title: Chest wall mechanics before and after diaphragm plication.
abstract: BACKGROUND
  Following diaphragmatic plication for unilateral paralysis, the effect on global chest wall function are unknown. Our hypothesis was that chest wall function would improve in both sides of the chest after plication of the paralysed side.
  
  
  METHODS
  Using Optoelectronic Plethysmography, total and regional chest wall volumes were measured in one patient before and after left diaphragmatic plication. Volumes were recorded at quiet breathing. Respiratory capacity improved during quiet breathing when measured before and 6 months after surgery. These improvements occur at the abdominal-rib cage level in both operated and contralateral. Prior to surgery the abdominal rib cage motion was out of phase to the upper rib cage and abdominal compartment in both sides of the chest. Synchrony of all three compartments was restored after plication.
  
  
  CONCLUSIONS
  This physiological study is the first published data in humans to show improvement in chest wall motion both in operated and contralateral side following diaphragmatic plication for unilateral paralysis.
authors.affiliation: Heart of England Foundation Trust, Birmingham, B9 5SS, UK.|Birmingham Medical School, University of Birmingham, Birmingham, UK.
authors.forename: Ghazi
authors.initials: G
authors.lastname: Elshafie
authors.affiliation: International Digital Laboratory, University of Warwick, Coventry, CV4 7AL, UK.
authors.forename: Johanna
authors.initials: J
authors.lastname: Acosta
authors.affiliation: Dipartimento di Elettronica, Informazione e Bioingegneria, Politecnico di Milano, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Aliverti
authors.affiliation: Heart of England Foundation Trust, Birmingham, B9 5SS, UK.
authors.forename: Amy
authors.initials: A
authors.lastname: Bradley
authors.affiliation: Birmingham Medical School, University of Birmingham, Birmingham, UK.
authors.forename: Prem
authors.initials: P
authors.lastname: Kumar
authors.affiliation: Heart of England Foundation Trust, Birmingham, B9 5SS, UK.
authors.forename: Pala
authors.initials: P
authors.lastname: Rajesh
authors.affiliation: Heart of England Foundation Trust, Birmingham, B9 5SS, UK. b.naidu@bham.ac.uk.|Birmingham Medical School, University of Birmingham, Birmingham, UK. b.naidu@bham.ac.uk.
authors.forename: Babu
authors.initials: B
authors.lastname: Naidu
mesh_terms: D003964:Diaphragm / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010991:Plethysmography / Q000379:methods; D011184:Postoperative Period; D012123:Pulmonary Ventilation / Q000502:physiology; D011859:Radiography; D012133:Respiratory Paralysis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D035441:Thoracic Wall / Q000503:physiopathology*
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