Poster n.

1049

Sonographic evaluation of the diaphragm muscle before

and after pulmonary rehabilitation
A. Longoni Respiratory Therapist, A. Paddeu MD, D. Mangiacasale MD, P. Pozzi MD, A.D. Marco MD,
L. Cattaneo MD, M. Vago Respiratory Therapist
Asst Lariana -U.O. of Specialistic Cardio-Respiratory Rehabilitation 2, Paola Giancola Foundation, Cant, Italy
angelo.longoni@asst-lariana.it

Objective: Working phases

To assess the diaphragmatic excursion before and
after a pulmonary rehabilitation program and to
compare its effectiveness with 6-minute walking
test (6MWT).

Methods: Fig. 1: Patient position Fig. 2:Right Subcostal/lateral

234 participants (Fig.11): COPD=112, OSAS=65,

Surgical=4, Neuromuscolar=17, Fibrothorax=7,
Bronchiectasis=7, Asthma=5, Pneumonia=6
Emphysema=4, Embolism=7, were investigated
with a sonographic measurements of the
diaphragm excursion in B-mode and M-mode (Fig.
Fig. 3: U.S. machine Fig. 4:U.S. B-mode
4-5) in normal and forced breathing (Fig. 6-7).
Improvements were then compared with those in
6MWT (Fig 9). The US machine (Fig.3) was a
portable one with a 1.3-4 MHz Sector Phased
Array Transducer. The sonography was completed
by the same RT therapist at bedside with patient in
semirecumber position (Fig.1) in right anterior
subcostal or lateral approach (Fig.2). All patients
followed the same rehabilitation program (Fig.8), Fig. 5: U.S. M-Mode Fig. 6: Normal breathe
based on breathing and callisthenics exercises,
theraband (30 a day), minibike or cyclette and
tapis roulant (30 twice a day).

Results:
US diaphragmatic motion improved in 76% vs Fig. 7: Forced breath Fig. 8: Exercise
56% of patients, as compared to 6MWT. In 20% of
patients the diaphragmatic motion remained
stationary 20% (38% 6MWT). Diaphragmatic
motion deteriorated in 4% of patients, as
compared to a 5% in 6MWT. We registered the
most improvements in critically-ill patients.

Fig.9: Walking Test 6 Fig.10: Results

Conclusion:
Our study suggests that US evaluation of the
diaphragmatic motion is a safe, fast and
reliable modality to monitor the effectivenes of a
pulmonary rehabilitation program. It may offer a
stronger advance than the common field tests in
terms of measuments of muscolar weakness,
especially in critically-ill patients (Fig. 10). Fig.11: Results from : 2014/2015

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