Cargando…

Body Position Affects Ultrasonographic Measurement of Diaphragm Contractility

PURPOSE: (1) Determine whether ultrasonography can detect differences in diaphragm contractility between body positions. (2) Perform reliability analysis of diaphragm thickness measurements in each test condition. METHODS: We used a repeated-measures experimental design with 45 healthy adults where...

Descripción completa

Detalles Bibliográficos
Autores principales: Brown, Christopher, Tseng, Shih-Chiao, Mitchell, Katy, Roddey, Toni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166710/
https://www.ncbi.nlm.nih.gov/pubmed/30319315
http://dx.doi.org/10.1097/CPT.0000000000000083
_version_ 1783360086318514176
author Brown, Christopher
Tseng, Shih-Chiao
Mitchell, Katy
Roddey, Toni
author_facet Brown, Christopher
Tseng, Shih-Chiao
Mitchell, Katy
Roddey, Toni
author_sort Brown, Christopher
collection PubMed
description PURPOSE: (1) Determine whether ultrasonography can detect differences in diaphragm contractility between body positions. (2) Perform reliability analysis of diaphragm thickness measurements in each test condition. METHODS: We used a repeated-measures experimental design with 45 healthy adults where 3 B-mode ultrasound images were collected at peak-inspiration and end-expiration in supine, sitting, and standing. Mean diaphragm thickening fractions were calculated for each test position. Statistical significance was tested using 1-way repeated-measures analysis of variance with planned comparisons. For reliability analysis, the intraclass correlation coefficient (3, 3) was calculated. RESULTS: Mean diaphragm thickening fraction increased from 60.2% (95% confidence interval [CI] 53.0%, 67.9%) in supine, to 96.5% (95% CI 83.2%, 109.9%) while seated and to 173.8% (95% CI 150.5%, 197.1%) while standing. Body position was a significant factor overall (P < .001), as were comparisons between each individual position (P < .001). Intraobserver reliability was excellent (>0.93) for all body positions tested. CONCLUSIONS: Ultrasound imaging detected positional differences in diaphragm contractility. The effect of gravitational loading on diaphragm length-tension, and body position-mediated changes in intra-abdominal pressure may explain the differences found. Future research should address methodological concerns and apply this method to patients participating in early mobilization programs in the intensive care unit.
format Online
Article
Text
id pubmed-6166710
institution National Center for Biotechnology Information
language English
publishDate 2018
publisher Lippincott Williams & Wilkins
record_format MEDLINE/PubMed
spelling pubmed-61667102018-10-12 Body Position Affects Ultrasonographic Measurement of Diaphragm Contractility Brown, Christopher Tseng, Shih-Chiao Mitchell, Katy Roddey, Toni Cardiopulm Phys Ther J Research Report PURPOSE: (1) Determine whether ultrasonography can detect differences in diaphragm contractility between body positions. (2) Perform reliability analysis of diaphragm thickness measurements in each test condition. METHODS: We used a repeated-measures experimental design with 45 healthy adults where 3 B-mode ultrasound images were collected at peak-inspiration and end-expiration in supine, sitting, and standing. Mean diaphragm thickening fractions were calculated for each test position. Statistical significance was tested using 1-way repeated-measures analysis of variance with planned comparisons. For reliability analysis, the intraclass correlation coefficient (3, 3) was calculated. RESULTS: Mean diaphragm thickening fraction increased from 60.2% (95% confidence interval [CI] 53.0%, 67.9%) in supine, to 96.5% (95% CI 83.2%, 109.9%) while seated and to 173.8% (95% CI 150.5%, 197.1%) while standing. Body position was a significant factor overall (P < .001), as were comparisons between each individual position (P < .001). Intraobserver reliability was excellent (>0.93) for all body positions tested. CONCLUSIONS: Ultrasound imaging detected positional differences in diaphragm contractility. The effect of gravitational loading on diaphragm length-tension, and body position-mediated changes in intra-abdominal pressure may explain the differences found. Future research should address methodological concerns and apply this method to patients participating in early mobilization programs in the intensive care unit. Lippincott Williams & Wilkins 2018-10 2018-05-30 /pmc/articles/PMC6166710/ /pubmed/30319315 http://dx.doi.org/10.1097/CPT.0000000000000083 Text en Copyright © [2018] The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Cardiovascular and Pulmonary Section, APTA This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Research Report
Brown, Christopher
Tseng, Shih-Chiao
Mitchell, Katy
Roddey, Toni
Body Position Affects Ultrasonographic Measurement of Diaphragm Contractility
title Body Position Affects Ultrasonographic Measurement of Diaphragm Contractility
title_full Body Position Affects Ultrasonographic Measurement of Diaphragm Contractility
title_fullStr Body Position Affects Ultrasonographic Measurement of Diaphragm Contractility
title_full_unstemmed Body Position Affects Ultrasonographic Measurement of Diaphragm Contractility
title_short Body Position Affects Ultrasonographic Measurement of Diaphragm Contractility
title_sort body position affects ultrasonographic measurement of diaphragm contractility
topic Research Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6166710/
https://www.ncbi.nlm.nih.gov/pubmed/30319315
http://dx.doi.org/10.1097/CPT.0000000000000083
work_keys_str_mv AT brownchristopher bodypositionaffectsultrasonographicmeasurementofdiaphragmcontractility
AT tsengshihchiao bodypositionaffectsultrasonographicmeasurementofdiaphragmcontractility
AT mitchellkaty bodypositionaffectsultrasonographicmeasurementofdiaphragmcontractility
AT roddeytoni bodypositionaffectsultrasonographicmeasurementofdiaphragmcontractility