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Cervical Spine Hyperextension and Altered Posturo-Respiratory Coupling in Patients With Obstructive Sleep Apnea Syndrome.

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  • معلومة اضافية
    • Contributors:
      Institut de Biomécanique Humaine Georges Charpak (IBHGC); Université Sorbonne Paris Nord-Arts et Métiers Sciences et Technologies; HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM)-HESAM Université - Communauté d'universités et d'établissements Hautes écoles Sorbonne Arts et métiers université (HESAM); Neurophysiologie Respiratoire Expérimentale et Clinique (UMRS 1158); Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU); Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP); CHU Pitié-Salpêtrière AP-HP; Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU); This work was supported in part by the Legs Poix (LEG1604) of the Chancellerie des Universités de Paris. LC wassupported by a Ph.D. fellowship from ENS Cachan. VA wasthe recipient of a grant poste d’accueil APHP/Arts et Métiersdélégation à la Recherche Clinique et à l’Innovation (DRCI),Assistance Publique Hôpitaux de Paris (APHP). SR-N wasthe recipient of a grant of ResMed (France). The authorsacknowledge the support of the Paristech BiomeCAM chair onsubject specific modeling, with the support of Société Généraleand COVEA.
    • بيانات النشر:
      HAL CCSD
      Frontiers media
    • الموضوع:
      2020
    • Collection:
      Université Paris 13: HAL
    • نبذة مختصرة :
      International audience ; Obstructive sleep apnea syndrome (OSAS) is associated with postural dysfunction characterized by abnormal spinal curvature and disturbance of balance and walking, whose pathophysiology is poorly understood. We hypothesized that it may be the result of a pathological interaction between postural and ventilatory functions. Twelve patients with OSAS (4 women, age 53 years [51-63] (median [quartiles]), apnea hypopnea index 31/h [24-41]) were compared with 12 healthy matched controls. Low dose biplanar X-rays (EOS® system) were acquired and personalized three-dimensional models of the spine and pelvis were reconstructed. We also estimated posturo-respiratory coupling by measurement of respiratory emergence, obtaining synchronized center of pressure data from a stabilometric platform and ventilation data recorded by an optico-electronic system of movement analysis. Compared with controls, OSAS patients, had cervical hyperextension with anterior projection of the head (angle OD-C7 12° [8; 14] vs. 5° [4; 8]; p = 0.002), and thoracic hyperkyphosis (angle T1-T12 65° [51; 71] vs. 49° [42; 59]; p = 0.039). Along the mediolateral axis: (1) center of pressure displacement was greater in OSAS patients, whose balance was poorer (19.2 mm [14.2; 31.5] vs. 8.5 [1.4; 17.8]; p = 0.008); (2) respiratory emergence was greater in OSAS patients, who showed increased postural disturbance of respiratory origin (19.2% [9.9; 24.0] vs. 8.1% [6.4; 10.4]; p = 0.028). These results are evidence for the centrally-mediated and primarily respiratory origin of the postural dysfunction in OSAS. It is characterized by an hyperextension of the cervical spine with a compensatory hyperkyphosis, and an alteration in posturo-respiratory coupling, apparently secondary to upper airway instability.
    • Relation:
      hal-02535514; https://hal.science/hal-02535514; https://hal.science/hal-02535514/document; https://hal.science/hal-02535514/file/IBHGC_FM_2020_CLAVEL.pdf
    • الرقم المعرف:
      10.3389/fmed.2020.00030
    • Rights:
      info:eu-repo/semantics/OpenAccess
    • الرقم المعرف:
      edsbas.B11777F6