{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T01:58:53Z","timestamp":1747187933809,"version":"3.40.5"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T00:00:00Z","timestamp":1618531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2012\/18404\u20138"],"award-info":[{"award-number":["2012\/18404\u20138"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2021,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and objective<\/jats:title><jats:p>The precise coordination of respiratory muscles during exercise minimizes work of breathing and avoids exercise intolerance. Fibrotic interstitial lung disease (f\u2010ILD) patients are exercise\u2010intolerant. We assessed whether respiratory muscle incoordination and thoracoabdominal asynchrony (TAA) occur in f\u2010ILD during exercise, and their relationship with pulmonary function and exercise performance.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We compared breathing pattern, respiratory mechanics, TAA and respiratory muscle recruitment in 31 f\u2010ILD patients and 31 healthy subjects at rest and during incremental cycle exercise. TAA was defined as phase angle (PhAng) &gt;20\u00b0.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During exercise, when compared with controls, f\u2010ILD patients presented increased and early recruitment of inspiratory rib cage muscle (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.05), and an increase in PhAng, indicating TAA. TAA was more frequent in f\u2010ILD patients than in controls, both at 50% of the maximum workload (42.3% vs. 10.7%, <jats:italic>p<\/jats:italic>\u00a0=\u20090.01) and at the peak (53.8% vs. 23%, <jats:italic>p<\/jats:italic>\u00a0=\u20090.02). Compared with f\u2010ILD patients without TAA, f\u2010ILD patients with TAA had lower lung volumes (forced vital capacity, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.01), greater dyspnoea (Medical Research Council\u2009&gt;\u20092 in 64.3%, <jats:italic>p<\/jats:italic>\u00a0=\u20090.02), worse exercise performance (lower maximal work rate % predicted, <jats:italic>p<\/jats:italic>\u00a0=\u20090.03; lower tidal volume, <jats:italic>p<\/jats:italic>\u00a0=\u20090.03; greater desaturation and dyspnoea, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.01) and presented higher oesophageal inspiratory pressures with lower gastric inspiratory pressures and higher recruitment of scalene (<jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.05).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Exercise induces TAA and higher recruitment of inspiratory accessory muscle in ILD patients. TAA during exercise occurred in more severely restricted ILD patients and was associated with exertional dyspnoea, desaturation and limited exercise performance.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.14064","type":"journal-article","created":{"date-parts":[[2021,4,16]],"date-time":"2021-04-16T23:58:55Z","timestamp":1618617535000},"page":"673-682","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Thoracoabdominal asynchrony associates with exercise intolerance in fibrotic interstitial lung diseases"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2278-4788","authenticated-orcid":false,"given":"Pauliane Vieira","family":"Santana","sequence":"first","affiliation":[{"name":"Pulmonary Division Heart Institute (InCor), Hospital das Cl\u00ednicas HCFMUSP, Faculdade de Medicina da Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Intensive Care Unit AC Camargo Cancer Center  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leticia Zumpano","family":"Cardenas","sequence":"additional","affiliation":[{"name":"Pulmonary Division Heart Institute (InCor), Hospital das Cl\u00ednicas HCFMUSP, Faculdade de Medicina da Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Intensive Care Unit AC Camargo Cancer Center  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeferson George","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Pulmonary Division Heart Institute (InCor), Hospital das Cl\u00ednicas HCFMUSP, Faculdade de Medicina da Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Intensive Care Unit AC Camargo Cancer Center  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos Roberto Ribeiro","family":"de Carvalho","sequence":"additional","affiliation":[{"name":"Pulmonary Division Heart Institute (InCor), Hospital das Cl\u00ednicas HCFMUSP, Faculdade de Medicina da Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andr\u00e9 Luis Pereira","family":"de Albuquerque","sequence":"additional","affiliation":[{"name":"Pulmonary Division Heart Institute (InCor), Hospital das Cl\u00ednicas HCFMUSP, Faculdade de Medicina da Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"S\u00edrio\u2010Liban\u00eas Teaching and Research Institute Hospital S\u00edrio Liban\u00eas  S\u00e3o Paulo SP Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Caruso","sequence":"additional","affiliation":[{"name":"Pulmonary Division Heart Institute (InCor), Hospital das Cl\u00ednicas HCFMUSP, Faculdade de Medicina da Universidade de S\u00e3o Paulo  S\u00e3o Paulo Brazil"},{"name":"Intensive Care Unit AC Camargo Cancer Center  S\u00e3o Paulo Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,4,16]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1997.83.4.1256"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1988.64.1.135"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2017.00082"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/thx.47.2.93"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.109.6.1566"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.127.6.2028"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000338787"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00109512"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1998.84.6.2000"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201504-0841OC"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00141607"},{"key":"e_1_2_9_13_1","doi-asserted-by":"crossref","first-page":"320","DOI":"10.4187\/respcare.01522","article-title":"Asynchronous thoraco\u2010abdominal motion contributes to decreased 6\u2010minute walk test in patients with COPD","volume":"58","author":"Chien J\u2010Y","year":"2013","journal-title":"Respir Care"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.05.00034205"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1806-37132007000400008"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.08-1541"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ultrasmedbio.2017.11.020"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.03999"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.166.4.518"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1806-37132012000600004"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.04.00029004"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1989.66.1.410"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1050-6411(00)00027-4"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.167.2.211"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1249\/00005768-198205000-00012"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.164.8.2103007"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1249\/MSS.0b013e318242987d"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00508.2016"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prrv.2009.02.004"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1996.81.1.437"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/141.2.337"},{"key":"e_1_2_9_32_1","first-page":"47","article-title":"Thoracoabdominal motion in chronic obstructive pulmonary disease","volume":"115","author":"Sharp JT","year":"1977","journal-title":"Am Rev Respir Dis"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/0034-5687(83)90057-9"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2018.00719"},{"key":"e_1_2_9_35_1","first-page":"1043","article-title":"Weaning from mechanical ventilation","volume":"138","author":"Marini J","year":"1988","journal-title":"Am Rev Respir Dis"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0182417"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/147.4.857"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1997.83.4.1242"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1988.64.6.2482"},{"key":"e_1_2_9_40_1","first-page":"121","article-title":"The regional distribution of ventilation and perfusion in paralysis of the diaphragm","volume":"119","author":"Loh L","year":"1979","journal-title":"Am Rev Respir Dis"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1186\/1465-9921-11-109"}],"container-title":["Respirology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/resp.14064","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/resp.14064","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/resp.14064","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T21:48:08Z","timestamp":1693000088000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/resp.14064"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,16]]},"references-count":40,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2021,7]]}},"alternative-id":["10.1111\/resp.14064"],"URL":"https:\/\/doi.org\/10.1111\/resp.14064","archive":["Portico"],"relation":{},"ISSN":["1323-7799","1440-1843"],"issn-type":[{"type":"print","value":"1323-7799"},{"type":"electronic","value":"1440-1843"}],"subject":[],"published":{"date-parts":[[2021,4,16]]},"assertion":[{"value":"2020-09-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-03-31","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2021-04-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}