The diaphragm is the primary muscle involved in active inspiration and serves also as an important anatomical landmark that separates the thoracic and abdominal cavity. However, the diaphragm muscle like other structures and organs in the human body has more than one function, and displays many anatomic links throughout the body, thereby forming a 'network of breathing'. Besides respiratory function, it is important for postural control as it stabilises the lumbar spine during loading tasks. It also plays a vital role in the vascular and lymphatic systems, as well as, is greatly involved in gastroesophageal functions such as swallowing, vomiting, and contributing to the gastroesophageal reflux barrier. In this paper we set out in detail the anatomy and embryology of the diaphragm and attempt to show it serves as both: an important exchange point of information, originating in different areas of the body, and a source of information in itself. The study also discusses all of its functions related to breathing.

The diaphragm is well known for its role as the principal muscle of respiration. However, according to previous studies, its role is multifactorial, from breathing through pain perception, regulation of emotional sphere, collaborating in gastroesophageal functions, facilitating the venous and lymphatic return, to an essential role in the maintenance of lumbar spine stability. The purpose of the study was to examine whether diaphragm function parameters (thickness and range of motion) are associated with static balance maintenance. A total of 142 participants were examined and divided into three groups: G1—patients qualified for lung resection due to cancer; G2 –patients after lobe resection; G3 –healthy subjects. Diaphragm thickness and excursion was measured using ultrasonography. Stabilometric parameters of balance were assessed by Zebris FDM-S platform. Greater diaphragm thickening during active breathing and diaphragm thickness fraction were associated with better static balance parameters. Limitation of diaphragm motion during quiet breathing and deep breathing was linked to balance disorders. There was no correlation between diaphragm muscle excursion during sniff maneuvers and balance parameters. Deterioration of diaphragm function observed after thoracic surgery was closely related with deterioration of balance maintenance. Impairment of diaphragm function manifested by decrease of muscle thickness and movement restriction is strongly associated with balance disorders in a clinical sample and among healthy subjects.

Background: Comprehensive cardiac rehabilitation (CR) is a process designed to restore full physical, psychological and social activity and to reduce cardiovascular risk factors. Fear of movement may contribute to the occurrence and intensification of hypokinesia, and consequently affect the effectiveness of therapy. The aim of the study was to determine the level of barriers of physical activity in patients undergoing cardiac rehabilitation. The relationship between selected determinants (age and health selfassessment) and the kinesiophobia level were also examined.Material/Methods: 115 people aged 40-84 years were examined: 50 females (x = 63.46; SD = 11.19) and 65 males (x = 64.65; SD = 10.59) - patients undergoing cardiac rehabilitation at the Upper-Silesian Medical Centre in Katowice. In the present study, the Polish version of questionnaires: Kinesiophobia Causes Scale (KCS) and Short Form Health Survey (SF-36) were used. Questionnaires were supplemented by authors’ short survey.Results: The patients presented an elevated level of kinesiophobia, both in general as well as in individual components. In women, the kinesiophobia level was higher than in men. The psychological domain was a greater barrier of physical activity than the biological one. Strong, negative correlations of psychological and biological domains of kinesiophobia to physical functioning (SF-36) were noted in women. In the case of men, correlations were weaker, but also statistically significant.Conclusions: 1. Sex differentiates patients in their kinesiophobia level 2. Poor self-assessment of health is associated with a greater intensification of kinesiophobia 3. A high level of kinesiophobia may negatively affect cardiac rehabilitation process

SummaryObjectives: The aim of the study was to adapt the English language version of the Short Health Anxiety Inventory (SHAI) developed by Salkovskis et al. to the Polish language and to investigate its psychometric properties and factor structure in clinical and non-clinical samples.Method: A total of 296 individuals participated in the study: 172 in the clinical sample (46% females and 54% males; mean age: 57.29 ± 13.01 years) and 124 in the non-clinical sample (51% females and 49% males; mean age: 54.45 ± 13.63). They completed the Polish language version of an 18-item SHAI and the Hamilton Anxiety Rating Scale (HAM-A). To assess psychometric properties, internal consistency, test-retest reliability, item-total statistics, construct and convergent validity, an analysis of ROC curves was performed.Results: Both samples had excellent internal consistency (Cronbach's α 0.91 and 0.92) and test-retest reliability (r=0.91 and r=0.94). Correlational analysis revealed a significant relationship of anxiety to SHAI total score and to each of the two SHAI subscales. Factor analysis revealed a two-factors solution, which accounted for 48% and 49% of the variance. A cut-off score of 20 was optimal for detecting a severe form of health anxiety in the clinical and non-clinical sample, providing the best balance between specificity and sensitivity.Discussion: Despite the widespread application of SHAI, a Polish language version has not yet been created. The psychometric properties of the scale confirmed a high reliability and accuracy of the proposed solutions. Conclusions:Our findings confirm that the SHAI-Polish version is a reliable and valid instrument for detecting health anxiety. hypochondriasis, health anxiety, Short Health Anxiety Inventory

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