RESUMO
STUDY DESIGN: Cross-sectional study. OBJECTIVE: To investigate the role of ultrasonographic measurement of the diaphragm thickness on pulmonary function tests in patients with spinal cord injury (SCI). SETTING: Rehabilitation center in Ankara, Turkey. METHODS: A total of 42 patients (34 M, 8 F) with SCI and 20 able-bodied volunteers (8 M, 12 F) were enrolled. Patients with SCI were divided into three groups according to their neurological (injury) levels. All participants underwent ultrasonographic measurements for diaphragm thickness on both sides and spirometric tests for pulmonary functions. The thickness ratio of the diaphragm was also calculated. RESULTS: There were seven patients (5 M, 2 F) in C2-C4 injury group, 14 patients (12 M, 2 F) in C5-T5 group, 21 patients (14 M, 7 F) in T6-L2 group, and 20 able-bodied volunteers (8 M, 12 F). The diaphragms of C2-C4 group were thicker than those of the controls at end-inspirium on the right side (2.7 ± 0.7 mm vs. 2.0 ± 0.5 mm; p = 0.035). The thickness ratios of C2-C4 group were lower than those of controls on the right (0.8 ± 0.4 vs. 1.5 ± 0.5; p = 0.005) and left (0.8 ± 0.5 vs. 1.6 ± 0.7; p = 0.003) sides. For all the pulmonary function tests (except for FEV1/FVC); patients with SCI had worse results than controls; and among the SCI groups, the higher the injury level, the worse the results. CONCLUSION: Although patients with high-level SCI had worse pulmonary function tests and decreased the contractile capacity of the diaphragm, they had thicker diaphragm muscles than controls. This may have been due to the compensatory effect of the diaphragm (performing its maximum contraction capacity and increasing frequency of inspiration).
Assuntos
Diafragma/diagnóstico por imagem , Diafragma/fisiologia , Testes de Função Respiratória/métodos , Traumatismos da Medula Espinal/diagnóstico por imagem , Traumatismos da Medula Espinal/fisiopatologia , Adulto , Vértebras Cervicais , Estudos Transversais , Feminino , Humanos , Vértebras Lombares , Masculino , Pessoa de Meia-Idade , Centros de Reabilitação , Traumatismos da Medula Espinal/epidemiologia , Espirometria/métodos , Vértebras Torácicas , Turquia/epidemiologia , Ultrassonografia/métodosRESUMO
The pertinent literature lacks overt technical data for optimal upper limb muscle botulinum toxin injections using ultrasound (US) imaging. Therefore, this guide is prepared for the commonly injected muscles of the upper limb and the shoulder girdle mainly in spasticity. It includes clinical information, anatomical description and explanation regarding the US imaging of several muscles. The figures have been organized to orient the readers on the innervation, injection sites, probe positioning and the US images simultaneously.
Assuntos
Toxinas Botulínicas Tipo A/uso terapêutico , Espasmo/diagnóstico por imagem , Espasmo/tratamento farmacológico , Ultrassonografia Doppler/métodos , Extremidade Superior/fisiopatologia , Feminino , Humanos , Injeções Intralesionais , Injeções Intramusculares , Masculino , Espasticidade Muscular/diagnóstico por imagem , Espasticidade Muscular/tratamento farmacológico , Prognóstico , Resultado do TratamentoRESUMO
The pertinent literature lacks overt technical data for optimal lower limb muscle botulinum toxin injections using ultrasound (US) imaging. Therefore, this guide is prepared for the commonly injected muscles of the lower limb and the pelvic girdle mainly in spasticity. It includes clinical information, anatomical description and explanation regarding the US imaging of several muscles. The figures have been organized to orient the readers on the innervation zones, injection sites, probe positionings and the US images simultaneously.
