Reliability of Diaphragmatic Mobility Assessment Using a Real Time Ultrasound Among Non-Specific Low Back Pain.

Mohan, Vikram; Hashim, Ummi Farhana; Dom, Sulaiman Md; Sitilerpisan, Patraporn; Paungmali, Aatit

doi:10.3329/bjms.v16i3.32871

“…It is an indicator to assess whether the body could inhale enough gas to meet the needs during each inspiration, which could refect the lung ventilation capacity. Te intrarater reliability of the diaphragm excursion measurement by M-mode ultrasound in this study was consistent with Mohan et al's study [42], which reported excellent ICC values (0.964 and 0.92, respectively), but inconsistent with Gram et al's study (ICC values range from 0.65 to 0.69) [43]. Te reason for this distinction between our study and Gram et al's study might be due to diferent interval measurement periods.…”

Section: Discussionsupporting

confidence: 92%

Ultrasonography Comparison of Diaphragm Morphological Structure and Function in Young and Middle-Aged Subjects with and without Non-Specific Chronic Low Back Pain: A Case-Control Study

Xiao

¹

,

Zheng

²

,

Dong

³

et al. 2022

Pain Research and Management

1

0

View full text Add to dashboard Cite

Background. It is reported that impaired postural control in patients with non-specific chronic low back pain (NCLBP) was associated with “core” trunk muscle incoordination. However, as the diaphragm is an important component of the “core” deep trunk muscle group, we still know little about the potential relationship between diaphragm dysfunction and NCLBP. Objectives. This case-control study is intended to investigate the changes of diaphragm morphological structure and function in young and middle-aged subjects with and without NCLBP by ultrasound evaluation and its possible validity in predicating the occurrence of NCLBP. Methods. 31 subjects with NCLBP (NCLBP group) and 32 matched healthy controls (HC group) were enrolled in this study. The diaphragm thickness at the end of inspiration (Tins) or expiration (Texp) during deep breathing was measured through B-mode ultrasound, and the diaphragm excursion (Texc) was estimated at deep breathing through M-mode ultrasound. The diaphragm thickness change rate (Trate) was calculated by the formula: T r a t e = T i n s − T exp / T exp × 100 % . Results. Compared with the HC group, the NCLBP group had a significant smaller degree of Tins (t = −3.90, P < 0.001 ), Texp (Z = −2.79, P = 0.005 ), and Trate (t = −2.03, P = 0.047 ). However, there was no statistical difference in Texc between the two groups (t = −1.42, P = 0.161 ). The binary logistic regression analysis indicated that Trate (OR = 16.038, P = 0.014 ) and Texp (OR = 7.714, P = 0.004 ) were potential risk factors for the occurrence of NCLBP. Conclusions. The diaphragm morphological structure and function were changed in young and middle-aged subjects with NCLBP, while the diaphragm thickness change rate (Trate) and diaphragm thickness at the end of expiration (Texp) may be conductive to the occurrence of NCLBP. Furthermore, these findings may suggest that abnormal diaphragm reeducation is necessary for the rehabilitation of patients with NCLBP.

show abstract

“…The distance between these two points corresponded to DM. This method of assessment has been considered reliable and valid (Mohan, Hashim, Md Dom, Sitilerpisan, & Paungmali, ; Toledo, Kodaira, Massarollo, Pereira, & Mies, ; Yamaguti et al, ).…”

Section: Methodsmentioning

confidence: 99%

Respiratory characteristics of individuals with non‐specific low back pain: A cross‐sectional study

Mohan

¹

,

Paungmali

²

,

Sitilerpisan

³

et al. 2018

Nursing & Health Sciences

Self Cite

View full text Add to dashboard Cite

Non-specific low back pain (NS-LBP) is known to cause respiratory dysfunction. In this study, we investigated alterations in breathing, respiratory strength and endurance, core stability, diaphragm mobility, and chest expansion among patients with NS-LBP and healthy individuals. The specific aim of the study was to correlate between respiratory function and other variables among NS-LBP patients. Thirty four patients with NS-LBP were matched with 34 healthy participants before undergoing total faulty breathing scale, spirometer, respiratory pressure meter, chest expansion, ultrasound, and pressure biofeedback measurements. There were signs of faulty breathing in the NS-LBP patients when compared to the healthy participants. Diaphragmatic mobility and respiratory muscle endurance were lower in the NS-LBP group. Chest expansion exhibited a significant decrease at the level of the fourth intercostal space in the NS-LBP group, but respiratory muscle strength and core stability were not significant between the two groups. Positive correlations were found to be fairly significant regarding respiratory muscle strength. The findings of this study indicated altered respiratory characteristics in the NS-LBP patients, and suggested that they would improve through respiratory exercises.

