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

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).

Automated summary

This study aimed to evaluate diaphragm thickness and excursion in patients with cervical spinal cord injury, finding that compared to control group, patients had significantly higher diaphragm thickness and greater diaphragmatic excursion. Ultrasound was shown to be a highly reliable tool for assessing diaphragm characteristics in these patients.