The use of ultrasonography in the evaluation of a patient with weak diaphragm after muscle retraining

1. Dott. FtR ANGELO LONGONI
Master of Physiotherapy and Respiratory Rehabilitation
Cardiac-Respiratory Rehabilitation Gym, “Paola Giancola foundation”
Asst Lariana-Como
ECO EVOLUTION in Respiratory Physiotherapy: THE DIAPHRAGM”
“Ultrasonography evaluation of a weak
diaphragm after a respiratory muscle training”

2. Dal 19 Settembre 2014 al 04 Marzo 2016:
Totali pazienti: n. 389
Totali ecografie diaframmatiche n. 730
Pazienti Cardiologici: n. 118
Privacy
Privacy
Pazienti Respiratori: n. 269

3. Normal Diaphragmatic Approach
M-Mode
AxillaryAnterior Subcostal
Inspirio
Espirio
probe
Inspirio
Espirio
B-Mode
probe
probe
Inspirio
Espirio

4. Paradoxical motion
Inspirio
Espirio
Inspirio
Espirio
Espirio
Inspirio
it seems normal

5. Left diaphragm at beginning
Right diaphragm with cpap Left diaphragm with cpap
2 cm
1 cm
2 cm2,2 cm
Right diaphragm at beginning

6. OSAS case report
L.R.Gina, F, 61years
Cpap
pressure
SpO2 94,3%
Sleep quality 83%
WT6’= 275 435 meters Daily Steps 55  1190
Sleep quality: 39,2% 83,9% Night SpO2 89%  94,3%

7. 6,9 cm 5,6 cm
Right diaphragm at the end Left diaphragm at the end
CONCLUSION
It’s possible to find diaphragmatic dysfunction in a unexpected patients
using M-mode ultrasonography. We believe that this tecnique is
inexpensive, widely available, easy to use as a badside exame for
clinicians and RT therapist. We can asses diaphragm excursion in quiet
and deep breathing in real time motion before and after a rehabilitative
program and it can be considered an outcome measure.