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논문KCI 등재

정상 아동과 뇌성마비 아동의 감소된 횡격막움직임 및 호흡 기능의 비교

Comparisons of Diaphragm Movement and Pulmonary Function Between Normal Children and Children With Cerebral Palsy

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초록

Background: Research efforts to improve the pulmonary function of children with cerebral palsy (CP) need to focus on their decreased diaphragmatic ability compared to normal children. Real-time ultrasonography is appropriate for demonstrating diaphragmatic mechanisms. Objects: This study aimed to compare diaphragm movement, pulmonary function, and pulmonary strength between normal children and children with CP by using ultrasonography M-mode. The correlation between general characteristics, diaphragm movement, pulmonary function, and pulmonary strength was also studied. Methods: The subjects of this study were 25 normal and 25 CP children between five and 14 years of age. Diaphragm movement was measured using real-time ultrasonography during quiet and deep breathing. Pulmonary function (such as forced expiratory volume in one second; FEV1 and peak expiratory flow; PEF) and pulmonary strength (such as maximum inspiratory pressure; MIP and maximum expiratory pressure; MEP) were measured. A paired t-test and Spearman’s Rho test, with a significance level of .05, were used for statistical analysis. Results: The between-group comparison revealed that normal children had significantly greater diaphragm movement, FEV1, PEF, MIP, and MEP (p<.05) than CP children. The results showed that general characteristics were significantly related to FEV1, PEF, MIP, and MEP (p<.05). Conclusion: In clinical settings, clinicians need to concern decreased diaphragm movement, pulmonary function, and pulmonary strength in CP group compared to normal children.

Abstract

Background: Research efforts to improve the pulmonary function of children with cerebral palsy (CP) need to focus on their decreased diaphragmatic ability compared to normal children. Real-time ultrasonography is appropriate for demonstrating diaphragmatic mechanisms. Objects: This study aimed to compare diaphragm movement, pulmonary function, and pulmonary strength between normal children and children with CP by using ultrasonography M-mode. The correlation between general characteristics, diaphragm movement, pulmonary function, and pulmonary strength was also studied. Methods: The subjects of this study were 25 normal and 25 CP children between five and 14 years of age. Diaphragm movement was measured using real-time ultrasonography during quiet and deep breathing. Pulmonary function (such as forced expiratory volume in one second; FEV1 and peak expiratory flow; PEF) and pulmonary strength (such as maximum inspiratory pressure; MIP and maximum expiratory pressure; MEP) were measured. A paired t-test and Spearman’s Rho test, with a significance level of .05, were used for statistical analysis. Results: The between-group comparison revealed that normal children had significantly greater diaphragm movement, FEV1, PEF, MIP, and MEP (p<.05) than CP children. The results showed that general characteristics were significantly related to FEV1, PEF, MIP, and MEP (p<.05). Conclusion: In clinical settings, clinicians need to concern decreased diaphragm movement, pulmonary function, and pulmonary strength in CP group compared to normal children.

참고문헌 (34)

