Department of Pediatrics, Division of Pediatric Pulmonary, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Department of Pediatrics, Thomas P Graham Jr. Division of Pediatric Cardiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Pediatr Pulmonol. 2023 Apr;58(4):1034-1041. doi: 10.1002/ppul.26289. Epub 2023 Jan 2.
Duchenne muscular dystrophy (DMD) is associated with progressive muscle weakness and respiratory decline. To date, studies have focused on respiratory decline and loss of ambulation as a metric of loss of skeletal muscle strength. However, new functional measures can assess skeletal muscle disease regardless of ambulatory status. The relationship between these tests and concurrent lung function is currently unexplored.
To assess the correlation between spirometry measurements and functional muscle assessments such as accelerometry and quantitative muscle testing (QMT).
Enrolled patients with DMD underwent accelerometry and QMT at study clinic visits. Any pulmonary function testing within 6 months of visit was obtained from the electronic medical record. The Spearman correlation coefficient was used to assess the relationship between spirometry and functional muscle testing.
Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV ) demonstrated the strongest correlation with accelerometry. Both FVC and FEV showed a similar relationship to accelerometry when activity was divided into intensity categories, with low intensity and moderate-to-vigorous activity categories showing the strongest correlation. Maximal expiratory pressure (MEP) and FVC showed the most robust correlations with total QMT (p < 0.001 and p < 0.01, respectively).
Lung function, specifically FVC percent predicted and FEV %p, shows a good correlation with upper and lower extremity skeletal muscle functional testing such as accelerometry and QMT.
杜氏肌营养不良症(DMD)与进行性肌肉无力和呼吸功能下降有关。迄今为止,研究主要集中在呼吸功能下降和步行能力丧失作为骨骼肌力量丧失的指标上。然而,新的功能测量方法可以评估骨骼肌疾病,而与步行能力无关。这些测试与同时进行的肺功能之间的关系目前尚未探索。
评估肺活量测定和功能肌肉评估(如加速度计和定量肌肉测试(QMT))之间的相关性。
入组的 DMD 患者在研究就诊时接受了加速度计和 QMT 检查。从电子病历中获取就诊前 6 个月内的任何肺功能测试结果。采用 Spearman 相关系数评估肺活量测定与功能肌肉测试之间的关系。
用力肺活量(FVC)和 1 秒用力呼气量(FEV )与加速度计的相关性最强。FVC 和 FEV 在活动分为强度类别时与加速度计呈相似的关系,低强度和中高强度活动类别显示出最强的相关性。最大呼气压力(MEP)和 FVC 与总 QMT 显示出最强的相关性(p<0.001 和 p<0.01,分别)。
肺功能,特别是 FVC 预测百分比和 FEV %p,与上肢和下肢骨骼肌功能测试(如加速度计和 QMT)具有良好的相关性。