Methods for Diagnosing and Predicting Diaphragm Dysfunction in the Recovery Period of a Stroke: a Narrative Review

Abstract

INTRODUCTION. Diaphragm is not only the main human respiratory muscle, it also plays an important role in maintaining intra-abdominal pressure, balance, upper limb motor function, swallowing and speech. In patients with cerebral stroke, the function of the diaphragm can be impaired on the side of hemiparesis in more than half of the cases and may negatively affect the entire recovery process. Moderate clinical manifestations of unilateral diaphragm dysfunction require special examination methods for diagnosis and planning of appropriate rehabilitation measures.
 AIM. To analyze the predictors and compare of methods for diagnosing diaphragm dysfunction in patients with hemiparesis during the recovery period of stroke to improve the quality of the rehabilitation diagnosis and the effectiveness of further rehabilitation process.
 DISCUSSION. An analysis of publications over the past five years was done. Anatomical and physiological aspects of the diaphragm are identified, and a comparison of manual and instrumental methods for the diaphragm function evaluation are presented. An assessment of diagnostic methods is given in terms of accuracy, accessibility and possibility of use for dynamic monitoring of patients. The main values of normal indicators of diaphragm function and their level in case of unilateral dysfunction are presented. Predictors of diaphragm dysfunction in patients with hemiparesis as a result of stroke are identified.
 CONCLUSION. Timely diagnosis of diaphragm dysfunction will ensure the appropriate rehabilitation goal setting during the recovery period of a stroke and will help to optimize the interventions and increase the effectiveness of rehabilitation process. The information is addressed primarily to specialists working in rehabilitation. The search was carried out using the Pubmed and RSCI databases.