DIAPHRAGMATIC MOBILITY, DISEASE SEVERITY, AND EXERCISE TOLERANCE IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Airflow obstruction in patients with Chronic Obstructive Pulmonary Disease represents the main disabling factor, in a progressive and irreversible manner. Respiratory muscle dysfunction correlates with disease mortality and morbidity and reduces the patient's tolerance to exercise and quality of life. Thus, this study aimed to evaluate diaphragmatic mobility, disease severity, and exercise tolerance in patients with COPD. Methods: The study included clinically stable patients diagnosed with COPD according to the GOLD 2019 guidelines. We excluded patients who had disease exacerbation during the study or in the last two months preceding the study those who were unable to perform any of the study assessments due to lack of understanding or cooperation, and those who had clinical intercurrences of cardiorespiratory and, or musculoskeletal nature during the assessments. The diaphragmatic mobility was measured by ultrasound, curvilinear transducer (1-5Mhz). The 6-minute walk test (6MWT) was performed according to the guidelines suggested by the American Thoracic Society. We used the COPD Assessment Test (CAT) and the modified Borg scale to assess the patient's quality of life and the degree of dyspnea, respectively. Results: Sixty-six patients were included and classified into three groups: mild COPD (n=16), moderate COPD (n=30), and severe/very severe COPD (n=20). The mean age of the patients was 63.7 ± 9.4 years, 53% were female, and the mean BMI was 27.6 ± 5.5 kg/m². Diaphragmatic mobility did not correlate with the distance walked on the 6MWT (p=0.8), CAT scores (p=0.2), and disease severity (p=0.9). It also did not correlate with other clinical and functional variables such as heart and respiratory rate, blood pressure peripheral oxygen saturation (SpO2), and Borg scores. Conclusion: In our study, diaphragmatic mobility measurements seem unable to identify disease severity and to correlate with other clinical and functional parameters.