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(Chest. 2001;119:1836-1839.)
© 2001 American College of Chest Physicians

Row-a-Boat Phenomenon*

Respiratory Compensation in Advanced Duchenne Muscular Dystrophy

Fumihiko Yasuma, MD, FCCP; Takashi Kato, MD; Yukihiko Matsuoka, MD and Masaaki Konagaya, MD

* From the Departments of Internal Medicine (Dr. Yasuma) and Neurology (Drs. Kato, Matsuoka, and Konagaya), Suzuka National Hospital, Suzuka, Japan.

Correspondence to: Fumihiko Yasuma, MD, FCCP, Physician-in-Chief, Department of Internal Medicine, Suzuka National Hospital, 3-2-1 Kasado, Suzuka, 513-8501 Japan; e-mail: f-yasuma{at}mtb.biglobe.ne.jp

Background: "Row-a-boat" phenomenon (RBP) is a spontaneous upper-body movement in patients with advanced Duchenne muscular dystrophy (DMD), when sitting upright supported by a belt around the body in a wheelchair. However, the role of RBP has not been clarified.

Objectives: To support the hypothesis that RBP is an abnormal pattern of respiration to compensate for the atrophied respiratory muscles in advanced DMD.

Patients and methods: Age, degree of ventilator dependency, and blood gas and spirometry values of 12 patients with spontaneous RBP were compared to those of 8 patients without RBP. All patients were men, and all exhibited a comparable level of motor function (unable to ambulate). Spirometry was undertaken with an ambulatory pneumotachograph in six patients with RBP in two conditions: sitting with RBP and sitting without RBP. In the latter condition, because a patient’s shoulders, neck, and head were manually restricted, RBP was prevented.

Results: We found that the patients with RBP were older (mean, 25.98 years vs 19.84 years), more dependent on mechanical ventilation (13.96 h/d vs 4.31 h/d), and had lower FVC and percentage of FVC (511.3 mL vs 762.5 mL and 13.37% vs 20.11%, respectively) than those without RBP. We also found that the frequency of RBP was identical with tidal breathing, and FVC was increased by 50.8% by simply allowing RBP.

Conclusion: We conclude that RBP is a respiratory movement to compensate for the atrophied respiratory muscles in advanced DMD.

Key Words: Duchenne muscular dystrophy • mechanical ventilation • respiratory failure • "row-a-boat" phenomenon




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F. Yasuma, T. Kato, and M. Naya
Adequate Tidal Volume With Row-a-Boat Phenomenon in Advanced Duchenne Muscular Dystrophy
Chest, May 1, 2002; 121(5): 1726 - 1726.
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