Pediatrics |

Effect of Spinal Deformity on Respiratory Function and Gastroesophageal Reflux in Patients With Severe Motor and Intellectual Dysfunction Syndrome FREE TO VIEW

Naoki Mori, PhD; Hajime Kurosawa, MD; Masanori Yosida, OTR; Azuma Hiramoto, MD; Noboru Chiba, PhD; Tamio keitoku, MS; Kayomi Matsumoto, PhD; Yuko Sano, PhD; Rika Imanishi
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Yamagata Prefectural University of Health Sciences, Yamagata City, Japan

Chest. 2015;148(4_MeetingAbstracts):781A. doi:10.1378/chest.2279578
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SESSION TITLE: Pediatrics Posters

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM

PURPOSE: Severe motor and intellectual dysfunction syndrome (SMIDS) is a disease condition that is close to profound intellectual and multiple disabilities (PIMD). The patients with SMIDS generally have severe spinal deformity, which resulted in significant respiratory dysfunction and complications such as fatal pneumonia. In this study, we hypothesize that Gastroesophageal (GER) reflux might be also involved in the spinal deformity. To this end, we verified the relation between spinal deformity and restrictive respiratory dysfunction, and additionally examined the effects of GER on breathing parameters in patients with SMIDS.

METHODS: Thirty-five patients with SMIDS (M: F 21:14, Age, 33.5y ± 12.1, means ± SD) were studied. Respiratory parameters observed during tidal breathing at the static supine posture.We measured respiratory frequency (f) rate, tidal volume (TV) by a portable spirometer (CHEST GRAPH Jr101, CHEST, Tokyo, Japan). Spinal curvature were measured by the Cobb method using the standard anterior-posterior radiographs. The grade of spinal deformity were divided into three groups according to the Cobb angle (CA) degree, Group A (0°~39°, n=12), Group B (40°~89°, n=10), and Group C (90°~120°, n=13). GER were diagnosed by pediatricians according to the standard guideline.

RESULTS: Both TV and f of Group B and C were significantly lower than those Group A (p<0.01), and were significantly correlated with CA degree. The patients with GER (n=10) had larger CA (93.4° ± 42.1 vs 57.6° ± 33.9) and more restrictive respiratory pattern than those without GER (p<0.01).

CONCLUSIONS: In the patients with SMIDS, the spinal deformity was related to respiratory dysfunction and GER.

CLINICAL IMPLICATIONS: Approaches to care spinal deformities such as physical therapies might be important to prevent GER as well as to decelerate progress in respiratory dysfuntion.

DISCLOSURE: The following authors have nothing to disclose: Naoki Mori, Hajime Kurosawa, Masanori Yosida, Azuma Hiramoto, Noboru Chiba, Tamio keitoku, Kayomi Matsumoto, Yuko Sano, Rika Imanishi

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