Clinical values of diaphragmatic movement in patients with chronic obstructive pulmonary disease

BMC Pulmonary Medicine

Research Article

Onyu Park¹  Sungchul Huh²  Ra Yu Yun³  Seung Eun Lee⁴  Yun Seong Kim⁴  Jae Heun Chung⁴  Taehwa Kim⁴ 

[1] College of Nursing, Pusan National University, Pusan National University Yangsan Hospital, Yangsan, South Korea;Department of Rehabilitation Medicine, Rehabilitation Hospital, Pusan National University Yangsan, Yangsan, South Korea;Department of Rehabilitation Medicine, Rehabilitation Hospital, Pusan National University Yangsan, Yangsan, South Korea;Pusan National University School of Medicine, Yangsan, South Korea;Division of Respiratory, Allergy and Critical Care Medicine, Department of Internal Medicine, Pusan National University Yangsan Hospital and Pusan National University School of Medicine, Geumo-ro 20, Beomeo-ri, 50612, Yangsan-si, Gyeongsangnam-do, Republic of Korea;BioMedical Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea;

关键词: 6-minute walk test;    Diaphragm;    Excursion;    FEV1;    Cut-off value;   

DOI  :  10.1186/s12890-022-02220-7

 received in 2022-04-25, accepted in 2022-11-02,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundThe limitation of activity due to dyspnea in chronic obstructive pulmonary disease (COPD) patients is affected by diaphragmatic dysfunction and reduced lung function. This study aimed to analyze the association between diaphragm function variables and forced expiratory volume in the first second (FEV1) and to estimate the clinical significance of diaphragm function in the correlation between COPD severity and lung function.MethodsThis prospective, single-center, cross-sectional observational study enrolled 60 COPD patients in a respiratory outpatient clinic. Data for baseline characteristics and the dyspnea scale were collected. Participants underwent a pulmonary function test (PFT), a 6-minute walk test (6MWT), and diaphragm function by ultrasonography.ResultsThe right excursion at forced breathing showed the most significant correlation with FEV1 (r = 0.370, p = 0.004). The cutoff value was 6.7 cm of the right diaphragmatic excursion at forced breathing to identify the FEV1 above 50% group. In the group with a right diaphragmatic excursion at forced breathing < 6.7 cm, modified Medical Research Council (mMRC), St. George's Respiratory Questionnaire and the total distance of 6MWT showed no difference between groups with FEV1 under and above 50% (p > 0.05). In the group with ≥ 6.7 cm, mMRC and the total distance of 6MWT showed a significant difference between FEV1 under and above 50% (p = 0.014, 456.7 ± 69.7 m vs. 513.9 ± 60.3 m, p = 0.018, respectively).ConclusionThe right diaphragmatic forced excursion was closely related to FEV1, and analysis according to the right diaphragmatic forced excursion-based cut-off value showed a significant difference between both groups. When the diaphragm function was maintained, there was a lot of difference in the 6MWT’s factors according to the FEV1 value. Our data suggest that diaphragmatic function should be performed when interpreting PFT.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

Fig. 3

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