PT  - JOURNAL ARTICLE
AU  - Angelo Longoni
AU  - Antonio Paddeu
AU  - Dionigi Mangiacasale
AU  - Paolo Pozzi
AU  - Laura Cattaneo
AU  - Mariele Vago
AU  - Albino De Marco
TI  - Sonographic evaluation of the diaphragm muscle before and after pulmonary rehabilitation
AID  - 10.1183/1393003.congress-2017.PA4901
DP  - 2017 Sep 01
TA  - European Respiratory Journal
PG  - PA4901
VI  - 50
IP  - suppl 61
4099  - http://erj.ersjournals.com/content/50/suppl_61/PA4901.short
4100  - http://erj.ersjournals.com/content/50/suppl_61/PA4901.full
SO  - Eur Respir J2017 Sep 01; 50
AB  - Aim: The purpose of this retroactive study was to assess the behavior of diaphragmatic excursion before and after a rehabilitation program in pulmonary diseases.Methods: 234 patients in 2014-15 (COPD=112, OSA=65, neuromuscolar=17, surgical=4, fibrotorax=7, bronchiectasis=7, asthma=5, pneumonia=6, emphysema=4, embolism=7) were investigated with sonographic measurements of the diaphragm motion and compared with 6-minute walk test. The ultrasound machine was a portable one with a 1.3-4 MHz sector phased array transducer with 14x24 mm footprint. The sonography was performed by the same RT therapist at bedside with patient in semirecumber position in anterior subcostal approach. All patients followed a rehabilitation program (the daily average of treatments was of 14 days), based on exercises of mobilization and breathing, retraining through calisthenics exercises, theraband, minibike or cyclette.Results: US diaphragm improved were 76%; WT6 improved 57%; US stationary 20%; WT6 stationary 38%; US worse 4%; WT6 worse 5%. The problems have occurred with critically ill patients for which the wt6 was not effective.Conclusion: Our study suggests that Ultrasound is a safe, reliable modality to set measurement of the diaphragmatic excursion. It can be a strong addition to lung function parameters to control the effects of rehabilitation programs and respiratory muscle training in the evaluation of ventilatory muscle strength.