Sonographic measurement of diaphragm movement in patients with tetraplegia.
METHODS
This was an observational, descriptive case-series study. The magnitude and direction of diaphragm movement during tidal and maximal inspiratory breaths in tetraplegic subjects were measured using B-mode sonography on a single occasion. Data were tabulated for descriptive analysis.


OBJECTIVE
There is a paucity of literature reporting dynamic movements of the paralyzed diaphragm. The aim of this pilot study was to investigate and record diaphragm movement in subjects with a cervical spinal cord injury (C1-C5), which had resulted in tetraplegia with partial or complete diaphragm paralysis. Subjects were patients of the Royal Adelaide Hospital in South Australia.


RESULTS
Three subjects participated in the study. The magnitude of diaphragm movement was small in two subjects and approached normal in one subject. During tidal inspiratory and maximal inspiratory breaths, the diaphragm moved in a caudal direction in two subjects. In the other subject, the diaphragm moved in a cephalad direction during a maximal inspiratory breath.


CONCLUSIONS
Imaging of diaphragm movement was well tolerated by three subjects with cervical spinal cord injury. The difference in magnitude of diaphragm movement was not fully explained by the level of injury and the American Spinal Injury Association classification.
Hardy
F
F
School of Health Sciences, University of South Australia, Adelaide, South Australia 5000, Australia. Frances.hardy@unisa.edu.au
Walker
J
J
Sawyer
T
T
D000368:Aged; D002574:Cervical Vertebrae / Q000293:injuries; D003964:Diaphragm / Q000294:innervation / Q000503:physiopathology*; D004185:Disability Evaluation; D004525:Efferent Pathways / Q000293:injuries / Q000503:physiopathology; D006801:Humans; D001239:Inhalation / Q000502:physiology; D007320:Inspiratory Capacity / Q000502:physiology; D008297:Male; D009119:Muscle Contraction / Q000502:physiology; D011237:Predictive Value of Tests; D011782:Quadriplegia / Q000150:complications / Q000503:physiopathology*; D012133:Respiratory Paralysis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology*; D012143:Respiratory Physiological Phenomena; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013116:Spinal Cord / Q000473:pathology / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology*; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult