Diaphragmatic excursion is correlated with the improvement in exercise tolerance after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease
Abstract Background In patients with chronic obstructive pulmonary disease (COPD), the maximum level of diaphragm excursion (DEmax) is correlated with dynamic lung hyperinflation and exercise tolerance. This study aimed to elucidate the utility of DEmax to predict the improvement in exercise toleran...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2021-10-01
|
| Series: | Respiratory Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12931-021-01870-1 |
| _version_ | 1819292600070307840 |
|---|---|
| author | Masashi Shiraishi Yuji Higashimoto Ryuji Sugiya Hiroki Mizusawa Yu Takeda Shuhei Fujita Osamu Nishiyama Shintarou Kudo Tamotsu Kimura Yasutaka Chiba Kanji Fukuda Yuji Tohda Hisako Matsumoto |
| author_facet | Masashi Shiraishi Yuji Higashimoto Ryuji Sugiya Hiroki Mizusawa Yu Takeda Shuhei Fujita Osamu Nishiyama Shintarou Kudo Tamotsu Kimura Yasutaka Chiba Kanji Fukuda Yuji Tohda Hisako Matsumoto |
| author_sort | Masashi Shiraishi |
| collection | DOAJ |
| description | Abstract Background In patients with chronic obstructive pulmonary disease (COPD), the maximum level of diaphragm excursion (DEmax) is correlated with dynamic lung hyperinflation and exercise tolerance. This study aimed to elucidate the utility of DEmax to predict the improvement in exercise tolerance after pulmonary rehabilitation (PR) in patients with COPD. Methods This was a prospective cohort study. Of the 62 patients with stable COPD who participated in the outpatient PR programme from April 2018 to February 2021, 50 completed the programme. Six-minute walk distance (6MWD) was performed to evaluate exercise tolerance, and ultrasonography was performed to measure DEmax. Responders to PR in exercise capacity were defined as patients who demonstrated an increase of > 30 m in 6MWD. The receiver operating characteristic (ROC) curve was used to determine the cut-off point of DEmax to predict responses to PR. Results Baseline levels of forced expiratory volume in 1 s, 6MWD, maximum inspiratory pressure, DEmax and quadriceps muscle strength were significantly higher, and peak dyspnoea of modified Borg (mBorg) scale score was lower in responders (n = 30) than in non-responders (n = 20) to PR (p < 0.01). In multivariate analysis, DEmax was significantly correlated with an increase of > 30 m in 6MWD. The area under the ROC curve of DEmax to predict responders was 0.915, with a sensitivity and specificity of 83% and 95%, respectively, at a cut-off value of 44.9 mm of DEmax. Conclusion DEmax could adequately predict the improvement in exercise tolerance after PR in patients with COPD. |
| first_indexed | 2024-12-24T03:57:06Z |
| format | Article |
| id | doaj.art-a3939293116c4429bf189deab29ef0fa |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-12-24T03:57:06Z |
| publishDate | 2021-10-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-a3939293116c4429bf189deab29ef0fa2022-12-21T17:16:25ZengBMCRespiratory Research1465-993X2021-10-012211810.1186/s12931-021-01870-1Diaphragmatic excursion is correlated with the improvement in exercise tolerance after pulmonary rehabilitation in patients with chronic obstructive pulmonary diseaseMasashi Shiraishi0Yuji Higashimoto1Ryuji Sugiya2Hiroki Mizusawa3Yu Takeda4Shuhei Fujita5Osamu Nishiyama6Shintarou Kudo7Tamotsu Kimura8Yasutaka Chiba9Kanji Fukuda10Yuji Tohda11Hisako Matsumoto12Department of Rehabilitation Medicine, Kindai University School of MedicineDepartment of Rehabilitation Medicine, Kindai University School of MedicineDepartment of Rehabilitation Medicine, Kindai University School of MedicineDepartment of Rehabilitation Medicine, Kindai University School of MedicineDepartment of Rehabilitation Medicine, Kindai University School of MedicineDepartment of Rehabilitation Medicine, Kindai University School of MedicineDepartment of Respiratory Medicine and Allergology, Kindai University School of MedicineInclusive Medical Science Research Institute, Morinomiya University of Medical SciencesDepartment of Rehabilitation Medicine, Kindai University School of MedicineDivision of Biostatistics, Clinical Research Center, Kindai University School of MedicineDepartment of Rehabilitation Medicine, Kindai University School of MedicineDepartment of Respiratory Medicine and Allergology, Kindai University School of MedicineDepartment of Respiratory Medicine and Allergology, Kindai University School of MedicineAbstract Background In patients with chronic obstructive pulmonary disease (COPD), the maximum level of diaphragm excursion (DEmax) is correlated with dynamic lung hyperinflation and exercise tolerance. This study aimed to elucidate the utility of DEmax to predict the improvement in exercise tolerance after pulmonary rehabilitation (PR) in patients with COPD. Methods This was a prospective cohort study. Of the 62 patients with stable COPD who participated in the outpatient PR