Ultrasonographic evaluation of diaphragm thickness and excursion in patients with cervical spinal cord injury

Abstract

Objective: To evaluate the diaphragm thickness and excursion in patients with cervical spinal cord injury and reliability of diaphragmatic ultrasonography.

Design: A Pilot Case–Control Study.

Setting: China Rehabilitation Research Center (CRRC) /Beijing BO AI Hospital.

Participants: Sixty participants with cervical spinal cord injury and sixty control participants were eligible for inclusion in this study.

Interventions: Ultrasonographic evaluation of the diaphragm.

Outcome Measures: All demographic data were evaluated. Diaphragm thickness, thickening ratio, and diaphragm excursions were assessed at the end of quiet tidal breathing and maximal inspiration. The reliability of inter- and intra-ultrasonography operators were evaluated.

Results: Diaphragm thickness was significantly higher in patients with cervical spinal cord injury than the control group (P < 0.001). Diaphragmatic excursion of the right hemidiaphragm was significantly greater in patients with cervical spinal cord injury than the control group (P < 0.001) at the end of quiet tidal breathing. No difference was found in diaphragmatic excursion between two groups (P = 0.32) at the end of maximal inspiration. No significant difference was shown between two groups in thickening ratio. Intraclass correlation coefficients of inter-and intra-ultrasonography operators for the thickness and excursions of the diaphragm were greater than 0.93.

Conclusion: Compared with the control group the diaphragm in patients with cervical spinal cord injury is hypertrophied and the diaphragm excursion is greater. Ultrasound is a highly reliable tool for the evaluation of diaphragm thickness and excursion in patients with cervical spinal cord injury.

Trial Registration: This trail was registered in Chinese Clinical Trial Registry (NO. ChiCTR-ROC-17010973).

Keywords:

• Diaphragm
• Ultrasound
• Spinal cord injury
• Reliability

Acknowledgment

We also like to thank all other members from the department of Spinal and Neural Function Reconstruction, Beijing Bo Ai Hospital, China Rehabilitation Research Center for their help that they offered.

Disclaimer statements

Ethical statements The study was approved by the Medical Ethics Committee of the Hospital, and all subjects provided written informed consent.

Conflict of interest The authors declare that they have no conflict of interest.

Additional information

Funding

This work was supported by the Basic Scientific Research Foundation of China Rehabilitation Research Center [grant number 2017ZX-21].