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Spirometry is Affected by Intelligence and Behavior in Duchenne Muscular Dystrophy
Author(s) -
Gauld Leanne M.,
Boynton Alison,
Betts Grant A.,
Johnston Heather
Publication year - 2005
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.20278
Subject(s) - spirometry , medicine , duchenne muscular dystrophy , physical therapy , crossover study , muscular dystrophy , pediatrics , intelligence quotient , asthma , psychiatry , cognition , pathology , alternative medicine , placebo
Children with Duchenne muscular dystrophy (DMD) have progressive respiratory muscle weakness. Spirometry monitors progress, but is effort‐dependent. Intelligence quotients (IQ) average one standard deviation below normal, and behavioral disturbance is common. Our aim was to assess if impaired intelligence or behavior influences spirometry in children with DMD, and if computerized visual incentives (CVI) are beneficial. Forty‐seven boys with DMD, of mean age 12.6 years (range, 6–19), were recruited. Full‐scale, performance, and verbal IQ, and parent‐and‐teacher‐reported oppositional behavior scores, were recorded. Each was divided into moderate, mild, and no impairment groups. A randomized crossover design was applied to performing spirometry with or without CVI first. A Jaeger Masterscope (version 4.60) was used. Linear regression defined the relationship between spirometry and both IQ and behavior scores. The paired Student's t ‐ test compared spirometry performed with and without CVI for the overall group and subgroups. Boys with DMD can adequately perform spirometry. There is an association between %FEV 1 and %FVC with full‐scale (r = 0.50, P = 0.002; r = 0.49, P = 0.003, respectively), performance (r = 0.68, P < 0.0005; r = 0.68, P < 0.0005, respectively) and verbal (r = 0.39, P = 0.043; r = 0.36, P = 0.037, respectively) IQ, but not with parent ( P = 0.77, P = 0.70, respectively) or teacher ( P = 0.90, P = 0.90, respectively)‐reported oppositional behavior scores. The effect of CVI was significant in those with moderate full‐scale ( P = 0.03), performance ( P = 0.002), and verbal ( P = 0.02) intellectual impairment, and moderately severe teacher‐reported oppositional behavior ( P = 0.02). In conclusion, spirometry results are related to intelligence in DMD. Using CVI improves the FVC obtained in those with moderate intellectual or behavioral impairment. Pediatr Pulmonol. © 2005 Wiley‐Liss, Inc.