Diaphragmatic mobility: relationship with lung function, respiratory muscle strength, dyspnea, and physical activity in daily life in patients with COPD

Rocha, Flávia Roberta; Brüggemann, Ana Karla Vieira; Francisco, Davi de Souza; Medeiros, Caroline Semprebom de; Rosal, Danielle; Paulin, Elaine

doi:10.1590/s1806-37562016000000097

Cited by 40 publications

(34 citation statements)

References 35 publications

(45 reference statements)

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“…In addition to affecting the peripheral musculature, muscle fatigue caused by the deleterious effects of COPD may compromise respiratory muscle function (Barreiro & Jaitovich, 2018). Among the respiratory muscles involved, the diaphragm is mechanically disadvantaged due to airway obstruction and lung hyperinsulflation, which leads to chronic reduction in the diaphragmatic apposition zone with abnormal lowering and shorter excursion during inspiration (Rocha et al, 2017), leading to a reduction in respiratory capacity (Santana, Prina, Albuquerque, Carvalho, & Caruso, 2016).…”

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confidence: 99%

Inspiratory muscle strength, diaphragmatic mobility, and body composition in chronic obstructive pulmonary disease

Souza

Cardim

Maia

et al. 2019

Physiotherapy Res Intl

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Background and purpose Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory disease that can cause repercussions on respiratory muscles and body composition. The aim of the current study was to evaluate inspiratory muscle strength, diaphragmatic mobility, and body composition in COPD subjects and to correlate these variables. Methods This was a cross‐sectional study performed with 21 COPD patients. Inspiratory muscle strength (manovacuometry), pulmonary function test (forced vital capacity [FVC], forced expiratory volume in 1 s [FEV1], and FEV1/FVC ratio), diaphragmatic mobility (ultrasonography), and body composition (bioelectrical impedance analysis) were examined. Results COPD individuals in Stages II (28.9%), III (52%), and IV (19%) according to Global Initiative for Chronic Obstructive Disease were recruited, 61.9% of which were men. Inspiratory muscle weakness was found in 47.6% of subjects, who presented a lower fat‐free mass percentage (p = 0.017) and smaller fat‐free mass index (p = 0.001) and greater fat mass percentage (p = 0.029) and less diaphragmatic mobility (p = 0.007) compared with the nonrespiratory weakness group. Maximal inspiratory pressure exhibited a moderately positive relationship to the fat‐free mass index (r = 0.767, p < 0.001) and a weak positive relationship to diaphragmatic mobility (r = 0.496, p = 0.022). Conclusion Our study showed a high prevalence of inspiratory muscle weakness based on the severity of airway obstruction and on the presence of muscular depletion. The evaluation of body composition detected important changes. It also demonstrated that not only muscular weakness was present in these patients but also this had repercussions on the mobility of the diaphragm muscle.

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mentioning

confidence: 99%

Inspiratory muscle strength, diaphragmatic mobility, and body composition in chronic obstructive pulmonary disease

Souza

Cardim

Maia

et al. 2019

Physiotherapy Res Intl

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“…Diaphragmatic dysfunction is strongly correlated with FEV 1 in COPD [27] and correlated with the perception of dyspnea among this group of patients. [28] Coticospinal pathway affection could be another factor for development of diaphragmatic dysfunction in COPD patients accordingly its evaluation could help in personalization of COPD management especially pulmonary rehabilitation programs. Chun et al found significant improvement of diaphragmatic motility after pulmonary rehabilitation using sonography.…”

Section: Discussionmentioning

confidence: 99%

Diaphragmatic Central Motor Conduction Changes In Chronic Obstructive Pulmonary Disease

