Respiratory muscles in COPD: be aware of the diaphragm

Albuquerque, André Luís Pereira de

doi:10.1590/s1806-37562018000010001

Cited by 6 publications

(2 citation statements)

References 13 publications

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“…The importance of recovering the diaphragm's mobility and strength is not only for alleviating symptoms but also related to survival in COPD patients [17]. Diaphragm function is largely assessed in these patients and it has been demonstrated that inspiratory muscle weakness is related to dyspnea and reduced quality of life [18].…”

Section: Discussionmentioning

confidence: 99%

Respiratory muscle training program supplemented by a cell-phone application in COPD patients with severe airflow limitation

Irina

Steluta

Tudorache

et al. 2021

Respiratory Medicine

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Section: Discussionmentioning

confidence: 99%

Respiratory muscle training program supplemented by a cell-phone application in COPD patients with severe airflow limitation

Irina

Steluta

Tudorache

et al. 2021

Respiratory Medicine

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“…[6][7][8][9] The dysfunction of the diaphragm in patients with COPD is inextricably linked to reduced pulmonary function, increased dyspnea, and reduced exercise tolerance. 10,11 Therefore, the role of the diaphragm in respiratory diseases, especially in chronic respiratory diseases, has received increased attention and is considered an important target of interventions for COPD disease progression and improving the pulmonary function, dyspnea, and exercise capacity of patients. 12,13 In recent years, diaphragmatic dysfunction in COPD patients has gained increasing attention.…”

Section: Introductionmentioning

confidence: 99%

Assessments and Targeted Rehabilitation Therapies for Diaphragmatic Dysfunction in Patients with Chronic Obstructive Pulmonary Disease: A Narrative Review

Chen¹,

Li²,

Wang³

et al. 2022

COPD

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This review summarizes the characteristics, assessment methods, and targeted rehabilitation therapies of diaphragm dysfunction in patients with chronic obstructive pulmonary disease (COPD). Methods: Extensive literature was searched in PubMed, the Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure Database, Wanfang, and SinoMed. Results: Under the influence of oxidative stress, inflammation, and other factors, the diaphragm function of patients with COPD changes in mobility, muscle strength, thickness, and thickening. In patients with COPD, diaphragm mobility can be assessed using ultrasound, X-ray fluoroscopy, and magnetic resonance imaging. Diaphragmatic strength can be measured by transdiaphragmatic pressure and maximal inspiratory pressure. Diaphragmatic thickness and thickening can be assessed using ultrasound. Rehabilitation therapies targeting the diaphragm include diaphragmatic breathing, diaphragm-related manual therapy, and phrenic nerve electrical stimulation. Diaphragmatic breathing is safe, simple, and not limited by places. Diaphragmatic manual therapies, which require patient cooperation and one-on-one operation by a professional therapist, are effective. Phrenic nerve electrical stimulation is suitable for patients with severe conditions. These therapies improve the diaphragmatic function, lung function, dyspnea, and exercise capacity of patients with COPD. Conclusion:The diaphragmatic function is commonly assessed in terms of mobility, strength, thickness, and thickening. Diaphragmatic targeted rehabilitation therapies have proven to be efficient, which are recommended to be included in the pulmonary rehabilitation strategy for patients with COPD.

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Diaphragm ultrasonography in adults with sickle cell anemia: evaluation of morphological and functional aspects

et al. 2020

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Objectives: To assess morphological and functional aspects of the diaphragm by ultrasonography (US) in adults with sickle cell anemia (SCA) and evaluate if the diaphragmatic musculature can play a role in changes found in pulmonary function tests (PFTs) of these patients. Methods: This is a cross-sectional observational and single-center study involving 40 adults with SCA who underwent diaphragm US and PFTs with a maximum of 1 month between the two tests. Diaphragm US was performed in B and M modes, and echogenicity, thickness and movement of the muscle was assessed in different respiratory maneuvers. Results: Diaphragms had preserved echogenicity and the thickness was not significantly different between the groups. The SCA group exhibited significantly higher movement of the right hemidiaphragm during deep breathing (p = 0.004) and the sniff test (p = 0.0008) and lower movement of the left hemidiaphragm during quiet breathing (p = 0.009). There was a predominance of restrictive pattern (65%) and a global reduction in respiratory muscle strength (RMS) (70%). Conclusions: This study shows that adults with SCA had normal morphostructural aspects and absence of diaphragm dysfunction. Otherwise, they presented greater movement of the right hemidiaphragm during deep breathing and sniff test maneuvers. Despite the restrictive pattern and the reduction in RMS found in PFTs, the diaphragm of young adults with SCA did not have weakness or paralysis.

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Respiratory muscles in COPD: be aware of the diaphragm

Cited by 6 publications

References 13 publications

Respiratory muscle training program supplemented by a cell-phone application in COPD patients with severe airflow limitation

Respiratory muscle training program supplemented by a cell-phone application in COPD patients with severe airflow limitation

Assessments and Targeted Rehabilitation Therapies for Diaphragmatic Dysfunction in Patients with Chronic Obstructive Pulmonary Disease: A Narrative Review

Diaphragm ultrasonography in adults with sickle cell anemia: evaluation of morphological and functional aspects

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