Mobility impact and methods of diaphragm monitoring in patients with chronic obstructive pulmonary disease: a systematic review

Nascimento, Iramar Baptistella do; Fleig, Raquel

doi:10.6061/clinics/2020/e1428

Cited by 3 publications

(7 citation statements)

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“…Improvement of diaphragm mobility upon chest physiotherapy has been demonstrated in subjects with COPD. 22 We, therefore, hypothesized enhancement of diaphragm movement upon the intervention using the BDD in our CF cohort. Ultrasound‐based functional diaphragm analysis was performed as demonstrated in Figure 2A–C .…”

Section: Resultsmentioning

confidence: 98%

Short‐term effects of a novel bronchial drainage device: A pilot cohort study in subjects with cystic fibrosis

Schmidt

Toth

Käppler-Schorn

et al. 2022

Health Science Reports

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Background and Aims In cystic fibrosis (CF) airways, impaired airway mucociliary clearance and mucus accumulation due to cystic fibrosis transmembrane conductance regulator defects contribute to inflammation, progressive structural lung damage, and decline of lung function. Physiotherapy is essential to promote mucus mobilization and removal in CF and is a key element of rehabilitation measures, but conventional techniques may be suboptimal to mobilize viscous mucus. This study aimed to test the specific effects of a novel bronchial drainage device (BDD) (Simeox®; PhysioAssist) in subjects with CF and evaluate lung function, diaphragm mobility, and sputum properties. Methods This prospective monocentric clinical cohort study in the setting of outpatient physiotherapy of CF patients ( n = 21) with stable CF lung disease collected pulmonary lung function tests (PFT), diaphragm mobility, and sputum properties before and after two physiotherapy sessions using the novel BDD. PFT was assessed using spirometry and diaphragm mobility using m‐mode ultrasound analysis. Spontaneous sputum samples were collected before and after using the BDD and analyzed for microstructure and DNA concentrations. Results PFT parameters (FEV 1 , FVC, MEF25/50/75) were not affected by the use of the BDD. Ultrasound analysis of diaphragm mobility revealed an increase in maximum diaphragm excursion upon the intervention. Mucus analysis demonstrated altered microstructure and higher DNA concentrations collected after using the BDD compared to samples collected before. Pearson correlation analysis showed significant correlations between changes in mucus properties and DNA levels in respective mucus samples. Conclusion Our results demonstrate that the novel BDD improves diaphragm mobility and alters sputum properties in subjects with CF. The novel BDD with unique properties may be further studied as a device in CF‐specific physiotherapy to facilitate sputum mobilization of CF patients.

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Section: Resultsmentioning

confidence: 98%

Short‐term effects of a novel bronchial drainage device: A pilot cohort study in subjects with cystic fibrosis

Schmidt

Toth

Käppler-Schorn

et al. 2022

Health Science Reports

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“…cause diaphragm fatigue or even respiratory failure, which will severely reduce patient's life quality. Previous studies mainly focused on evaluation of diaphragm morphology or functional imaging (Kharma, 2013;Koo et al, 2018;Do Nascimento and Fleig, 2020). Traditional X-ray imaging is a preliminary test for evaluating diaphragm morphology alteration (Chetta et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

Quantitative evaluation of diaphragmatic motion during forced breathing in chronic obstructive pulmonary disease patients using dynamic chest radiography

Chen

Zhong²,

Wang³

et al. 2022

Front. Integr. Neurosci.

