Publications by authors named "Nicolas Audag"

12 Publications

  • Page 1 of 1

Screening for oropharyngeal dysphagia in adult patients with neuromuscular diseases using the Sydney Swallow Questionnaire.

Muscle Nerve 2021 Apr 23. Epub 2021 Apr 23.

Institut de Recherche Expérimentale et Clinique, Pôle de Pneumologie, ORL & Dermatologie, Groupe Recherche en Kinésithérapie Respiratoire, Université Catholique de Louvain, Brussels, Belgium.

Introduction/aims: Oropharyngeal dysphagia is common in patients with neuromuscular diseases (NMDs). Its early recognition is vital for proper management. We tested a large cohort of adult NMD patients for oropharyngeal dysphagia using the Sydney Swallow Questionnaire (SSQ). We also looked for possible differences in characteristics of oropharyngeal dysphagia in various NMD groups and diseases. Finally, we compared results of this screening with those from their corresponding medical records for eventual "clinical history" of dysphagia.

Methods: We asked patients to fill in the SSQ during follow-up outpatient visits at our neuromuscular reference center. A total score above the cutoff score of 118.5 out of 1700 was indicative of oropharyngeal dysphagia.

Results: Of the 304 adult patients assessed for eligibility, 201 NMD patients (96 women and 105 men, aged 49.0 ± 16.2 years) were included and tested in this study. Oropharyngeal dysphagia was detected in 45% of all the NMD patients when using the SSQ, whereas only 12% had a positive medical record for dysphagia. The median SSQ scores for patients with myotonic syndromes (including myotonic dystrophy type 1), with amyotrophic lateral sclerosis, and with facioscapulohumeral dystrophy were above the cutoff score. The SSQ scores obtained revealed distinct oropharyngeal dysphagia characteristics in the different NMD groups and diseases.

Discussion: The SSQ tests positively for oropharyngeal dysphagia in a higher proportion of NMD patients compared with their medical records. The distinct oropharyngeal dysphagia characteristics we revealed in different NMD groups and diseases may help to elaborate adapted clinical approaches in the management of oropharyngeal dysphagia.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/mus.27254DOI Listing
April 2021

Mouthpiece ventilation in neuromuscular disorders: Narrative review of technical issues important for clinical success.

Respir Med 2021 Apr-May;180:106373. Epub 2021 Mar 24.

Norwegian Advisory Unit on Home Mechanical Ventilation, Thoracic Department, Haukeland University Hospital, Bergen, Norway. Electronic address:

In neuromuscular disorders (NMDs), nocturnal non-invasive ventilation (NIV) via a nasal mask is offered when hypercapnic respiratory failure occurs. With disease progression, nocturnal NIV needs to be extended into the daytime. Mouthpiece ventilation (MPV) is an option for daytime NIV. MPV represents a difficult task for home ventilators due to rapidly changing load conditions resulting from intermittent connections and disconnections from MPV circuit. The 252nd ENMC International Expert Workshop, held March 6th to 8th 2020 in Amsterdam, reported general guidelines for management of daytime MPV in NMDs. This report could not present all the detail regarding the technical issues important for clinical success of MPV. Based on the expert workshop discussions and the evidence from existing studies, the current narrative review aims to identify the technical issues of MPV and offers guidance via a decisional algorithm and educational figures providing relevant information that is important for successful implementation of MPV.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.rmed.2021.106373DOI Listing
March 2021

Predictive model for the 1-minute sit-to-stand test in healthy children aged 6 to 12 years.

Ann Phys Rehabil Med 2021 Mar 16;64(2):101410. Epub 2020 Jul 16.

Service de médecine physique et readaptation, cliniques universitaires Saint-Luc, Bruxelles, Belgium.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.rehab.2020.05.013DOI Listing
March 2021

Intrapulmonary percussive ventilation leading to 20-minutes breath-hold potentially useful for radiation treatments.

Radiother Oncol 2019 12 25;141:292-295. Epub 2019 Oct 25.

Pôle de Pneumologie, ORL & Dermatologie (PNEU), Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium; Haute Ecole Léonard de Vinci, PARNASSE-ISEI, Brussels, Belgium; Secteur de kinésithérapie, Cliniques universitaires Saint-Luc, Brussels, Belgium; Service de Pneumologie, Cliniques universitaires Saint-Luc, Brussels, Belgium.

We developed a training protocol based on Intrapulmonary Percussive Ventilation in order to prolong breath-hold while nearly suppressing the thorax motion. This protocol allowed ten subjects to achieve a 20-minutes-breath-hold, while reducing the residual surface motion to 1 mm around its mean position for more than 95% of the breath-hold duration.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.radonc.2019.09.024DOI Listing
December 2019

Screening and evaluation tools of dysphagia in adults with neuromuscular diseases: a systematic review.

Ther Adv Chronic Dis 2019 31;10:2040622318821622. Epub 2019 Jan 31.

Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium.

