An evaluation of diaphragmatic movements in hemiplegic patients

Abstract

Objective: The aim of this study was to evaluate the effect of hemiplegia on diaphragmatic movements using motion-mode ultrasonography. Methods: 23 hemiplegic patients who were diagnosed with a single-hemisphere lesion (mean age 60.5 years; 13 males and 10 females) and a control group of 20 patients (13 males and 7 females) were all evaluated by ultrasonography. Ultrasonography recordings were made of the amplitude of diaphragmatic movement during spontaneous and deep breathing. The patients underwent lung function tests. Results: When the hemiplegic and control groups were compared, the forced vital capacity, forced expired volume in 1 s, maximum inspiratory pressure and maximum expiratory pressure values were significantly lower in the groups with right and left hemiplegia (p,0.05). When a comparison was made between the right hemiplegic group and the control group and between the left hemiplegic group and the control group in terms of diaphragmatic excursions, for both groups, no significant difference was determined between the movements of the right hemidiaphragm during spontaneous and deep breathing and those of the left hemidiaphragm in spontaneous respiration. In contrast, for both hemiplegic groups, a significant decrease was noted in the movements of the left hemidiaphragm in deep respiration. Conclusion: The diaphragm is both contralaterally innervated and ipsilaterally innervated, and innervation exhibits marked variations from person to person. This provides an explanation for varying diaphragmatic movements in hemiplegic cases during deep respiration.

Feasibility of Early Physical Therapy Program In-Hospital Patients with Acute Ischemic Stroke

“…All pulmonary function measurements were taken after three attempts, the best achievement is reported. Assessing diaphragmatic movement by ultrasonography published already [11,12] were applied with Fukuda UF-750 XT ultrasonography system with a 3.5 MHz sector transducer. Symmetric intercostal probe positions were chosen between the midaxillary and midclavicular lines.…”

A Review of the Ultrasound Assessment of Diaphragmatic Function in Clinical Practice

“…During contraction, this area shortens and thickens as a result of muscle contraction [58]. The physical dimensions of the appositional area and the configuration and motion of the dome of the diaphragm can be quantified by US as reported by several authors [22,23,24,26,27,30,32,41,49,50,60,61,62,63,64,65,66] (fig. 1; table 2).…”

Noninvasive evaluation of respiratory muscles in pre-clinical model of Duchenne Muscular Dystrophy

“…This situation is consistent with changes in diaphragmatic mobility cited by Azeredo (2002). Voyvoda et al (2012) established that paralysis and deficit of the diaphragm has multiple etiologies. Diaphragm movement can be affected by conditions of the phrenic nerve tract abnormalities or transmission of the neuromuscular junction, diaphragm muscle diseases and chest and abdomen diseases.…”

“…Distrophy causes muscle tissue degeneration and the muscular fibers are replaced by adipose tissue and collagen which increase the echogenicity, thus allowing the muscular margins to be determined by ultrasound (Zaidman et al 2010, Jansen et al 2012, Oliveira 2012. In recent times, the US also has been employed to monitor the diaphragmatic movements in patients with respiratory diseases (Voyvoda et al 2012).…”