{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T16:26:14Z","timestamp":1778689574926,"version":"3.51.4"},"reference-count":56,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T00:00:00Z","timestamp":1592265600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2020,11]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Advanced stages of Duchenne muscular dystrophy (DMD) result in muscle weakness and the inability to generate an effective cough. Several factors influence the effectiveness of cough in patients with DMD. The aim of this study was to assess whether differences in positioning affect cough peak flow (CPF) and muscular electromyographic activation in subjects with DMD compared with paired healthy subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>Optoelectronic plethysmography and surface electromyography were used to assess chest wall volumes, chest wall inspiratory capacity, CPF, breathing pattern, and electromyographic activity of sternocleidomastoid, scalene, rectus abdominis, and external oblique muscles during inspiratory and expiratory cough phases in the supine position, supine position with headrest raised at 45\u00b0, and sitting with back support at 80\u00b0 in 12 subjects with DMD and 12 healthy subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      Subjects with DMD had lower CPF (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .01) in comparison to control subjects in all positions; the DMD group also exhibited lower CPF (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .045) in the supine position versus 80\u00b0. Moreover, the relative volume contributions of the rib cage and abdominal compartments to tidal volume modified significantly with posture. The electromyographic activity during inspiratory and expiratory cough phases was lower in subjects with DMD compared to healthy subjects for all evaluated muscles (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05), but no significant differences were observed with posture change.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>In subjects with DMD, posture influenced CPF and the relative contribution of the rib cage and abdominal compartments to tidal volume. However, muscular electromyographic activation was not influenced by posture in subjects with DMD and healthy subjects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.07426","type":"journal-article","created":{"date-parts":[[2020,6,16]],"date-time":"2020-06-16T20:22:46Z","timestamp":1592338966000},"page":"1668-1677","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Effects of Positioning on Cough Peak Flow and Muscular Electromyographic Activation in Duchenne Muscular Dystrophy"],"prefix":"10.1177","volume":"65","author":[{"given":"Layana","family":"Marques","sequence":"first","affiliation":[{"name":"PneumoCardioVascular Lab, Hospital Universitario Onofe Lopes, Empresa Brasileira de Servi\u00e7os Hospitalares, Natal, Brazil."},{"name":"Laborat\u00f3rio de Inova\u00e7\u00e3o Tecnol\u00f3gica em Reabilita\u00e7\u00e3o, Departamento de Fisioterapia, Universidade Federal do Rio Grande do 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