Send to

Choose Destination
Chron Respir Dis. 2017 May;14(2):110-116. doi: 10.1177/1479972316674413. Epub 2017 Feb 24.

Short-term effect of volume recruitment-derecruitment manoeuvre on chest-wall motion in Duchenne muscular dystrophy.

Author information

1 Physiology, Functional Testing Department and Technological Innovations Centre, Raymond Poincaré Teaching Hospital, Garches, France.
2 UMR Inserm 1179, Université de Versailles Saint-Quentin-en-Yvelines, Versailles, France.
3 Laboratoire Européen Performance Santé Altitude (LEPSA: EA4604), Université de Perpignan Via Dominitia (UPVD), Font Romeu, France.


Because progressive respiratory muscle weakness leads to decreased chest-wall motion with eventual ribcage stiffening, the purpose was to compare vital capacity (VC) and contributions of chest-wall compartments before and after volume recruitment-derecruitment manoeuvres (VRDM) in Duchenne muscular dystrophy (DMD). We studied nine patients with DMD and VC lower than 30% of predicted. VRDM was performed using 15 insufflations-exsufflations of +30 to -30 cmH2O. VC and three-dimensional chest-wall motion were measured, as well as oxygen saturation, transcutaneous partial pressure of carbon dioxide and the rapid shallow breathing index (respiratory rate/tidal volume) before (baseline) and immediately and 1 hour after VRDM. VC increased significantly immediately after VRDM (108% ± 7% of baseline, p = 0.018) but returned to baseline within 1 hour, and the rapid shallow breathing index increased significantly. The non-dominant side systematically increased immediately after VRDM ( p = 0.0077), and in the six patients with abnormal breathing asymmetry (difference >10% of VC) at baseline, this asymmetry was corrected immediately and/or 1 hour after VRDM. VRDM improved VC and reduced chest-wall motion asymmetry, but this beneficial effect waned rapidly with respiratory muscle fatigue, suggesting that VRDM may need to be repeated during the day to produce lasting benefits.


Duchenne muscular dystrophy; lung function; mechanical insufflation–exsufflation; physiotherapy; respiratory mechanics

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Atypon Icon for PubMed Central
Loading ...
Support Center