Normal Diaphragmatic Motion and the Effects of Body Composition

Kantarcı, Fatih; Mihmanlı, İsmail; Demirel, Mustafa Kemal; Harmanci, Kemal; Akman, Canan; Aydoğan, Fatih; Mihmanlı, Aydanur; Uysal, Ömer

doi:10.7863/jum.2004.23.2.255

Cited by 97 publications

(73 citation statements)

References 19 publications

(19 reference statements)

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“…Kantarci et al 99 described a mean left diaphragm excursion of 49 Ϯ 11 mm in healthy subjects, which was significantly lower in female, young, and underweight subjects. In a prospective study designed to determine the reference values for diaphragm amplitudes recorded by M-mode ultrasonography, Boussuges et al 84 defined the normal values during tidal and deep breathing in male and female healthy subjects (1.8 Ϯ 0.3 and 7 Ϯ 0.6 cm and 1.6 Ϯ 0.3 and 5.7 Ϯ 1 cm, respectively).…”

Section: Diaphragm Displacementmentioning

confidence: 99%

Ultrasonographic Assessment of Diaphragm Function in Critically Ill Subjects

Umbrello

Formenti

2016

Respir Care

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The majority of patients admitted to the ICU require mechanical ventilation as a part of their process of care. However, mechanical ventilation itself or the underlying disease can lead to dysfunction of the diaphragm, a condition that may contribute to the failure of weaning from mechanical ventilation. However, extended time on the ventilator increases health-care costs and greatly increases patient morbidity and mortality. Nevertheless, symptoms and signs of muscle disease in a bedridden (or bed rest-only) ICU patient are often difficult to assess because of concomitant confounding factors. Conventional assessment of diaphragm function lacks specific, noninvasive, time-saving, and easily performed bedside tools or requires patient cooperation. Recently, the use of ultrasound has raised great interest as a simple, noninvasive method of quantification of diaphragm contractile activity. In this review, we discuss the physiology and the relevant pathophysiology of diaphragm function, and we summarize the recent findings concerning the evaluation of its (dys)function in critically ill patients, with a special focus on the role of ultrasounds. We describe how to assess diaphragm excursion and diaphragm thickening during breathing and the meaning of these measurements under spontaneous or mechanical ventilation as well as the reference values in health and disease. The spread of ultrasonographic assessment of diaphragm function may possibly result in timely identification of patients with diaphragm dysfunction and to a potential improvement in the assessment of recovery from diaphragm weakness.

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Section: Diaphragm Displacementmentioning

confidence: 99%

Ultrasonographic Assessment of Diaphragm Function in Critically Ill Subjects

Umbrello

Formenti

2016

Respir Care

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“…Some authors have reported that women show 11-20% less diaphragmatic excursion during deep breathing, in comparison with men. (28,29) In the present study, the women showed 5% and 8% less diaphragmatic mobility during ISFOD and ISVOD, respectively, than did the men. Considering that during incentive spirometry, there are maximal amplitude inspiratory patterns, our results are in agreement with those of the studies mentioned above, although the difference was of lesser magnitude in our study.…”

Section: Discussionmentioning

confidence: 73%

“…(30) Our results showed that the mobility/FVC (mm/L) ratio was significantly greater in women than in men, indicating that women performed better than did men on all three types of breathing exercises. One group of authors (28) reported that BMI can be considered another factor affecting diaphragmatic mobility in healthy subjects. In the present study, this variable seems to have had no influence on the results of the comparison between men and women, since the two were similar in terms of BMI.…”

Section: Discussionmentioning

confidence: 99%

Mobilidade diafragmática durante espirometria de incentivo orientada a fluxo e a volume em indivíduos sadios

