Mobility impact and methods of diaphragm monitoring in patients with chronic obstructive pulmonary disease: a systematic review
The objectives of the study were to identify the factors that limit diaphragmatic mobility and evaluate the therapeutic results of the monitoring methods previously used in patients with chronic obstructive pulmonary disease. The PubMed, Web of Science, Scopus, and LILACS databases were used. A gray...
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| Format: | Article |
| Language: | English |
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Elsevier España
2020-01-01
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| Series: | Clinics |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322020000100401&tlng=en |
| _version_ | 1811227990678306816 |
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| author | Iramar Baptistella do Nascimento Raquel Fleig |
| author_facet | Iramar Baptistella do Nascimento Raquel Fleig |
| author_sort | Iramar Baptistella do Nascimento |
| collection | DOAJ |
| description | The objectives of the study were to identify the factors that limit diaphragmatic mobility and evaluate the therapeutic results of the monitoring methods previously used in patients with chronic obstructive pulmonary disease. The PubMed, Web of Science, Scopus, and LILACS databases were used. A gray literature search was conducted with Google scholar. PRISMA was used, and the bias risk analysis adapted from the Cochrane Handbook for clinical trials and, for other studies, the Downs and Black checklist were used. Twenty-five articles were included in the qualitative synthesis analysis on physiotherapeutic techniques and diaphragmatic mobility. Eight clinical trials indicated satisfactory domains, and on the Downs and Black scale, 17 cohort studies were evaluated to have an acceptable score. Different conditions must be observed; for example, for postoperative assessments the supine position is suggested to be the most appropriate position to verify diaphragm excursion, although it has been shown to be associated with difficulty of restriction and matching in samples. Therefore, we identified the need for contemporary adjustments and strategies that used imaging instruments, preferably in the dorsal position. Therapeutic evidence on the association between the instrumental method and diaphragmatic mobility can be controversial. The ultrasound measurements indicated some relevance for different analyses, for pulmonary hyperinflation as well as diaphragm thickness and mobilization, in COPD patients. In particular, the study suggests that the ultrasound technique with B-mode for analysis and M-mode for diaphragmatic excursion be used with a 2 - 5 MHz with the patient in the supine position. However, the methods used to monitor diaphragm excursion should be adapted to the conditions of the patients, and additional investigations of their characteristics should be performed. More selective inclusion criteria and better matching in the samples are very important. In addition, more narrow age, sex and weight categories are important, especially in patients with chronic obstructive pulmonary disease. |
| first_indexed | 2024-04-12T09:50:59Z |
| format | Article |
| id | doaj.art-7b83ca12e5ff447293e0adeaf00b0706 |
| institution | Directory Open Access Journal |
| issn | 1980-5322 |
| language | English |
| last_indexed | 2024-04-12T09:50:59Z |
| publishDate | 2020-01-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-7b83ca12e5ff447293e0adeaf00b07062022-12-22T03:37:49ZengElsevier EspañaClinics1980-53222020-01-017510.6061/clinics/2020/e1428Mobility impact and methods of diaphragm monitoring in patients with chronic obstructive pulmonary disease: a systematic reviewIramar Baptistella do Nascimentohttps://orcid.org/0000-0003-1268-2777Raquel Fleighttps://orcid.org/0000-0003-1934-6936The objectives of the study were to identify the factors that limit diaphragmatic mobility and evaluate the therapeutic results of the monitoring methods previously used in patients with chronic obstructive pulmonary disease. The PubMed, Web of Science, Scopus, and LILACS databases were used. A gray literature search was conducted with Google scholar. PRISMA was used, and the bias risk analysis adapted from the Cochrane Handbook for clinical trials and, for other studies, the Downs and Black checklist were used. Twenty-five articles were included in the qualitative synthesis analysis on physiotherapeutic techniques and diaphragmatic mobility. Eight clinical trials indicated satisfactory domains, and on the Downs and Black scale, 17 cohort studies were evaluated to have an acceptable score. Different conditions must be observed; for example, for postoperative assessments the supine position is suggested to be the most appropriate position to verify diaphragm excursion, although it has been shown to be associated with difficulty of restriction and matching in samples. Therefore, we identified the need for contemporary adjustments and strategies that used imaging instruments, preferably in the dorsal position. Therapeutic evidence on the association between the instrumental method and diaphragmatic mobility can be controversial. The ultrasound measurements indicated some relevance for different analyses, for pulmonary hyperinflation as well as diaphragm thickness and mobilization, in COPD patients. In particular, the study suggests that the ultrasound technique with B-mode for analysis and M-mode for diaphragmatic excursion be used with a 2 - 5 MHz with the patient in the supine position. However, the methods used to monitor diaphragm excursion should be adapted to the conditions of the patients, and additional investigations of their characteristics should be performed. More selective inclusion criteria and better matching in the samples are very important. In addition, more narrow age, sex and weight categories are important, especially in patients with chronic obstructive pulmonary disease.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322020000100401&tlng=enChronic Obstructive Pulmonary DiseaseMovementDiaphragmReproducibility of Results |
| spellingShingle | Iramar Baptistella do Nascimento Raquel Fleig Mobility impact and methods of diaphragm monitoring in patients with chronic obstructive pulmonary disease: a systematic review Clinics Chronic Obstructive Pulmonary Disease Movement Diaphragm Reproducibility of Results |
| title | Mobility impact and methods of diaphragm monitoring in patients with chronic obstructive pulmonary disease: a systematic review |
| title_full | Mobility impact and methods of diaphragm monitoring in patients with chronic obstructive pulmonary disease: a systematic review |
| title_fullStr | Mobility impact and methods of diaphragm monitoring in patients with chronic obstructive pulmonary disease: a systematic review |
| title_full_unstemmed | Mobility impact and methods of diaphragm monitoring in patients with chronic obstructive pulmonary disease: a systematic review |
| title_short | Mobility impact and methods of diaphragm monitoring in patients with chronic obstructive pulmonary disease: a systematic review |
| title_sort | mobility impact and methods of diaphragm monitoring in patients with chronic obstructive pulmonary disease a systematic review |
| topic | Chronic Obstructive Pulmonary Disease Movement Diaphragm Reproducibility of Results |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322020000100401&tlng=en |
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