Abstract
Respiratory disease is the most common cause of both acute and chronic illness in children. Optimal management of respiratory disease relies on accurate assessment of disease severity and response to interventions. Current measures of pulmonary function are both unsuited to use in pre-school age children as well as poorly representing the range of pathophysiological changes occurring across the spectrum of lung diseases in children. Electromyography of the parasternal intercostal muscles (EMGpara), as a marker of respiratory system load-capacity balance, may represent a novel, effort-independent method for assessment of respiratory disease in paediatric populations.The studies within this thesis assessed the application of EMGpara in evaluating response to clinical interventions in children with asthma and cystic fibrosis, as well as obtaining values of EMGpara values in healthy children, and comparing these measures of EMGpara to those obtained in the children with respiratory disease. This thesis also further investigated the relationship between EMGpara and conventional measures of pulmonary function in both adult and paediatric subjects.
Reductions in EMGpara activity were demonstrated following administration of bronchodilator in children with asthma, and with resolution of an infective exacerbation in children hospitalised for an acute exacerbation of cystic fibrosis lung disease. Data from a large cohort of healthy children, as well as highlighting technical and developmental considerations relevant to clinical application of the EMGpara technique, also demonstrated higher levels of EMGpara in children with respiratory disease compared to healthy controls. The absence of statistically significant correlations between EMGpara and standard pulmonary function variables from the studies conducted in both children with respiratory disease and in adult subjects undergoing incremental induced bronchoconstriction indicated the complex, multifactorial relationship between respiratory muscle activity and pulmonary function. While EMGpara cannot be viewed as a substitute for conventional lung function techniques, the data from the studies contained within this thesis support further investigation and development of this novel method to assess of respiratory disease.
| Date of Award | 2014 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Gerrard Rafferty (Supervisor) & Anne Greenough (Supervisor) |