pulmonary complications in neuromuscular disease", 9, pp.167~185 (1998)
  8. "The effects of seating position on the respiratory patterns of preschoolers with cerebral palsy", 27, pp.283~288 (2004)
  9. "Speech", pp.112~117 (1997), Butterworth-Heinemann
  10. "Posture and movement of the child with cerebral palsy", pp.79~ (2000), Therapy Skill Builders
  11. "Effect of a soft Boston orthosis on pulmonary mechanics in severe cerebral palsy", 28, pp.53~58 (1999)
  12. "The effects of intermittent positive pressure breathing on patients with respiratory muscle weakness", pp.132~7
  13. "The effects of tetraplegia on chest wall statics", pp.121~4
  14. "Prevention of pectus excavatum for children with spinal muscular atrophy type 1", 82, pp.815~819 (2003)
  15. "Spinal muscular atrophy: kinematic breathing analysis", 75, pp.332~339 (1996)
  16. "Kinematic analysis of patients with spinal muscular atrophy during spontaneous breathing and mechanical ventilation", 77, pp.188~192 (1998)
  17. "Developmental changes in chest wall compliance in infancy and early childhood", 78, pp.179~184 (1995)
  18. "Mechanical work of breathing derived from rib cage and abdominal V-P partitioning", pp.752~63
  19. "Mechanical aspects of chest wall distortion", pp.295~304
  20. "Diaphragmatic work of breathing in premature human infants", pp.1410~5
  21. "Distortion of chest wall and work of diaphragm in preterm infants", pp.164~9
  22. "Sleep abnormalities in patients with severe cerebral palsy", pp.304~11
  23. "Sleep abnormalities in patients with severe cerebral palsy", pp.304~11

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