Total respiratory resistance and reactance in ankylosing spondylitis and kyphoscoliosis

Abstract

Ankylosing spondylitis and kyphoscoliosis both alter the function of the lung by modifying the mechanical properties of the thoracic cage. The purpose of the present study was to assess the changes in total respiratory resistance (Rrs) and reactance (Xrs) in these patients and to compare these data with conventional pulmonary function tests. In 16 patients with ankylosing spondylitis and seven with kyphoscoliosis we measured lung volumes, maximal flows, diffusing capacity, airway resistance, lung compliance and Rrs and Xrs between 2-26 Hz by means of the forced oscillation technique (FOT). In the patients with ankylosing spondylitis mean total lung capacity was 83% predicted (range 60-105%). Mean values of Rrs were normal; there was a small decrease in Xrs at the lowest frequency. In the patients with kyphoscoliosis mean total lung capacity (TLC) was 41% predicted for arm span (range 26-75%). Mean Rrs was elevated with a negative frequency dependence, and mean Xrs was decreased. The observed differences in Rrs and Xrs between the two groups of patients are related to differences in severity of the restriction. There is evidence that the changes in Rrs and Xrs in both groups are mainly attributable to an increase in chest wall resistance and a decrease in chest wall compliance, while in the patients with kyphoscoliosis an increase in airway resistance and a decrease in lung compliance also intervenes.

Respiratory oscillometry and functional analyses in patients with idiopathic scoliosis

“…The increase in resistance values (Figure 1) are in line with the observed increase in Raw evaluated by body plethysmography. These findings are in line with those obtained by van Noord et al (8), which attributed the increase to a marked decrease in pulmonary volume. A similar decrease in pulmonary volume was observed in the present study (Table 2).…”

“…Measurements of chest wall recoil are seldom performed in clinical practice because it is very difficult to obtain reliable data in untrained subjects. Therefore, the ability of oscillometry in providing information on the mechanical behavior of airways, lungs, and chest wall is of special interest in the analysis of patients with scoliosis (8). Although this method has been successfully applied to improve our understanding of abnormal respiratory mechanics in several diseases (6), there are few data in the literature about the use of oscillometry in scoliosis.…”

“…Although this method has been successfully applied to improve our understanding of abnormal respiratory mechanics in several diseases (6), there are few data in the literature about the use of oscillometry in scoliosis. In fact, only one study has addressed this question (8). The cited study examined a small group of patients with scoliosis (n=7) without considering the effects of spinal inclination and functional level of these patients.…”

Single-stage bilateral conversion arthroplasty for hip fusion via direct anterior approach in a patient with severe ankylosing spondylitis and kyphoscoliosis: a case report

“…These factors not only hinder patient mobility but also restrict respiratory capacity [ 16 , 17 ]. This issue is much more prominent in cases with AS and accompanying spine deformities like kyphoscoliosis that multiplies the challenges due to cervical spine and temporomandibular joint mobility limitations and further restrictions in respiratory capacity as in these complex cases the thoracolumbar spine is severely affected and deformed [ 12 , 18 ].…”

The 4DBODY system as a new tool for chest mobility assessment in patients with ankylosing spondylitis

“…The rigidity of the chest and its joints combined with pain and an abnormal respiratory pattern may lead to decreasing pulmonary function [ 27 ] and weakening respiratory muscles [ 28 ]. Research conducted by Sahin et al [ 29 ] revealed that AS patients were characterized by significantly lower chest expansion, respiratory muscle weakness, FVC and FEV1 parameters.…”