  1. Alexander C, "Diaphragmatic movements and the diagnosis of diaphragmatic paralysis", Clin Radiol, 17(1), pp.79~83 (1966)[DOI]
  2. Ayoub J, "Non-Invasive quantification of diaphragm Kinecs using M-mode sonography", Can J Anaesth, 44(7), pp.739~744 (1997)[DOI]
  3. Bax M, "Proposed definition and classification of cerebral palsy", Dev Med Child Neurol, 47(8), pp.571~576 (2005)[DOI]
  4. Blair E, "Epidemiology of cerebral palsy", Semin Fetal Neonatal Med, 11(2), pp.117~125 (2006)[DOI]
  5. Boussuges A, "Diaphragmatic motion studied by M-mode ultrasonography: Methods, reproducibility, and normal values", Chest, 135(2), pp.391~400 (2009)[DOI]
  6. de Almeida IC1, "Effects of hemiplegy on pulmonary function and diaphragmatic dome displacement", Respir Physiol Neurobiol, 178(2), pp.196~201 (2011)[DOI]
  7. de Leeuw M, "Impact of diaphragmatic paralysis after cardiothoracic surgery in children", J Thorac Cardiovasc Surg, 118(3), pp.510~517 (1999)[DOI]
  8. Epelman M, "M-mode sonography of diaphragmatic motion: description of technique and experience in 278 pediatric patients", Pediatr Radiol, 35(7), pp.661~667 (2005)[DOI]
  9. Ersoz M1, "Decreased chest mobility in children with spastic cerebral palsy", Turk J Pediatr, 48(4), pp.344~350 (2006)
  10. Finkelstein SM, "Reliability and validity of spirometry measurements in a paperless home monitoring diary program for lung transplantation", Heart Lung, 22(6), pp.523~533 (1993)
  11. Fitzgerald DA, "Assessing and managing lung disease and sleep disordered breathing in chlidren with cerebral palsy", Paediatr Respir Rev, 10(1), pp.18~24 (2009)
  12. Heinzmann-Filho JP, "Normal values for respiratory muscle strength in healthy preschoolers and school children", Respir Med, 106(12), pp.1639~1646 (2012)[DOI]
  13. Johnson A, "Prevalence and characteristics of children with cerebral palsy in europe", Dev Med Child Neurol, 44(9), pp.633~640 (2002)
  14. Jung J, "Effects of abdominal stimulation during inspiratory muscle training in respiratory function of chronic stroke patient", J Phys Ther Sci, 26(1), pp.73~76 (2014)[DOI]
  15. Liu CL, "Effects of age on 1-second forced expiratory volume response to bronchodilation", Int J Gerontol, 3(3), pp.149~155 (2009)[DOI]
  16. Lynn DJ, "Respiratory dysfunction in muscular dystrophy and other myopathies", Clin Chest Med, 15(4), pp.661~674 (1994)
  17. McCandless RE, "The role of the thoracic diaphragm", Aust J Physiother, 21(3), pp.104~108 (1975)[DOI]
  18. Mok Q, "Phrenic nerve injury in infants and children undergoing cardiac surgery", Br Heart J, 65(5), pp.287~292 (1991)[DOI]
  19. Voyvoda N, "An evaluation of diaphragmatic movements in hemiplegic patients", Br J Radiol, 85(1012), pp.411~414 (2012)[DOI]
  20. Onders RP, "Final analysis of the pilot trial of diaphragm pacing in amyotrophic lateral sclerosis with long-term follow-up: Diaphragm pacing positively affects diaphragm respiration", Am J Surg, 207(3), pp.393~397 (2014)[DOI]
  21. Ostensjo S, "The use and impact of assistive devices and other environmental modifications on everyday activities and care in young children with cerbral palsy", Disabil Rehabili, 27(14), pp.849~861 (2005)[DOI]
  22. Palisano R, "Development and reliability of a system to classify gross motor function in children with cerebral palsy", Dev Med Child Nuerol, 39(4), pp.214~223 (1997)
  23. Papastamelos C, "Developmental changes in chest wall compliance in infancy and early childhood", J Appl Physiol, 78(1), pp.179~184 (1995)[DOI]
  24. 박은숙, "Comparison of the Ratio of Upper to Lower Chest Wall in Children with Spastic Quadriplegic Cerebral Palsy and Normally Developed Children", Yonsei Medical Journal, 47(2), pp.237~242 (2006), 연세대학교의과대학
  25. Park GR, "Demonstration of phrenic nerve paralysis and its subsequent recovery by ultrasound", Intensive Care Med, 7(3), pp.145~146 (1981)[DOI]
  26. Paul E, "Aetiology and epidemiology of cerebral palsy", Paediatr Child Health, 22(9), pp.361~366 (2012)[DOI]
  27. Pausano R, "Gross motor function classification system for cerebral palsy", Dye Med Child Nuerol, 39, pp.214~223 (1997)
  28. Quanjer PH, "Peak expiratory flow conclusions and recommendations of a working party of the european respiration society", Eur Respir J, 24, pp.2S~8S (1997)
  29. Riccabona M, "Application of M-mode sonography to functional evaluation in pediatric patients", Eur Radiol, 8(8), pp.1457~1461 (1998)[DOI]
  30. Tarver RD, "Imaging the diaphragm and its disorder", J Thorac Imaging, 4(1), pp.1~18 (1989)
  31. Urvoas E, "Diaphragmatic paralysis in children: Diagnosis by TM-mode ultrasound", Pediatr Radiol, 24(8), pp.564~568 (1994)[DOI]
  32. Wang HY, "Relationships between respiratory muscle strength and daily living function in children with cerebral palsy", Res Dev Disabil, 33(4), pp.1176~1182 (2012)[DOI]
  33. Wilcox PG, "Diaphragmatic weakness and paralysis", Lung, 167(6), pp.323~341 (1987)
  34. Wood E, "The child with cerebral palsy: Diagnosis and beyond", Semin Pediartr Neurol, 13(4), pp.286~296 (2006)[DOI]

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