The Relationship Between Diaphragmatic Mobility And Other Respiratory Parameters Of Patients With Selected Neurological Conditions

Abstract

Background: Patients with neurological conditions such as stroke and Spinal cord injury (SCI) present with reduction in respiratory function. The diaphragm, which is the chief muscle of inspiration may be impaired in these patients.
Objective: This study evaluated the diaphragmatic mobility and other respiratory parameters of patients with stroke and cervical SCI.
Methods: The study involved 43 patients with stroke and 30 with cervical SCI in the acute stage. Their diaphragmatic mobility,  spirometry and Maximum Inspiratory and Expiratory Pressures (MIP and MEP) were assessed using a diagnostic ultrasound machine, a spirometer and a manometer respectively. Data obtained were compared with that of their age and sex matched apparently healthy
individuals. Mann Whitney U test was used to compare the data obtained from the subjects with neurological conditions with those obtained from their age and sex matched apparently healthy individuals. Spearman's rank test was used to determine the correlation between diaphragm mobility and other respiratory parameters assessed. Level of significance was set at p<0.05.
Results: Subjects with stroke, had significant reduction in the diaphragmatic mobility (right hemiplegics: p=0.009, left hemiplegics: p=0.002) of the paretic side when compared to the non paretic side. There was significant reduction in diaphragm mobility (on both hemi-thorax), spirometry, MIP and MEP of the subjects with stroke and SCI when compared with those of their age and sex matched
apparently healthy individuals (p=0.001). There was a positive correlation among diaphragm mobility and Forced Vital Capacity (FVC), Forced Expiratory Volume in First second (FEV ) and MIP (p<0.05) in 1 subjects with stroke while subjects with SCI, had positive  correlation among diaphragm mobility and all Spirometry and MIP (p<0.05). Diaphragm mobility showed no correlation with MEP in both stroke and SCI (p>0.05).
Conclusion: Patients with stroke and SCI in the acute stage have reduced diaphragmatic mobility and other respiratory parameters (Spirometry, MIP and MEP). The diaphragmatic mobility was also positively correlated with the pressure generated by the inspiratory muscles and some Spirometry. This necessitates adequate rehabilitation of the respiratory function in this group of patients.

Keywords: Diaphragm Mobility, Spirometry, Maximum Inspiratory and Expiratory Pressure, Stoke, Spinal Cord Injury