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Biomedical subjects

Bari Hoffman-Ruddy

Publications and source records attributed to Bari Hoffman-Ruddy.

3 recordsLinked to original sources

Tutorial on maximum inspiratory and expiratory mouth pressures in individuals with idiopathic Parkinson disease (IPD) and the preliminary results of an expiratory muscle strength training program.

Respiratory symptoms are recognized as sequelae of motor dysfunction in idiopathic Parkinson's disease (IPD) and these symptoms have the potential to cause problems with swallow, cough, voice and speech. Specifically, maneuvers that require rapid activation and coordination of upper airway and chest wall musculature become progressively impaired as motor dysfunction progresses during the natural course of the disease. This study reports on the maximum inspiratory and expiratory pressures produced by 28 participants (average age 64) diagnosed with moderate to severe IPD (average stage 2.5 with a range of 2.0-3.0). All measures were collected during the "medication on" state. Outcomes of a specific respiratory muscle strength training technique for improving maximum expiratory pressure are reported for three of the patients in this study. Techniques that focus on strengthening the respiratory muscles in patients with IPD (other than with low load breathing exercises), have not been previously reported. The results of this pilot study demonstrate that respiratory muscle weakness may be an important factor in the respiratory complications in IPD and that respiratory muscle strength training has the potential to improve expiratory muscle strength for this population. This improvement has the potential to positively impact high forced respiratory activities, such as forced breathing maneuvers, swallow, cough and speech functions that require greater magnitude and duration of expiration.

Adult↗

An adaptive driver and real-time deformation algorithm for visualization of high-density lung models.

Technological advances in Augmented Reality (AR) and extraction of 3D patient specific medical data led to the creation of medical visualization using AR environments, in which the 3D data is registered and synchronized with the position of the patient. One of the challenges in such visualization environments is maintaining an accurate shape of the 3D data for self-deformable models such as lungs. An accurate deformation of lung model with 3D visualization may significantly increase the teaching and diagnosing ability of physicians. Modeling the deformation of lungs primarily involves the accurate representation of Pressure-volume relationship and the hysteresis in the relationship during inhalation and exhalation. This paper explains a real-time physiologically accurate deformation algorithm and its hardware rendering. We then introduce a novel approach for the representation of accurate pressure volume relationship based on an analogy with classical mechanics. Our simulation results show that the hysteresis obtained is more accurate as compared to current lung models. Thus in our approach a physically realistic deformation of lung model is obtained by the integration of the accurate PV relationship with real-time deformation method.

Algorithms↗

Inspiratory pressure threshold training for upper airway limitation: a case of bilateral abductor vocal fold paralysis.

A single subject design was used to determine if pressure threshold training strengthens the inspiratory muscles in a subject with a limited glottal airway as well as diminish dyspnea and improve parameters of speech. The subject was a 19-year-old woman whose glottal airway was limited due to bilateral abductor vocal fold paralysis following a thyroidectomy. A 5-week inspiratory muscle strength-training program was implemented using a pressure-threshold trainer to strengthen the inspiratory muscles with the intent of enabling the generation of higher inspiratory pressures. The pressure threshold on the trainer was set at 75% of the subject's maximum inspiratory pressure (MIP). The subject was required to generate sufficient inspiratory pressure to bring air through the trainer during an inspiratory maneuver. MIP was the dependent variable used as an indication of inspiratory muscle strength. MIP increased by 47% following the training program. Maximal minute ventilation and oxygen uptake increased posttraining. Dyspnea during exercise and speech decreased as reported by the subject. Total reading duration and pause duration demonstrated a declining trend during connected speech. The results indicated that inspiratory muscle training using a pressure threshold device improves functional tasks such as exercise and speech in a subject with upper airway limitation.

Adult↗