Investigating the clinical use of structured light plethysmography to assess lung function in children with neuromuscular disorders

BackgroundChildren and young people with neuromuscular disorders (NMD), such as Duchenne Muscular Dystrophy (DMD), develop progressive respiratory muscles weakness and pulmonary restriction. Pulmonary function monitoring of the decline in lung function allows for timely intervention with cough assist techniques and nocturnal non-invasive ventilation (NIV). NMD may find the measurement of lung function difficult using current techniques. Structured Light Plethysmography (SLP) has been proposed as a novel, non-contact, self-calibrating, non-invasive method of assessing lung function. The overarching aim of this study was to investigate the use of SLP as a novel method for monitoring respiratory function in children with neuromuscular disease.MethodsSLP thoraco-abdominal (TA) displacement was correlated with forced vital capacity measurements recorded by spirometry and the repeatability of the measurements with both methods examined. SLP tidal breathing parameters were investigated to assess the range and repeatability of regional right and left side TA displacement and rib cage and abdominal wall displacement.ResultsThe comparison of the FVC measured with SLP and with spirometry, while having good correlation (R = 0.78) had poor measurement agreement (95% limits of agreement: -1.2 to 1.2L) The mean relative contribution of right and left TA displacement in healthy controls was 50:50 with a narrow range. Repeatability of this measure with SLP was found to be good in healthy controls and moderate in NMD children with/without scoliosis but with a wider range. The majority of the control group displayed a predominant rib cage displacement during tidal breathing and those who displayed predominant abdominal wall displacement showed displacement of both regions close to 50:50 with similar results for the rib cage and abdomen. In comparison, children with NMD have a more variable contribution for all of these parameters. In addition, SLP was able to detect a reduction in abdominal contribution to TA displacement with age in the DMD group and detect paradoxical breathing in children with NMD. Using SLP tracings during tidal breathing we were able to identify three specific patterns of breathing amongst healthy individuals and in children with NMD.ConclusionsSLP is a novel method for measuring lung function that requires limited patient cooperation and may be especially useful in children with neuromuscular disorders. Measuring the relative contributions of the right and left chest wall and chest versus abdominal movements allows a more detailed assessment

Crop Updates 2003 - Geraldton

This session covers twenty eight papers from different authors Seasonal Outlook: What is in store for 2003, David Stephens, Department of Agriculture Examining The Management Options For Wheat Crops In The Coming Season, James Fisher, Department of Agriculture GMO’s – what do they offer? Ian Edwards, Grain Bio Tech Australia Pty Ltd The Big Gamble – Wheat prices for 2003, Dennis Wise, Profarmer Market outlook for other grains, Andrew Young, General Manager Agricorp Stripe rust – where to now for the WA wheat industry? Robert Loughman, Ciara Beard and Greg Shea, Department of Agriculture Baudin and Hamlin – new generation of malting barley developed in Western Australia, Blakely Paynter, Roslyn Jettner and Kevin Young, Department of Agriculture DBM in Canola, Kevin Walden, Department of Agriculture The latest on Lupin diseases, Geoff Thomas, Department of Agriculture Wheat variety performance in 2002 compared to the long term, Robin Wilson, Iain Barclay, Robyn McLean, Robert Loughman, Jenny Garlinge, Bill Lambe, Neil Venn and Peter Clarke, Department of Agriculture Do wide rows drought proof lupins on red loam? Martin Harries, Bob French, Wayne Parker and Murray Blyth, Department of Agriculture Do wide rows drought proof lupins on a sandy loam? Martin Harries, Bob French, Wayne Parker and Murray Blyth, Department of Agriculture Profit Proving Precision Agriculture, Peter Norris, Agronomy For Profit, Greg Lyle, CSIRO Land and Water, Yuna Farm Improvement Group Annual ryegrass seedbanks: the good, the bad, and the ugly, Kathryn Steadman, University of Western Australia, Amander Ellery, CSIRO Plant Industry, Sally C Peltzer, Department of Agriculture Wheat management packages for low rainfall areas, Kari-Lee Falconer, Department of Agriculture Ground water 1. Atrazine, Russell Speed, Department of Agriculture Groundwater 2. Current Trends, Russell Speed, Department of Agriculture Herbicide tolerance of wheat, lupins and pastures, Terry Piper and Harmohinder Dhammu, Department of Agriculture Farming with Tramlines, Bindi Webb, Paul Blackwell, Department of Agriculture, Phil Logue, Binnu, Nigel Moffat, Geraldton, Rohan Ford, Binnu, Miles Obst, Mingenew, The role of green manure crops in renovating poor performing paddocks: What’s it worth? Frances Hoyle, Leanne Schulz and Judith Devenish Department of Agriculture The looming threat of wild radish, Peter Newman, Department of Agriculture Does one ‘size’ fit all? Grant Morrow, Syngenta Crop Protection Climate Forecasts on the Internet, Ian Foster and David Stephens, Department of Agriculture Moisture delving = more reliable lupin establishment, Paul Blackwell, and Wayne Parker, Department of Agriculture Tramline Designs for better Weed control and Wheat value from non-spraying tramlines in a dry season, Paul Blackwell, Bindi Webb and Darshan Sharma, Department of Agriculture Biserrula Grazing Trial, Marnie Thomas, Department of Agriculture Performance of IT and TT canola varieties in the medium and high rainfall agzones of W.A., 2001-02, Graham Walton, Hasan Zaheer and Paul Carmody, Department of Agriculture Rapid Catchment Appraisal in Northern Agricultural Region, Mike Clarke, Paul Raper, Department of Agricultur