ECO EVOLUTION in Respiratory Physiotherapy: THE DIAPHRAGM”

“Ultrasonography evaluation of a weak

diaphragm after a respiratory muscle training”

Dott. FtR ANGELO LONGONI

Master of Physiotherapy and Respiratory Rehabilitation
Cardiac-Respiratory Rehabilitation Gym, “Paola Giancola foundation”
Asst Lariana-Como
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Pazienti Cardiologici: n. 118

Dal 19 Settembre 2014 al 04 Marzo 2016:

Totali pazienti: n. 389
Totali ecografie diaframmatiche n. 730
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Pazienti Respiratori: n. 269

Normal Diaphragmatic Approach

Espirio
Inspirio
Anterior Subcostal Axillary probe

probe

probe

Inspirio
Inspirio

Espirio
Espirio

B-Mode M-Mode
 Paradoxical motion
Inspirio

Espirio

Espirio Inspirio
it seems normal

Espirio

Inspirio
Right diaphragm at beginning Left diaphragm at beginning

1 cm
2 cm

2,2 cm 2 cm

Right diaphragm with cpap Left diaphragm with cpap

 OSAS case report

Cpap
L.R.Gina, F, 61years pressure

Sleep quality 83%

SpO2 94,3%

WT6’= 275 435 meters Daily Steps 55  1190

Sleep quality: 39,2% 83,9% Night SpO2 89%  94,3%
 Right diaphragm at the end Left diaphragm at the end

6,9 cm 5,6 cm

CONCLUSION

It’s possible to find diaphragmatic dysfunction in a unexpected patients

using M-mode ultrasonography. We believe that this tecnique is
inexpensive, widely available, easy to use as a badside exame for
clinicians and RT therapist. We can asses diaphragm excursion in quiet
and deep breathing in real time motion before and after a rehabilitative
program and it can be considered an outcome measure.