ALS/Motor Neuron Diseases Unit, Neurology Department, Hospital del Mar, Barcelona, Spain.
ALS/Motor Neuron Diseases Unit, Pneumology Department, Hospital del Mar, Barcelona, Spain.
Muscle Nerve. 2024 Feb;69(2):213-217. doi: 10.1002/mus.27987. Epub 2023 Oct 20.
INTRODUCTION/AIMS: Cough impairment is common in individuals with neuromuscular disorders and is associated with respiratory infections and shorter survival. Cough strength is assessed by measuring cough peak flow (CPF) using a flow meter, but this method requires a complex device setup and trained staff. The aim of the study is to evaluate the reliability of a smartphone app to estimate CPF based on cough sounds in a cohort of individuals with neuromuscular disorders.
Individuals with neuromuscular disorders underwent CPF measurement with a flow meter and a smartphone app. A CPF <270 L/min was considered abnormal.
Of the 50 patients studied, 26 had amyotrophic lateral sclerosis (52%), 15 had hereditary myopathies (30%), and 9 had myasthenia gravis (18%). The intraclass correlation coefficient (ICC) between the CPF measured with a flow meter and CPF estimated with cough sounds was 0.774 (p < .001) even if the patients had orofacial weakness (ICC = 0.806, p < .001). The smartphone app had 94.4% sensitivity and 100% specificity to detect patients with CPF of less than 270 L/min.
Our findings suggest that sounds measured with a smartphone app provide a reliable estimate of CPF in patients with neuromuscular disorders, even in the presence of with orofacial weakness. This may be a convenient way to monitor respiratory involvement in patients with neuromuscular disorders, but larger studies of more diverse patient cohorts are needed.
简介/目的：咳嗽障碍在神经肌肉疾病患者中很常见，与呼吸道感染和生存时间缩短有关。咳嗽峰值流量（CPF）可通过使用流量计测量咳嗽声来评估，但这种方法需要复杂的设备设置和经过培训的人员。本研究旨在评估智能手机应用程序基于神经肌肉疾病患者的咳嗽声估计 CPF 的可靠性。
神经肌肉疾病患者使用流量计和智能手机应用程序进行 CPF 测量。CPF <270 L/min 被认为异常。
在 50 名研究患者中，26 名患有肌萎缩侧索硬化症（52%），15 名患有遗传性肌病（30%），9 名患有重症肌无力（18%）。使用流量计测量的 CPF 与使用咳嗽声估计的 CPF 之间的组内相关系数（ICC）为 0.774（p < 0.001），即使患者存在口面肌无力（ICC=0.806，p < 0.001）。智能手机应用程序检测 CPF 小于 270 L/min 的患者的敏感性为 94.4%，特异性为 100%。
我们的发现表明，智能手机应用程序测量的声音可可靠估计神经肌肉疾病患者的 CPF，即使存在口面肌无力。这可能是监测神经肌肉疾病患者呼吸受累的一种便捷方法，但需要更大规模、更多样化患者队列的研究。
