Physical Status and Upper Airway Function in Neuromuscular Patients

Degree Physical Status and Upper Airway Function in Neuromuscular Patients

Inside of studies that report an upper airway function impaired, the upper limb strength has been demonstrated to be determinant in breath, speech and swallow performance. Nevertheless, no previous studies in neuromuscular disease have explored the relation between general disability and upper airway function.

There is a suspicion of upper airway which is associated with physical deterioration, however the extent to which if feeds back has not been explored.

Study Overview

• Status: Completed
• Conditions: Neuromuscular Diseases; Physical Disability; Airway Disease

• Study Type: Observational
• Enrollment (Actual): 41

Contacts and Locations

Study Locations

• Spain
  • Granada, Spain
    • University of Granada

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 6 years to 65 years (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

Patients diagnosed of neuromuscular disease aged 6-65 years with an impairment of the upper airway, whether in ventilatory, deglutory or communication capacity.

Description

Inclusion Criteria:

• Diagnosis of Neuromuscular disease
• Between 6 and 65 years
• Impairment of the upper airway
• Accepted to sign the informed consent

Exclusion Criteria:

• Cognitive impairment.
• Diagnose of autism spectrum disorder or severe intellectual disability
• Physical or functional impairment that limits the performance of evaluation

Study Plan

How is the study designed?

Number of groups / cohorts

3

Cohorts and Interventions

Group / Cohort
Control group; Healthy subjects
Neuromuscular low physical status group; Patients diagnosed of Neuromuscular disease with low physical status
Neuromuscular high physical status group; Patients diagnosed of Neuromuscular disease with high physical status

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hand grip strength	Hand grip strength will be evaluated with a pressure dynamometer according to the protocol, to their maximum ability in a seated position . The average of three attempts for the dominant hand will be recorded. It has been proven that it can be used as an indicator of general health and as a strong predictor of future mortality, disability, falls, complications and resource utilization.	Baseline
Respiratory function	Respiratory function will be evaluated with spirometry following standardized protocols. Collected variables will be Forced Expiratory Volume in the First Second (FEV1), Forced Vital Capacity (FVC) and Maximal Voluntary Ventilation (MVV).	Baseline
Peak expiratory flow	Peak expiratory flow is a person's maximum speed of expiration, as measured with a peak flow meter, a small, hand-held device used to monitor a person's ability to breathe out air. It will be measured following standardized protocols.	Baseline

