Ultrasonographic evaluation of diaphragm thickness and excursion in patients with cervical spinal cord injury

Abstract

Objective: To evaluate the diaphragm thickness and excursion in patients with cervical spinal cord injury and reliability of diaphragmatic ultrasonography. Design: A Pilot Case–Control Study. Setting: China Rehabilitation Research Center (CRRC) /Beijing BO AI Hospital. Participants: Sixty participants with cervical spinal cord injury and sixty control participants were eligible for inclusion in this study. Interventions: Ultrasonographic evaluation of the diaphragm. Outcome Measures: All demographic data were evaluated. Diaphragm thickness, thickening ratio, and diaphragm excursions were assessed at the end of quiet tidal breathing and maximal inspiration. The reliability of inter- and intra-ultrasonography operators were evaluated. Results: Diaphragm thickness was significantly higher in patients with cervical spinal cord injury than the control group (P < 0.001). Diaphragmatic excursion of the right hemidiaphragm was significantly greater in patients with cervical spinal cord injury than the control group (P < 0.001) at the end of quiet tidal breathing. No difference was found in diaphragmatic excursion between two groups (P = 0.32) at the end of maximal inspiration. No significant difference was shown between two groups in thickening ratio. Intraclass correlation coefficients of inter-and intra-ultrasonography operators for the thickness and excursions of the diaphragm were greater than 0.93. Conclusion: Compared with the control group the diaphragm in patients with cervical spinal cord injury is hypertrophied and the diaphragm excursion is greater. Ultrasound is a highly reliable tool for the evaluation of diaphragm thickness and excursion in patients with cervical spinal cord injury. Trial Registration: This trail was registered in Chinese Clinical Trial Registry (NO. ChiCTR-ROC-17010973).