Decreased respiratory performance of children and adolescents with myelomeningocele who use a wheelchair – preliminary data

Abstract

Myelomeningocele (MMC) is a neural tube defect that often causes spinal cord injury at the thoracolumbar region, as well as sensory and motor paralysis in the lower limbs. This leads to continuous use of a wheelchair and, consequently, a sedentary lifestyle, predisposition to muscle weakness, cardiovascular and respiratory disorders, obesity, and structural alterations in the spine. We assessed the respiratory function and shoulder strength of MMC participants who were wheelchair-users and had no respiratory complaints and compared them to healthy children and adolescents. MMC (n=10) and healthy (n=25) participants of both genders with a mean age of 12.45 years (SD=2.1) were assessed for weight, height, respiratory performance, and isometric peak for shoulder flexors, extensors, abductors, and adductors, using an isokinetic dynamometer. Medullary lesion, functional levels, and abnormal curvatures of the spine were assessed for MMC participants. The level of spinal cord injury for the majority of the MMC participants was high lumbar and they had scoliosis. MMC showed lower values for forced vital capacity, forced expiratory volume at the first second, forced expiratory flow (25–75%), maximal voluntary ventilation, and isometric peak for shoulder flexors and adductors compared to healthy participants. This indicated a decreased vital capacity, respiratory muscle endurance, and shoulder muscle strength.

Cardiac Autonomic Modulation of Heart Rate Recovery in Children with Spina Bifida

“…Thus, higher VE/VCO 2 values may be related to a worse pulmonary hemodynamic profile, as well as to a reduction in cardiovascular autonomic modulation and in cardiovascular function which could cause a reduction in aerobic functional capacity [44]. It has been suggested too that ventilatory inefficiency due to the restrictive pulmonary pattern caused by postural deformity, especially in those who use wheelchairs [45][46][47], may be another factor determining low oxygen uptake. When we evaluated the results of the absolute VO 2 at anaerobic threshold, we did not identify any differences between groups when they were composed of all participants, but when a correction for body mass was made, the SB group had higher values.…”

Fadiga muscular periférica de membros superiores em crianças e adolescentes típicos e com espinha bífida

“…Martins, E. J., A. C. Gastaldi, G. B.Q Davoli, M. M. Leonardi-Figueiredo, and A. C. Mattiello-Sverzut. 2019…”