show abstract

“…Eight included articles measured the thickness [ 35 , 38 – 41 , 43 , 48 , 52 ], nine measured excursion [ 36 , 37 , 42 – 45 , 47 , 49 , 52 ], three measured stiffness [ 23 , 24 , 26 ], two measured strain [ 46 , 47 ], and one measured motion velocity of diaphragm [ 50 ]; one included study measured the thickness [ 51 ], and one measured stiffness of intercostal muscles [ 25 ]; one included study measured the thickness of transverse abdominals and internus obliquus with different approaches [ 34 ]. The details of each measurement approach are described in Supplementary File-S 4 .…”

Section: Resultsmentioning

confidence: 99%

“…Two included studies [ 42 , 43 ] consistently reported sufficient within- (ICC = 0.74–0.76) and between-day intra-rater reliability (ICC = 0.78–0.92) of using M-mode USG to measure the right hemidiaphragm excursion. The COSMIN ratings of both studies were doubtful, and the quality of evidence was very low.…”

Section: Resultsmentioning

confidence: 99%

Reliability and validity of ultrasonography in evaluating the thickness, excursion, stiffness, and strain rate of respiratory muscles in non-hospitalized individuals: a systematic review

Zhou,

Fu,

Huang

et al. 2023

View full text Add to dashboard Cite

Objective To summarize the reliability and validity of ultrasonography in evaluating the stiffness, excursion, stiffness, or strain rate of diaphragm, intercostals and abdominal muscles in healthy or non-hospitalized individuals. Literature search PubMed, Embase, SPORTDiscus, CINAHL and Cochrane Library were searched from inception to May 30, 2022. Study selection criteria Case–control, cross-sectional, and longitudinal studies were included if they investigated the reliability or validity of various ultrasonography technologies (e.g., brightness-mode, motion-mode, shear wave elastography) in measuring the thickness, excursion, stiffness, or strain rate of any respiratory muscles. Data synthesis Relevant data were summarized based on healthy and different patient populations. The methodological quality by different checklist depending on study design. The quality of evidence of each psychometric property was graded by the Grading of Recommendations, Assessment, Development and Evaluations, respectively. Results This review included 24 studies with 787 healthy or non-hospitalized individuals (e.g., lower back pain (LBP), adolescent idiopathic scoliosis (AIS), and chronic obstructive pulmonary disease (COPD)). Both inspiratory (diaphragm and intercostal muscles) and expiratory muscles (abdominal muscles) were investigated. Moderate-quality evidence supported sufficient (intra-class correlation coefficient > 0.7) within-day intra-rater reliability of B-mode ultrasonography in measuring right diaphragmatic thickness among people with LBP, sufficient between-day intra-rater reliability of M-mode ultrasonography in measuring right diaphragmatic excursion in non-hospitalized individuals. The quality of evidence for all other measurement properties in various populations was low or very low. High-quality evidence supported sufficient positive correlations between diaphragm excursion and forced expiratory volume in the first second or forced vital capacity (r > = 0.3) in healthy individuals. Conclusions Despite the reported sufficient reliability and validity of using ultrasonography to assess the thickness, excursion, stiffness, and strain rate of respiratory muscles in non-hospitalized individuals, further large-scale studies are warranted to improve the quality of evidence regarding using ultrasonography for these measurements in clinical practice. Researchers should establish their own reliability before using various types of ultrasonography to evaluate respiratory muscle functions. Trial registration PROSPERO NO. CRD42022322945.

show abstract

Reliability of Diaphragmatic Mobility Assessment Using a Real Time Ultrasound Among Non-Specific Low Back Pain.

Cited by 5 publications

References 14 publications

Ultrasonography Comparison of Diaphragm Morphological Structure and Function in Young and Middle-Aged Subjects with and without Non-Specific Chronic Low Back Pain: A Case-Control Study

Ultrasonography Comparison of Diaphragm Morphological Structure and Function in Young and Middle-Aged Subjects with and without Non-Specific Chronic Low Back Pain: A Case-Control Study

Respiratory characteristics of individuals with non‐specific low back pain: A cross‐sectional study

Reliability and validity of ultrasonography in evaluating the thickness, excursion, stiffness, and strain rate of respiratory muscles in non-hospitalized individuals: a systematic review

Contact Info

Product

Resources

About