Journal of Applied Physiology AJP: Gastrointestinal and Liver Physiology
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J Appl Physiol (December 5, 2003). doi:10.1152/japplphysiol.00914.2003
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Submitted on August 27, 2003
Accepted on November 27, 2003

Reproducibility and responsiveness of a non-invasive EMG technique of the respiratory muscles in COPD patients and in healthy subjects

Marieke L Duiverman1, Leo A van Eykern2, Peter W Vennik1, Gerard H Koeter1, Eric J Maarsingh3, and Peter J Wijkstra1*

1 Department of Pulmonary Diseases/ Home Mechanical Ventilation, University Hospital Groningen, Groningen, Groningen, The Netherlands
2 Department of Neurology and Medical Physiology, University Hospital Groningen, Groningen, Groningen, The Netherlands
3 Emma Childrens Hospital, Academic Medical Center, Amsterdam, Noord Holland, The Netherlands

* To whom correspondence should be addressed. E-mail: p.j.wijkstra{at}int.azg.nl.

In the present study we assessed the reproducibility and responsiveness of transcutaneous electromyography (EMG) of the respiratory muscles in patients with chronic obstructive pulmonary disease (COPD) and healthy subjects, during breathing against an inspiratory load. In 7 healthy subjects and 7 COPD patients EMG signals of the frontal and dorsal diaphragm, intercostal muscles, abdominal muscles and scalene muscles were derived on 2 different days, both during breathing at rest (T0) and during breathing through an inspiratory threshold device of 7 (T1), 14 (T2) and 21 (T3) cm H2O. For analysis, we used the logarithm of the ratio of the inspiratory activity during the subsequent loads and the activity at baseline (log EMGAR. Reproducibility of the EMG was assessed by comparing the log EMGAR values measured at test day 1 and 2 in both groups. Responsiveness (sensitivity to change) of the EMG was assessed by comparing the log EMGAR values of the COPD patients to those of the healthy subjects at each load. During day 1 and 2 log EMGAR values of the diaphragm and the intercostal muscles correlated significantly. For the scalene muscles significant correlation's were found for the COPD patients. Although inspiratory muscle activity increased significantly during the subsequent loads in all participants, the COPD patients displayed a significantly greater increase in intercostal and left scalene muscle activity compared to the healthy subjects. In conclusion, the present study showed that the EMG technique is a reproducible and sensitive technique to assess breathing patterns in COPD patients and healthy subjects.




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