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ObjectiveTo quantitatively evaluate the bilateral diaphragmatic motion difference during forced breathing between chronic obstructive pulmonary disease (COPD) patients and healthy individuals using dynamic chest radiography technique.MethodsThis prospective study included the COPD patients (n: 96, f/m: 17/79, age: 66 ± 8 years old) and healthy individuals (n: 50, f/m: 42/8, age: 53 ± 5 years old) that underwent dynamic chest radiography with a flat panel X-ray detector system during forced breathing in a standing position. After analyzing the excursions, duration and velocity of diaphragmatic motion were automatically calculated using the postprocessing software. The parameters of diaphragmatic motion including excursion, duration, velocity, inhalation/exhalation times were assessed in all subjects for both diaphragms. The correlation between lung function parameters and diaphragmatic motion excursions were further evaluated.ResultsThe excursions of diaphragmatic motion in COPD patients were significantly decreased in COPD patients compared with healthy individuals during forced breathing (P < 0.05). The excursion in COPD patients was 35.93 ± 13.07 mm vs. 41.49 ± 12.07 mm in healthy individuals in the left diaphragm, and 32.05 ± 12.29 mm in COPD patients vs. 36.88 ± 10.96 mm in healthy individuals in the right diaphragm. The duration of diaphragmatic motion significantly decreased in COPD patients, compared with the healthy individuals (P < 0.05). The inhalation time in COPD patients was 2.03 ± 1.19 s vs. 2.53 ± 0.83 s in healthy individuals in the left diaphragm and 1.94 ± 1.32 s in COPD patients vs. 2.23 ± 1.21 s in healthy individuals in the right diaphragm. The exhalation time was 4.77 ± 1.32 s in COPD patients vs. 6.40 ± 2.73 s in healthy individuals in the left diaphragm and 4.94 ± 3.30 s in COPD patients vs. 6.72 ± 2.58 s in healthy individuals in the right diaphragm. The peak velocity of diaphragmatic motion showed no significant difference between COPD and healthy groups. The excursions of bilateral diaphragmatic motion showed moderate correlation with FEV1/FVC (r = 0.44, P < 0.001). Multi-linear regression analysis showed that the excursions of bilateral diaphragm are significantly associated with COPD occurrence (P < 0.05).ConclusionThe excursions and duration of diaphragmatic motion during forced breathing are significantly decreased in COPD patients, compared with healthy individuals. Our study showed that precise bilateral diaphragmatic motion activity can be evaluated by dynamic chest radiography.

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“…Because ventilation and swallowing result from coordinated movements of the aerodigestive tract, kinematic analysis of aerodigestive movements is crucial for understanding healthy and disordered respiratory‐swallow patterns. Recent studies in humans and murine models have used visual tracking of diaphragm excursion on videofluoroscopy in healthy populations and respiratory disorders 17–19 because the movement of the diaphragm accounts for approximately 80% of ventilatory exchange 20 . Diaphragm excursion is predictable in healthy populations and relatively robust against changes in position 21 .…”

Section: Introductionmentioning

confidence: 99%

“…Diaphragm excursion is predictable in healthy populations and relatively robust against changes in position 21 . Videofluoroscopy for visual tracking of diaphragm excursion on functional ventilatory tasks is a gold standard of assessment of diaphragm dysfunction 20,22 . The current study uses visual tracking of the diaphragm as a respiratory trace, to allow for concurrent analysis of respiratory and bolus kinematics.…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies in humans and murine models have used visual tracking of diaphragm excursion on videofluoroscopy in healthy populations and respiratory disorders [17][18][19] because the movement of the diaphragm accounts for approximately 80% of ventilatory exchange. 20 Diaphragm excursion is predictable in healthy populations and relatively robust against changes in position. 21 Videofluoroscopy for visual tracking of diaphragm excursion on functional ventilatory tasks is a gold standard of assessment of diaphragm dysfunction.…”

Section: Introductionmentioning

confidence: 99%

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Respiratory‐swallow coordination in a rat model of chemoradiation

2021

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Background Chemoradiation treatment (CRT) for head and neck cancer (HNC) is associated with postswallow inhale events that elevate the risk of penetration/aspiration. The purpose of this study was to assess the validity of a rat model for investigating the effect of CRT on respiratory‐swallow coordination. Methods Videofluoroscopic swallow study was performed on 10 Sprague‐Dawley rats 3 months post‐CRT (3 mg/kg Cisplatin, 10 fractions of 4.5 Gy/day radiotherapy to tongue base), and 10 naïve controls. We examined the effect of CRT on swallow apnea duration, diaphragm movement, and bolus kinematics. Results CRT rats had a significant increase in postswallow inhale (p = 0.008), which was associated with significantly longer swallow apnea durations, lower diaphragm displacement at swallow onset, and faster pharyngoesophageal bolus speed. Conclusion The rat CRT model is valid for the study of respiratory‐swallow coordination due to the consistency of findings in this study with those reported in clinical CRT studies in HNC.

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Mobility impact and methods of diaphragm monitoring in patients with chronic obstructive pulmonary disease: a systematic review

Cited by 3 publications

References 50 publications

Short‐term effects of a novel bronchial drainage device: A pilot cohort study in subjects with cystic fibrosis

Short‐term effects of a novel bronchial drainage device: A pilot cohort study in subjects with cystic fibrosis

Quantitative evaluation of diaphragmatic motion during forced breathing in chronic obstructive pulmonary disease patients using dynamic chest radiography

Respiratory‐swallow coordination in a rat model of chemoradiation

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