Shafiek

2019

Preprint

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16 Background and objectives: Respiratory muscles dysfunction has been reported in 17 COPD. Transcranial magnetic stimulation (TMS) is easy non-invasive that has been 18 used for assessing the respiratory corticospinal pathways particularly of diaphragm. 19 We aimed to study the cortico-diaphragmatic motor system changes in COPD using 20 TMS and to correlate the findings with the pulmonary function.21 Methods: A case control study recruited 30 stable COPD from the out-patient 22 respiratory clinic of Main Alexandria University hospital-Egypt and 17 healthy 23 control subjects who were subjected to spirometry. Cortical conduction of the 24 diaphragm was performed by TMS to all participants followed by cervical magnetic 25 stimulation of the phrenic nerve roots. Diaphragmatic resting motor threshold 26 (DRMT), cortical motor evoked potential latency (CMEPL), CMEP amplitude 27 (CMEPA), peripheral motor evoked potential latency (PMEPL), PMEP amplitude 28 (PMEPA) and central motor conduction time (CMCT) were measured.29 Results: 66.7% of COPD patients had severe and very severe COPD with median age 30 of 59 (55-63) years. There was statistically significant bilateral decrease in DRMT, 31 CMEPA and PMEPA in COPD group versus healthy subjects and significant increase 32 in CMEPL and PMEPL (p <0.01). Left CMCT was significantly prolonged in COPD 33 group versus healthy subjects (p <0.0001) but not right CMCT. Further, there was 34 significant increase in CMEPL and CMCT of left versus right diaphragm in COPD 35 group (p= 0.003 and 0.001 respectively) that inversely correlated with FEV 1 % and 36 FVC% predicted.3 37 Conclusion: Central cortico-diaphragmatic motor system is affected in COPD 38 patients with heterogeneity of both sides that is correlated with pulmonary function. 39 Significance: Coticospinal pathway affection could be a factor for development of 40 diaphragmatic dysfunction in COPD patients accordingly its evaluation could help in 41 personalization of COPD management especially pulmonary rehabilitation programs 42 Keywords: Transcranial magnetic stimulation, corticospinal pathways, phrenic nerve, 43 pulmonary function 44 45 46 4 47 Introduction 48 Chronic obstructive pulmonary disease (COPD) is mainly presented with dyspnea and 49 exercise limitation secondary to irreversible airflow obstruction; however, nowadays 50 COPD is considered as multi-systemic inflammatory disorder rather than simple 51 respiratory disease.[1] Respiratory muscles dysfunction has been reported in COPD 52 compared to healthy elderly individuals [2] and has been implicated in the development 53 of dyspnea. 54 Respiratory muscles, particularly the diaphragm which is considered the main 55 inspiratory muscle, are affected in COPD in two main ways. Firstly, change of shape 56 and geometry of the chest wall secondary to air trapping and hyperinflation in COPD 57 leads to chronic reduction of the apposition zone of the diaphragm [3] and shorten of 58 the diaphragm fiber sarcomere.[4] Secondly, local activation of muscle proteases and 59 ...

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“…7 Assim, como o volume expiratório forçado no primeiro segundo (VEF 1 ), a relação entre VEF 1 /CVF também diminui conforme aumenta a idade. 8 Dessa maneira, acredita-se que a utilização de diferentes intervenções além das convencionais para a melhora da força muscular respiratória, como a flauta doce, são novas estratégias de promoção da saúde em diferentes espaços e contextos. Portanto, o objetivo deste estudo foi avaliar o efeito do treinamento com flauta doce sobre a força muscular de idosas.…”

Section: Introductionunclassified

Efeito do treinamento com flauta doce na força muscular respiratória de idosas: estudo piloto

Viana

Oliveira

Perogari

et al. 2019

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Objetivo: O objetivo deste estudo foi mensurar a força muscular respiratória de idosas com treinamento com flauta doce. Métodos: Estudo quasi-experimental realizado com cinco idosas. As idosas foram submetidas a oito semanas de treinamento presenciais de 90 minutos com flauta doce referente a música “Noite Feliz”. A mensuração da força muscular respiratória foi realizada antes e após o período de treinamento, por meio de um manovacuômetro e a função respiratória por meio da espirometria. Utilizou-se a estatística descritiva e inferencial, considerando p<0,05. Resultados: A prova de função pulmonar não apresentou nenhuma alteração, com média de CVF, VEF1, VEF1/CVF (80±5, 82±5 e 89±6 %, respectivamente). No entanto, a PImáx e a PEmáx apresentaram aumentos significantemente após o treinamento (54±20 vs 98±8 cmH2O, p<0,04 e 40±14 vs 68±17 cmH2O, p<0,03 respectivamente). Conclusão: Houve aumento da força muscular respiratório de idosas submetidas a um treinamento com flauta doce.

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Diaphragmatic mobility: relationship with lung function, respiratory muscle strength, dyspnea, and physical activity in daily life in patients with COPD

Cited by 40 publications

References 35 publications

Inspiratory muscle strength, diaphragmatic mobility, and body composition in chronic obstructive pulmonary disease

Inspiratory muscle strength, diaphragmatic mobility, and body composition in chronic obstructive pulmonary disease

Diaphragmatic Central Motor Conduction Changes In Chronic Obstructive Pulmonary Disease

Efeito do treinamento com flauta doce na força muscular respiratória de idosas: estudo piloto

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