Yamaguti¹,

Sakamoto

Panazzolo

et al. 2010

J. bras. pneumol.

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Objective: To compare the diaphragmatic mobility of healthy subjects during incentive spirometry with a volumeoriented device, during incentive spirometry with a flow-oriented device, and during diaphragmatic breathing. To compare men and women in terms of diaphragmatic mobility during these three types of breathing exercises. Methods:We evaluated the pulmonary function and diaphragmatic mobility of 17 adult healthy volunteers (9 women and 8 men). Diaphragmatic mobility was measured via ultrasound during diaphragmatic breathing and during the use of the two types of incentive spirometers. Results: Diaphragmatic mobility was significantly greater during the use of the volume-oriented incentive spirometer than during the use of the flow-oriented incentive spirometer (70.16 ± 12.83 mm vs. 63.66 ± 10.82 mm; p = 0.02). Diaphragmatic breathing led to a greater diaphragmatic mobility than did the use of the flow-oriented incentive spirometer (69.62 ± 11.83 mm vs. 63.66 ± 10.82 mm; p = 0.02). During all three types of breathing exercises, the women showed a higher mobility/ FVC ratio than did the men. Conclusions: Incentive spirometry with a volume-oriented device and diaphragmatic breathing promoted greater diaphragmatic mobility than did incentive spirometry with a flow-oriented device. Women performed better on the three types of breathing exercises than did men. ResumoObjetivo: Comparar a mobilidade diafragmática de indivíduos sadios durante a espirometria de incentivo orientada a volume, durante a espirometria de incentivo orientada a fluxo e durante exercícios diafragmáticos. Comparar a mobilidade diafragmática entre homens e mulheres durante esses três tipos de exercícios respiratórios. Métodos: Foram avaliadas a função pulmonar e a mobilidade diafragmática de 17 voluntários sadios adultos (9 mulheres e 8 homens). A avaliação da mobilidade do diafragma foi realizada durante a execução de exercícios diafragmáticos e durante o uso dos dois tipos de espirômetros de incentivo, por meio de um método ultrassonográfico. Resultados: A mobilidade diafragmática avaliada durante a utilização do espirômetro orientado a volume foi significativamente maior que aquela durante o uso do espirômetro orientado a fluxo (70,16 ± 12,83 mm vs. 63,66 ± 10,82 mm; p = 0,02). Os exercícios diafragmáticos promoveram maior mobilidade diafragmática do que o uso do espirômetro orientado a fluxo (69,62 ± 11,83 mm vs. 63,66 ± 10,82 mm; p = 0,02). Durante os três tipos de exercícios respiratórios, a relação mobilidade/CVF foi significativamente maior nas mulheres do que nos homens. Conclusões: A espirometria de incentivo orientada a volume e o exercício diafragmático promoveram maior mobilidade diafragmática do que a espirometria de incentivo orientada a fluxo. As mulheres apresentaram um melhor desempenho nos três tipos de exercícios respiratórios avaliados do que os homens. Original ArticleDiaphragmatic mobility in healthy subjects during incentive spirometry with a flow-oriented device and with a volume-oriented device J Bras Pneumol...

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“…Researchers assessing diaphragmatic motion using m-mode USI have found that gender, body mass index, waist circumference, and age influence the amount of excursion. 68 These findings highlight the need to further assess the effects of these variables on measurement of muscular function when using m-mode for RUSI.…”

Section: M-mode Ultrasound Imagingmentioning

confidence: 99%

Rehabilitative Ultrasound Imaging: Understanding the Technology and Its Applications

Whittaker

Teyhen

Elliott

et al. 2007

J Orthop Sports Phys Ther

193

101

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From an historical perspective, ultrasound imaging (USI) has been used for medical purposes since the 1950s. The primary use of USI continues to be for traditional radiological goals, which consider the morphological characteristics and structural integrity of various organs and tissues. However, as the technology has been embraced as a safe, portable, objective, and relatively inexpensive means of examination, the ingenuity and diversity of applications has extended beyond these realms.Ultrasound imaging related to musculoskeletal rehabilitation has been developing rapidly since the 1980s. The first report of muscle imaging linked to rehabilitation was in 1968, when Ikai and Fukunaga 63 related the size of the upper arm muscles to strength. However, it was the work of Dr Archie Young and colleagues at the University of Oxford in the 1980s that sowed the seeds for the use of USI by physical therapists. A striking finding of their work was how dramatic limb muscle wasting is underestimated with a tape measure.144 Several studies of the quadriceps muscle followed, including investigation of the effect of knee joint injury, t SynopSiS: The use of ultrasound imaging by physical therapists is growing in popularity. This commentary has 2 aims. The first is to introduce the concept of rehabilitative ultrasound imaging (RUSI), provide a definition of the scope of this emerging tool in regard to the physical therapy profession, and describe how this relates to the larger field of medical ultrasound imaging. The second aim is to provide an overview of basic ultrasound imaging and instrumentation principles, including an understanding of the various modes and applications of the technology with respect to neuromusculoskeletal rehabilitation and in relation to other common imaging modalities. J Orthop Sports Phys Ther 2007;37(8):434-449. doi:10.2519/jospt.2007 for a review). This early research used compound B-scanning, which enabled whole cross sections of large muscles to be captured, because the image could be built up as the transducer was moved over the skin. The compound technique, which was expensive, was phased out as a routine tool and replaced by real-time USI (definitions are provided in the appenDix) both in general medical and musculoskeletal settings.A recent (1990s) resurgence in the interest of rehabilitative applications of USI has been seen amongst clinical therapists. This stems from a series of studies in which USI was used to detect atrophy of the lumbar multifidus (isolated to the side and spinal level of symptoms) in individuals with acute low back pain (LBP), 51 as well as to determine that recovery of this muscle was not automatic when pain subsided, 49 thus required specific training to reduce risk of future episodes. 47 In addition, these studies

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Normal Diaphragmatic Motion and the Effects of Body Composition

Cited by 97 publications

References 19 publications

Ultrasonographic Assessment of Diaphragm Function in Critically Ill Subjects

Ultrasonographic Assessment of Diaphragm Function in Critically Ill Subjects

Mobilidade diafragmática durante espirometria de incentivo orientada a fluxo e a volume em indivíduos sadios

Rehabilitative Ultrasound Imaging: Understanding the Technology and Its Applications

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