Ultrasonographic Diaphragmatic Motion Analysis and Its Correlation With Pulmonary Function in Hemiplegic Stroke Patients

Abstract

ObjectiveTo evaluate diaphragmatic motion via M-mode ultrasonography and to correlate it with pulmonary function in stroke patients.MethodsThis was a preliminary study comprised of ten stroke patients and sixteen healthy volunteers. The M-mode ultrasonographic probe was positioned in the subcostal anterior region of the abdomen for transverse scanning of the diaphragm during quiet breathing, voluntary sniffing, and deep breathing. We analyzed diaphragmatic motion and the relationship between diaphragmatic motion and pulmonary function.ResultsAll stroke patients had restrictive pulmonary dysfunction. Compared to that exhibited by control subjects, stroke patients exhibited a significant unilateral reduction in motion on the hemiplegic side, primarily during volitional breathing. Diaphragmatic excursion in right-hemiplegic patients was reduced on both sides compared to that in control subjects. However, diaphragmatic excursion was reduced only on the left side and increased on the right side in left-hemiplegic patients compared to that in control subjects. Left diaphragmatic motion during deep breathing correlated positively with forced vital capacity (rho=0.86, p=0.007) and forced expiratory volume in 1 second (rho=0.79, p=0.021).ConclusionReductions in diaphragmatic motion and pulmonary function can occur in stroke patients. Thus, this should be assessed prior to the initiation of rehabilitation therapy, and M-mode ultrasonography can be used for this purpose. It is a non-invasive method providing quantitative information that is correlated with pulmonary function.

Impact of Cervical Stabilization Exercises and Breathing Retraining Impact on the Respiratory Function of Elderly Stroke Patients with Hemiplegia: a Randomized Control Trial

“…The physical activities and emotional disorder of older hemiplegic patients could not be prevented, but adequate physical activities and exercise combined with regular breathing have been reported to have positive effects on physical as well as emotional functions [25].Thus, in this study, FVC, FEV1, the FEV1 to FVC ratio, MIP, and MEP were used to compare and measure the respiratory function of stroke patients. These measurements are widely used in the clinical setting and have lower variability than other respiratory indices [26]. In this study, there were significant changes in FVC in all groups, and there were also significant differences between experimental group1 and the control group as well as between experimental group2 and the control group after 6 weeks.…”

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

“…Changes in diaphragmatic movement -higher positioning of the diaphragm and decreased excursion of the paretic side during deep breathing are reported in several studies [11,22]. Jung K et al, [22] report restrictive pulmonary dysfunction and unilateral reduction in motion of the diaphragm during volitional breathing. At present study smaller amplitude of hemidiaphragm movement of the affected side relative to the unaffected side during spontaneous and deep breathing are reported.…”

“…Impaired respiratory function may be a consequence of weakness or/and postural trunk dysfunction [20,21]. Changes in diaphragmatic movement -higher positioning of the diaphragm and decreased excursion of the paretic side during deep breathing are reported in several studies [11,22]. Jung K et al, [22] report restrictive pulmonary dysfunction and unilateral reduction in motion of the diaphragm during volitional breathing.…”

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

“…Recent studies underline the role of the technique in assessing a wide range of chronic diseases, such as neurological, neuromuscular and respiratory conditions. Recent data suggest that US can provide important information on ventilatory impairment in amyotrophic lateral sclerosis and hemiplegic stroke patients [36,46]. There are also some initial reports suggesting a role for US in the diagnosis of infectious (e.g.…”

“…There are several indications to assess the diaphragm by US in clinical practice [34,35,36,37]. The test may be used in medical, surgical or intensive care settings as listed in table 1.…”