Background: The purpose of this systematic review was to summarize the different dysphagia screening and evaluation tools, and to identify their measurement properties in adults with neuromuscular diseases (NMDs).

Methods: A systematic review was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search strategy was conducted across three databases ( and ). Measurement properties of each tools and the Quality Index, developed by Downs and Black, were considered for the different investigated studies.

Results: The search strategy produced 2221 articles. After removal of duplicates and full-text analysis, 19 studies were included. Most of the publications focused on amyotrophic lateral sclerosis (ALS; = 10) and Duchenne muscular dystrophy (DMD; = 4). A total of 12 tools, listed as instrumental and noninstrumental examinations, were retrieved. A total of five of them used videofluoroscopic swallow study (VFSS). Measurement properties of the tools are not completely described in detail in many studies. The neuromuscular disease swallowing status scale, a noninstrumental tool, is the only one that assessed all measurement properties in ALS patients. The median score reported for the Quality Index was 16.

Conclusions: This systematic review identified 12 different tools for the screening and evaluation of dysphagia in adults with NMD. Majority of the studies presented VFSS as a valid and reliable examination to assess dysphagia in ALS and DMD. Other tools were mainly evaluated in ALS patients, but further studies are needed to complete their measurement properties. In other NMDs, no firm conclusion can be made because of insufficient data and heterogeneity of NMDs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1177/2040622318821622DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357297PMC
January 2019

Validation and Reliability of the French Version of the Sydney Swallow Questionnaire.

Dysphagia 2019 08 1;34(4):556-566. Epub 2019 Feb 1.

Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium.

Oropharyngeal dysphagia is frequently under-reported and early detection may lead to adapt strategies of rehabilitation and management decisions. The Sydney Swallow Questionnaire (SSQ), a self-reported questionnaire for the detection and quantification of oropharyngeal dysphagia, was previously adapted and validated in other languages but not in French. The purposes of this study were to develop and validate a French version of SSQ (SSQ-f) and to assess its psychometric properties. This SSQ-f, obtained by back-translation and cross-cultural adaptation, was validated in 27 patients with impaired swallowing and 27 healthy controls. After inclusion, patients filled in the SSQ-f and performed a videofluoroscopic swallow study. The penetration aspiration scale (PAS) and Dysphagia outcome and severity scale (DOSS) were assigned to assess construct validity. Sensitivity and specificity of cut-off scores for the SSQ-f were assessed by the receiver operating characteristic (ROC) curves. Moreover, the SSQ-f was repeated after 2 weeks to evaluate its test-retest reliability. The results supported that SSQ-f was considered understandable. Its total score was strongly correlated to the DOSS (r = - 0.873) and to the PAS (r = 0.738). It demonstrated acceptable internal consistency, with Cronbach's alpha values ranging from 0.744 to 0.956. The test-retest reliability was excellent. According to the ROC curve, cut-off scores of 118.5 or 218.5 were proposed for determining oropharyngeal dysphagia using DOSS as a reference and 755.0, using PAS as reference. No ceiling or floor effects were observed. In conclusion, the SSQ-f is a valid and reliable instrument to measure and detect oropharyngeal dysphagia in French-speaking subjects and can be used in a clinical setting.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00455-019-09978-9DOI Listing
August 2019

Learning and Encouragement Effects on Six-Minute Walking Test in Children.

J Pediatr 2018 07 24;198:98-103. Epub 2018 Apr 24.

Institute of Experimental and Clinical Research (IREC), Pole of Pulmonology, ORL & Dermatology, Catholic University of Louvain, Brussels, Belgium; Department of Physical Medicine and Rehabilitation, Saint-Luc University Clinics, Brussels, Belgium; Leonard de Vinci High School, Parnasse-Deux Alice, Brussels, Belgium; Pulmonology Unit, University Hospital Saint-Luc, Brussels, Belgium. Electronic address:

Objectives: To evaluate learning and encouragement effects on the 6-minute walk test in children between 6 and 12 years of age.

Study Design: Two 6-minute walk tests separated by a 10-minute resting period were performed by healthy children between 6 and 12 years of age to evaluate the learning (part 1) and encouragement effects (part 2; randomization with and without encouragement). Distance and cardiorespiratory variables were used as outcomes.

Results: 148 children were recruited. The intraclass correlation coefficient estimates were 0.927 (95% CI, 0.893-0.951; part 1) and 0.844 (95% CI, 0.744-0.907; part 2). The test-retest agreement was verified for distance (P = .679) with a bias of 1.1 m (95% CI, -4 to 6), but the increase in distance with encouragement was significantly and clinically relevant (P < .001; +41 m; 95% CI, 33-50).

Conclusion: No training is required for the 6-minute walk test in children, in contrast with adults, but there was an encouragement effect on the walked distance in these children. Guidelines should take these results into account.

Trial Registration: ClinicalTrials.gov: NCT03276299.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.jpeds.2018.02.073DOI Listing
July 2018

Intrapulmonary Percussive Ventilation as an Airway Clearance Technique in Subjects With Chronic Obstructive Airway Diseases.