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Hospital Anxiety and Depression Scale	Anxiety and depression will be assessed with the Hospital Anxiety and Depression Scale (HADS) . This scale is composed of 14 items divided into two subscales, 7 items of anxiety and 7 items of depression, involving higher values worse psycho-emotional state.	Baseline
European Quality of Life-5 Dimensions (EQ-5D)	The perception of the level of health and the quality of life were evaluated with the questionnaire European Quality of Life-5 Dimensions (EQ-5D). It is composed of 2 parts in which health status is assessed: Descriptive system: It consists on 5 dimensions that include mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Patients classify their health status in 3 severity levels: having no problems, having some or moderate problems, being unable to do/having extreme problems.; Visual Analog Scale, by which respondents can report their perceived health status with a grade ranging from 0 (the worst possible health status) to 100 (the best possible health status).	Baseline
Fatigue Severity Scale	Fatigue severity scale (FSS) will be used to measure fatigue. It consists of 9 items with answers that the patient scores between 1 and 7. The total is calculated by adding all the items. For children will be used The PedsQL™ Multidimensional Fatigue Scale, which is composed of 18 items comprising 3 dimensions (general fatigue, sleep/rest fatigue, cognitive fatigue), evaluated thorough a Liker scale with values from 0 (never) to 4 (almost always), referring to difficulty presented.	Baseline
World Health Organization Disability Assessment Scale (WHODAS) 2.0 (WD2)	To measure the degree of disability, the World Health Organization Disability Assessment Scale, WHODAS 2.0 (WD2) will be used. It measures changes in functioning and levels of difficulty in carrying out and carrying out its activities . The WD2 scale is composed of 36 items divided into 6 domains, evaluated through a Likert scale with values from 1 to 5, referring to the difficulty presented. Higher scores show a greater degree of disability.	Baseline
Activity Limitations in Children and Adults With Neuromuscular Disorders (ACTIVLIM)	The Activity Limitations in Children and Adults With Neuromuscular Disorders (ACTIVLIM) questionnaire is an instrument to measure functional limitation and has been calibrated in children and adults with neuromuscular diseases, according to the difficulty of patients to perform daily activities that require the use of the upper extremities and / or lower.	Baseline
Brief pain inventory	For pain assessment we will use a specific brief pain questionnaire, Brief Pain Inventory , which consists of three parts. In the first, the patient will indicate in a drawing the area in which he presents this pain. The second part refers to the pain felt in the last days, where it is scored, as in the previous questionnaire, from 0 to 10 (0 being no pain and 10 being the maximum pain felt). Finally, in a third part we see how that pain influences the different activities that the patient performs in his day to day.	Baseline
Muscle strength of the neck	To evaluate the muscle strength of the neck in neuromuscular patients, neck dynamometry will be performed. With subtests in which front bending, extension, pure lateral flexion, lateral flexion with rotation and pure rotation were measures.	Baseline
Eating Assessment Tool-10 (EAT-10)	The EAT-10 is a self-administered instrument that evaluate specific symptoms of dysphagia with 10 items and each item have a range from zero (no problem to swallow) to four (a serious problem for life). In the case of patients pediatric with dysphagia it used Pediatric Eating Assessment Tool (PEDI-EAT-10)	Baseline
Swallowing quality of life questionnaire (SWAL-QOL)	To measure the possible swallowing problems in daily life we will used the SWAL-QOL, it contains 44 items and each item was scored from zero (the worst state) to four (the best state) . This questionnaire consists of 44 items, consisting of 11 subscales. With a Likert type score in which the patient scores between 1 and 5. Where 1 indicates the worst state and 5 the most favorable.	Baseline
Functional Oral Intake Scale (FOIS) questionnaire	The severity of swallowing will be assessed using the Functional Oral Intake Scale (FOIS) questionnaire . This scale consists of 7 levels, with 1 being the most severe and 7 being the least severe, the patient has to select the level with which he is.	Baseline
Karaduman Chewing Performance Scale (KCPS)	There are also questionnaires like Karaduman Chewing Performance Scale (KCPS) , that permitted us evaluate the function of chewing, this test has not been used in previous studies in adults, so in this study we have only used it in the childrens patients.	Baseline
Orofacial Myofunctional Evaluation with Scores (OMES)	Clinical evaluation of the orofacial myofunctional condition will be evaluated using the Orofacial Myofunctional Evaluation with Scores (OMES) . It consisting of 4 subscales: appearance and posture, mobility and functions (breathing, deglutition, mastication). The examiner attributed scores on a 3 point scale: 3=normal, 2= insufficient ability; and 1= absence of ability or being unable to perform the task.	Baseline
Volume Viscosity Clinical Exploration Method (MECV-V)	Volume Viscosity Clinical Exploration Method (MECV-V) , this test provides us with information about the volume to which the 5ml, 10ml and 20 ml patients are able to feed and tells us what viscosity, nectar, liquid and pudding. It is used in the diagnosis of oropharyngeal dysphagia.	Baseline
Voice handicap index (VHI-30)	The phonatory function and it´s repercussion on daily life will be evaluated by the Voice handicap index (VHI-30) . This scale consists of 30 items, consisting of 3 subscales, functional, physical and emotional. In which the patient must indicate the presence or symptoms of dysphonia with a Likert type score of 5 points, in which 0 indicates never and 4 always indicates.	Baseline
Grade, Roughness, Breathing, Asthenia, Effort (GRBAS)	Perceptual scale of Grade, Roughness, Breathing, Asthenia, Effort (GRBAS) . Will be used to analyze qualitative aspects of the voice, it is completed by the evaluator who qualifies as: 0 normal, 1 mild, 2 moderate, 3 severe, each quality of the voice (Degree of dysphonia, scratchy, blown, weak or asthenic, tight or strangled).	Baseline
Functional evaluation of the voice	The functional evaluation of the voice will allow us to measure the intensity, frequency and duration of the voice: To evaluate the intensity of the voice, measured in decibels (dB), we will use a sound level meter; To evaluate the frequency of the voice , measured in Hz (Hz), we use the PRAAT software (Praat from the Dutch "speak"). In addition, the duration of the phonation and breathing times , measured in Sg, will be evaluated, for this we use an audio recorder.	Baseline

Collaborators and Investigators

• Sponsor: Universidad de Granada

Study record dates

Study Major Dates

• Study Start (Actual): July 20, 2020
• Primary Completion (Actual): August 15, 2020
• Study Completion (Actual): September 1, 2020

Study Registration Dates

• First Submitted: July 8, 2020
• First Submitted That Met QC Criteria: July 13, 2020
• First Posted (Actual): July 16, 2020

Study Record Updates

• Last Update Posted (Actual): October 14, 2020
• Last Update Submitted That Met QC Criteria: October 9, 2020
• Last Verified: October 1, 2020

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Nervous System Diseases; Neuromuscular Diseases
• Other Study ID Numbers: DF0091UG

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No