Investigating the correlation between pulmonary function tests and ultrasonographic diaphragm measurements and the effects of respiratory exercises on these parameters in hemiplegic patients

Kilicoglu, Mehmet Serkan; Yurdakul, Ozan Volkan; Çelik, Yusuf; Aydın, Teoman

doi:10.1080/10749357.2021.1911748

Cited by 7 publications

(15 citation statements)

References 29 publications

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“…Diaphragm thickness measurement: With all the study participants in the supine position, a high-frequency linear array transducer (10–14 MHz) was used to measure the diaphragm thickness at the zone of apposition during inspiration or expiration. The probe was positioned on the chest wall at approximately the anterior axillary line at the eighth and ninth intercostal spaces [ 14 ] ( Figure 1 d). With the probe perpendicular to two ribs, the diaphragm can be visualized as a three-layered structure consisting of a relatively non-echogenic muscular layer bounded by echogenic membranes of the peritoneum and diaphragmatic pleura [ 39 ].…”

Section: Methodsmentioning

confidence: 99%

“…Therefore, diaphragm paralysis is under-diagnosed because of its varied and often non-specific presentation [ 13 ]. Early detection of diaphragm dysfunction is important for protecting patients from comorbid pulmonary problems [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Diaphragmatic dysfunction can be confirmed by a number of tests that mainly include chest radiograph [ 15 ], multi-slice spiral CT [ 16 ], magnetic resonance imaging (MRI) [ 17 ], sniff test [ 18 ], pulmonary-function test [ 14 ], respiratory muscle strength [ 19 ], transdiaphragmatic pressure (Pdi) [ 20 ], ultrasonography, electromyography (EMG) [ 21 ], transcranial magnetic stimulation (TMS) [ 11 ], etc. [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

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Assessment of Diaphragm in Hemiplegic Patients after Stroke with Ultrasound and Its Correlation of Extremity Motor and Balance Function

Liu

Deng

et al. 2022

Brain Sciences

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Background: A variety of functional disorders can be caused after stroke, among which impairment of respiratory function is a frequent and serious complication of stroke patients. The aim of this study was to examine diaphragmatic function after stroke by diaphragm ultrasonography and then to apply to explore its correlation with extremity motor function and balance function of the hemiplegia patients. Methods: This cross-sectional observational study recruited 48 hemiplegic patients after stroke and 20 matched healthy participants. The data of demographic and ultrasonographic assessment of all healthy subjects were recorded, and 45 patients successfully underwent baseline data assessment in the first 48 h following admission, including post-stroke duration, stroke type, hemiplegia side, pipeline feeding, pulmonary infection, ultrasonographic assessment for diaphragm, Fugl–Meyer Motor Function Assessment Scale (FMA Scale), and Berg Balance Scale assessment. Ultrasonographic assessment parameters included diaphragm mobility under quiet and deep breathing, diaphragm thickness at end-inspiratory and end-expiratory, and calculated thickening fraction of the diaphragm. The aim was to analyze the diaphragm function of hemiplegic patients after stroke and to explore its correlation with extremity motor function and balance function. Results: The incidence of diaphragmatic dysfunction under deep breath was 46.67% in 45 hemiplegia patients after stroke at the convalescent phase. The paralyzed hemidiaphragm had major impairments, and the mobility of the hemiplegic diaphragm was significantly reduced during deep breathing (p < 0.05). Moreover, the thickness fraction of hemiplegic side was extremely diminished when contrasted with the healthy control and non-hemiplegic side (p < 0.05). We respectively compared the diaphragm mobility under deep breath on the hemiplegic and non-hemiplegic side of patients with left and right hemiplegia and found there was no significant difference between the hemiplegic side of right and left hemiplegia (p > 0.05), but the non-hemiplegic side of right hemiplegia was significantly weaker than that of left hemiplegia patients (p < 0.05). The diaphragm mobility of stroke patients under quiet breath was positively correlated with age and FMA Scale score (R2 = 0.296, p < 0.05), and significant positive correlations were found between the diaphragm mobility under deep breath and Berg Balance Scale score (R2= 0.11, p < 0.05), diaphragm thickness at end-inspiratory and FMA Scale score (R2 = 0.152, p < 0.05), and end-expiratory thickness and FMA Scale score (R2 = 0.204, p < 0.05). Conclusions: The mobility and thickness fraction of the hemiplegic diaphragm after stroke by diaphragm ultrasonography were significantly reduced during deep breathing. Diaphragm mobility on bilateral sides of the right hemiplegia patients were reduced during deep breathing. Moreover, the hemiplegic diaphragmatic function was positively correlated with extremity motor and balance function of the hemiplegia patients.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assessment of Diaphragm in Hemiplegic Patients after Stroke with Ultrasound and Its Correlation of Extremity Motor and Balance Function

