Gallena Sally J K, Solomon Nancy Pearl, Johnson Arthur T, Vossoughi Jafar, Tian Wei
Am J Speech Lang Pathol. 2015 Aug;24(3):470-9. doi: 10.1044/2015_AJSLP-14-0110.
An investigational, portable instrument was used to assess inspiratory (R(i)) and expiratory (R(e)) resistances during resting tidal breathing (RTB), postexercise breathing (PEB), and recovery breathing (RB) in athletes with and without paradoxical vocal fold motion disorder (PVFMD).
Prospective, controlled, repeated measures within-subject and between-groups design. Twenty-four teenage female athletes, 12 with and 12 without PVFMD, breathed into the Airflow Perturbation Device for baseline measures of respiratory resistance and for two successive 1-min trials after treadmill running for up to 12 min. Exercise duration and dyspnea ratings were collected and compared across groups.
Athletes with PVFMD had lower than control R(i) and R(e) values during RTB that significantly increased at PEB and decreased during RB. Control athletes' R(e) decreased significantly from RTB to PEB but not from PEB to RB, whereas R(i) did not change from RTB to PEB but decreased from PEB to RB. Athletes without PVFMD ran longer, providing lower dyspnea ratings.
Immediately following exercise, athletes with PVFMD experienced increased respiratory resistance that affected their exercise performance. The difference in resting respiratory resistances between groups is intriguing and could point to anatomical differences or neural adaptation in teenagers with PVFMD. The Airflow Perturbation Device appears to be a clinically feasible tool that can provide insight into PVFMD and objective data for tracking treatment progress.
使用一种研究性便携式仪器,评估有无矛盾性声带运动障碍(PVFMD)的运动员在静息潮气呼吸(RTB)、运动后呼吸(PEB)和恢复呼吸(RB)过程中的吸气阻力(R(i))和呼气阻力(R(e))。
采用前瞻性、对照、受试者内和组间重复测量设计。24名青少年女性运动员,其中12名有PVFMD,12名无PVFMD,向气流扰动装置吹气,以测量呼吸阻力的基线值,并在跑步机上跑步长达12分钟后连续进行两次1分钟的试验。收集并比较各组的运动持续时间和呼吸困难评分。
患有PVFMD的运动员在RTB期间的R(i)和R(e)值低于对照组,在PEB时显著增加,在RB时降低。对照组运动员的R(e)从RTB到PEB显著降低,但从PEB到RB没有变化,而R(i)从RTB到PEB没有变化,但从PEB到RB降低。没有PVFMD的运动员跑得更长,呼吸困难评分更低。
运动后,患有PVFMD的运动员立即出现呼吸阻力增加,这影响了他们的运动表现。两组之间静息呼吸阻力的差异很有趣,可能表明患有PVFMD的青少年存在解剖学差异或神经适应性变化。气流扰动装置似乎是一种临床上可行的工具,可以深入了解PVFMD,并为跟踪治疗进展提供客观数据。