Respir Care 2018 May 24;63(5):620-631. Epub 2018 Apr 24.

Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium.

Background: Airway clearance techniques are regularly proposed as a part of the treatment in chronic obstructive airway diseases. Intrapulmonary percussive ventilation (IPV) is used as an airway clearance technique in patients affected by excessive lung secretions. The aim of this systematic review is to summarize the physiological and clinical effects related to the use of IPV as an airway clearance technique in chronic obstructive airway diseases.

Methods: This systematic review followed the PRISMA guidelines. Randomized, controlled, comparative, and cohort studies investigating IPV as an airway clearance technique were identified and reviewed from 3 databases. Two reviewers independently assessed study quality and reviewed the selected studies.

Results: 278 subjects from 12 studies were included in the final analysis, with 3 diseases studied. Only one of the included studies had a sample size > 50 subjects. The main findings showed that IPV improves gas exchange during exacerbation and could reduce the hospital length of stay for patients with COPD. In subjects with cystic fibrosis, neither lung function nor other parameters were improved.

Conclusions: The systematic use of IPV as an airway clearance technique in chronic obstructive airway diseases is not supported by sufficiently strong evidence to recommend routine use in this patient population.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4187/respcare.05876DOI Listing
May 2018

Validation of 6 min step test and 4-m gait speed in children: A randomized cross-over study.

Gait Posture 2018 Mar 24;61:19-24. Epub 2017 Dec 24.

Service de Médecine Physique et Réadaptation, Cliniques universitaires Saint-Luc, Bruxelles, Belgium. Electronic address:

Introduction: Even if 6-min walking test (6MWT) is the criterion standard for functional exercise performance evaluation, new field tests are required as practical alternative. This study aims to establish the validity of the 6-min step test (6MST) and the 4-m gait speed (4MGS) in children.

Method: It is a randomized cross-over trial. Sixty one healthy children from 6 to 12 years were recruited. 6MWT, 6MST and 4MGS were randomly performed on three consecutive days. Pulsed oxygen saturation (SpO2), heart rate (HR), dyspnea (VAS) and fatigue (PCERT) were used as outcomes.

Results: The distance walked during 6MWT was correlated to the number of steps during 6MST (r = 0.320; p = 0.013) and not correlated to 4MGS (r = -0.074; p = 0.575). No correlation between number of steps during 6MST and 4MGS (r = -0.129; p = 0.332) was found. HR was lower than the theoretical maximal HR after the tests. The increase in HR was significantly higher for 6MST and significantly lower for 4MGS than for 6MWT and it was higher for 6MST than for 4MGS. Dyspnea and perceived exertion were lower after 6MWT than after 6MST and higher than after 4MGS. They were also higher during 6MST than during 4MGS.

Conclusion: The three field tests are feasible in children. The 6MST and 4MGS are not valid surrogates to 6MWT in healthy children for functional exercise performance evaluation. Moreover, the cardio-respiratory response differs between the three tests.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.gaitpost.2017.12.011DOI Listing
March 2018

In Vitro and In Vivo Comparison of Two Nebulizers Used for Inhaled Pentamidine Delivery.

Arch Bronconeumol 2017 Dec 3;53(12):697-698. Epub 2017 Jun 3.

Service de Médecine Physique et Réadaptation, Cliniques universitaires Saint-Luc, Brussels, Belgium; Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium; Service de Pneumologie, Cliniques universitaires Saint-Luc, Brussels, Belgium.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.arbres.2017.05.001DOI Listing
December 2017

Screening and evaluation tools of dysphagia in children with neuromuscular diseases: a systematic review.

Dev Med Child Neurol 2017 06 9;59(6):591-596. Epub 2016 Dec 9.

Institut de Recherche Expérimentale et Clinique (IREC), Pôle de Pneumologie, ORL & Dermatologie, Université Catholique de Louvain, Brussels, Belgium.

Aim: Dysphagia is frequent in paediatric patients with neuromuscular diseases (pNMD). Its detection is important for initiating early diagnosis and treatment as well as for minimizing related complications. The aim of this study was to review the literature on dysphagia screening and evaluation tools in pNMD.

Method: A systematic review was performed on the basis of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Three databases (PubMed, CINAHL, and ScienceDirect) were searched. Measurement properties of tools and the quality index developed by Downs and Black were considered.

Results: Our search yielded four studies and four different tools for paediatric patients with Duchenne muscular dystrophy (DMD). The Sydney Swallow Questionnaire, surface electromyography, Neuromuscular Disease Swallowing Status Scale, and videofluoroscopic swallow study showed interesting properties for DMD. No data were available for other NMD and children under 9 years. The mean total score for the quality index was 17.5.

Interpretation: We did not identify any superior validated tools, either for screening or for evaluation of dysphagia, and no widely accepted protocol. Further studies are needed to identify the simplest assessment with the best psychometric properties for pNMD. We recommend establishing a specific tool for pNMD.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/dmcn.13354DOI Listing
June 2017