programme from April 2018 to February 2021, 50 completed the programme. Six-minute walk distance (6MWD) was performed to evaluate exercise tolerance, and ultrasonography was performed to measure DEmax. Responders to PR in exercise capacity were defined as patients who demonstrated an increase of > 30 m in 6MWD. The receiver operating characteristic (ROC) curve was used to determine the cut-off point of DEmax to predict responses to PR. Results Baseline levels of forced expiratory volume in 1 s, 6MWD, maximum inspiratory pressure, DEmax and quadriceps muscle strength were significantly higher, and peak dyspnoea of modified Borg (mBorg) scale score was lower in responders (n = 30) than in non-responders (n = 20) to PR (p < 0.01). In multivariate analysis, DEmax was significantly correlated with an increase of > 30 m in 6MWD. The area under the ROC curve of DEmax to predict responders was 0.915, with a sensitivity and specificity of 83% and 95%, respectively, at a cut-off value of 44.9 mm of DEmax. Conclusion DEmax could adequately predict the improvement in exercise tolerance after PR in patients with COPD.https://doi.org/10.1186/s12931-021-01870-1Pulmonary rehabilitationDiaphragmatic excursionCOPDSix-minute walk distance (6MWD) |
| spellingShingle | Masashi Shiraishi Yuji Higashimoto Ryuji Sugiya Hiroki Mizusawa Yu Takeda Shuhei Fujita Osamu Nishiyama Shintarou Kudo Tamotsu Kimura Yasutaka Chiba Kanji Fukuda Yuji Tohda Hisako Matsumoto Diaphragmatic excursion is correlated with the improvement in exercise tolerance after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease Respiratory Research Pulmonary rehabilitation Diaphragmatic excursion COPD Six-minute walk distance (6MWD) |
| title | Diaphragmatic excursion is correlated with the improvement in exercise tolerance after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease |
| title_full | Diaphragmatic excursion is correlated with the improvement in exercise tolerance after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease |
| title_fullStr | Diaphragmatic excursion is correlated with the improvement in exercise tolerance after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease |
| title_full_unstemmed | Diaphragmatic excursion is correlated with the improvement in exercise tolerance after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease |
| title_short | Diaphragmatic excursion is correlated with the improvement in exercise tolerance after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease |
| title_sort | diaphragmatic excursion is correlated with the improvement in exercise tolerance after pulmonary rehabilitation in patients with chronic obstructive pulmonary disease |
| topic | Pulmonary rehabilitation Diaphragmatic excursion COPD Six-minute walk distance (6MWD) |
| url | https://doi.org/10.1186/s12931-021-01870-1 |
| work_keys_str_mv | AT masashishiraishi diaphragmaticexcursioniscorrelatedwiththeimprovementinexercisetoleranceafterpulmonaryrehabilitationinpatientswithchronicobstructivepulmonarydisease AT yujihigashimoto diaphragmaticexcursioniscorrelatedwiththeimprovementinexercisetoleranceafterpulmonaryrehabilitationinpatientswithchronicobstructivepulmonarydisease AT ryujisugiya diaphragmaticexcursioniscorrelatedwiththeimprovementinexercisetoleranceafterpulmonaryrehabilitationinpatientswithchronicobstructivepulmonarydisease AT hirokimizusawa diaphragmaticexcursioniscorrelatedwiththeimprovementinexercisetoleranceafterpulmonaryrehabilitationinpatientswithchronicobstructivepulmonarydisease AT yutakeda diaphragmaticexcursioniscorrelatedwiththeimprovementinexercisetoleranceafterpulmonaryrehabilitationinpatientswithchronicobstructivepulmonarydisease AT shuheifujita diaphragmaticexcursioniscorrelatedwiththeimprovementinexercisetoleranceafterpulmonaryrehabilitationinpatientswithchronicobstructivepulmonarydisease AT osamunishiyama diaphragmaticexcursioniscorrelatedwiththeimprovementinexercisetoleranceafterpulmonaryrehabilitationinpatientswithchronicobstructivepulmonarydisease AT shintaroukudo diaphragmaticexcursioniscorrelatedwiththeimprovementinexercisetoleranceafterpulmonaryrehabilitationinpatientswithchronicobstructivepulmonarydisease AT tamotsukimura diaphragmaticexcursioniscorrelatedwiththeimprovementinexercisetoleranceafterpulmonaryrehabilitationinpatientswithchronicobstructivepulmonarydisease AT yasutakachiba diaphragmaticexcursioniscorrelatedwiththeimprovementinexercisetoleranceafterpulmonaryrehabilitationinpatientswithchronicobstructivepulmonarydisease AT kanjifukuda diaphragmaticexcursioniscorrelatedwiththeimprovementinexercisetoleranceafterpulmonaryrehabilitationinpatientswithchronicobstructivepulmonarydisease AT yujitohda diaphragmaticexcursioniscorrelatedwiththeimprovementinexercisetoleranceafterpulmonaryrehabilitationinpatientswithchronicobstructivepulmonarydisease AT hisakomatsumoto diaphragmaticexcursioniscorrelatedwiththeimprovementinexercisetoleranceafterpulmonaryrehabilitationinpatientswithchronicobstructivepulmonarydisease |