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Observational Study
. 2023 Jan 27;23(1):33.
doi: 10.1186/s12890-022-02220-7.

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

Taehwa Kim #  1   2 , Sungchul Huh #  3 , Jae Heun Chung  1   2 , Yun Seong Kim  1   2 , Ra Yu Yun  3   4 , Onyu Park  5 , Seung Eun Lee  6   7
Affiliations
Observational Study

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

Taehwa Kim et al. BMC Pulm Med. .

Abstract

Background: The 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.

Methods: This 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.

Results: The 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).

Conclusion: The 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.

Keywords: 6-minute walk test; Cut-off value; Diaphragm; Excursion; FEV1.

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Conflict of interest statement

The authors have no conflicts of interest or funding sources to declare.

Figures

Fig. 1
Fig. 1
Correlation between forced expiratory volume in 1 s and diaphragm function Right forced excursion, and left forced excursion in the supine position and right end-expiratory thickness were correlated to forced expiratory volume in 1 s
See this image and copyright information in PMC

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