This work by respiratory physiotherapist Angelo Longoni aims to demonstrate how the use of diaphragmatic ultrasound can be helpful in the evaluation of results of rehabilitative respiratory programs.

1. “ 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”, Cantù, Italy
angelo.longoni@asst-lariana.it
To assess the diaphragmatic excursion before and
after a pulmonary rehabilitation program and to
compare its effectiveness with 6-minute walking
test (6MWT).
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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.
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),
based on breathing and callisthenics exercises,
theraband (30’ a day), minibike or cyclette and
tapis roulant (30’ twice a day).
Poster n.1049
Objective:
Methods:
Results:
Bibliography:
Working phases
Fig. 1: Patient position Fig. 2:Right Subcostal/lateral
Fig.9: Walking Test 6’ Fig.10: Results
Fig. 5: U.S. M-Mode Fig. 6: Normal breathe
Conclusion:
US diaphragmatic motion improved in 76% vs
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.
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
Fig. 7: Forced breath Fig. 8: Exercise
Fig. 3: U.S. machine Fig. 4:U.S. B-mode
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