Liu

Deng

et al. 2022

Brain Sciences

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“…The impairment of respiratory function is a frequent and serious complication for stroke patients ( Kim et al, 2015 ). Early detection of respiratory dysfunction is important for protecting patients from comorbid pulmonary problems ( Kılıçoğlu et al, 2022 ). By summarizing the function of respiratory muscle on hemiplegic side and non-hemiplegic side of stroke patients in the studies included, we found that the average thickness of diaphragm on the hemiplegic side of stroke patients was significantly lower than that on the non-hemiplegic side, while the average thickness of abdominal expiratory muscles on the hemiplegic side were mostly lower than that on the non-hemiplegic side.…”

Section: Discussionmentioning

confidence: 99%

“…Because ultrasonography can distinguish a functioning from a nonfunctioning diaphragm, it can be used to diagnose both unilateral and bilateral diaphragmatic paralysis and to monitor recovery of the paralyzed diaphragm ( Gottesman and McCool, 1997 ; Summerhill et al, 2008 ). Respiratory exercises could contribute to the well-being of the stroke patients and this contribution could be followed up by diaphragm ultrasound ( Kılıçoğlu et al, 2022 ).…”

Section: Clinical Applications Of the Patients With Strokementioning

confidence: 99%

Respiratory muscle ultrasonography evaluation and its clinical application in stroke patients: A review

2023

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BackgroundRespiratory muscle ultrasound is a widely available, highly feasible technique that can be used to study the contribution of the individual respiratory muscles related to respiratory dysfunction. Stroke disrupts multiple functions, and the respiratory function is often significantly decreased in stroke patients.MethodA search of the MEDLINE, Web of Science, and PubMed databases was conducted. We identified studies measuring respiratory muscles in healthy and patients by ultrasonography. Two reviewers independently extracted and documented data regarding to the criteria. Data were extracted including participant demographics, ultrasonography evaluation protocol, subject population, reference values, etc.ResultA total of 1954 participants from 39 studies were included. Among them, there were 1,135 participants from 19 studies on diaphragm, 259 participants from 6 studies on extra-diaphragmatic inspiratory muscles, and 560 participants from 14 studies on abdominal expiratory muscles. The ultrasonic evaluation of diaphragm and abdominal expiratory muscle thickness had a relatively typically approach, while, extra-diaphragmatic inspiratory muscles were mainly used in ICU that lack of a consistent paradigm.ConclusionDiaphragm and expiratory muscle ultrasound has been widely used in the assessment of respiratory muscle function. On the contrary, there is not enough evidence to assess extra-diaphragmatic inspiratory muscles by ultrasound. In addition, the thickness of the diaphragm on the hemiplegic side was lower than that on the non-hemiplegic side in stroke patients. For internal oblique muscle (IO), rectus abdominis muscle (RA), transversus abdominis muscle (TrA), and external oblique muscle (EO), most studies showed that the thickness on the hemiplegic side was lower than that on the non-hemiplegic side.Clinical Trial Registration: The protocol of this review was registered in the PROSPERO database (CRD42022352901).

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Effects of cardiorespiratory physiotherapy on lung function in stroke: a network meta-analysis

Kim,

Cho

2024

Topics in Stroke Rehabilitation

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Investigating the correlation between pulmonary function tests and ultrasonographic diaphragm measurements and the effects of respiratory exercises on these parameters in hemiplegic patients

Cited by 7 publications

References 29 publications

Assessment of Diaphragm in Hemiplegic Patients after Stroke with Ultrasound and Its Correlation of Extremity Motor and Balance Function

Assessment of Diaphragm in Hemiplegic Patients after Stroke with Ultrasound and Its Correlation of Extremity Motor and Balance Function

Respiratory muscle ultrasonography evaluation and its clinical application in stroke patients: A review

Effects of cardiorespiratory physiotherapy on lung function in stroke: a network meta-analysis

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