Dr Louise Hansell1,2, A/Prof Maree Milross2, Mr David Chapman3,5,6, Ms Mia Axe1, Mr Bosco Leung1, Ms Nidhi Nair2, Dr Danielle Stone3,4
1Physiotherapy Department, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, Australia, 2Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia, 3Department of Respiratory Medicine, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, Australia, 4Department of Speech Pathology, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, Australia, 5Airway Physiology and Imaging Group, Woolcock Institute of Medical Research, Macquarie University, Macquarie Park, Australia, 6chool of Life Sciences, University of Technology Sydney, Ultimo, Australia
Biography:
Dr Louise Hansell is a physiotherapist and ECR, involved in two programs of research focused on 1) novel assessment of respiratory function using diaphragm and lung ultrasound and 2) environmental sustainability in healthcare. She holds a Post Doctoral Research Fellowship with the University of Sydney and a research officer role building research capacity within Northern Sydney LHD. She has produced 9 publications (100% SJR Q1 journals), and has been cited 105 times. Louise was recently invited to be a member of the World Interactive Network Focused on UltraSound (WINFOCUS) expert panel of the Second International Consensus Conference on Lung Ultrasound.
Abstract:
Introduction:
Overactive supraglottic structures in exercise-induced laryngeal obstruction (EILO) could be associated with an overactive diaphragm. The aim of this study was to compare diaphragm function, using diaphragm ultrasound (dUS), in healthy adults and adults with EILO, during tidal breathing.
Methods:
dUS was performed on healthy adults (n=14) and adults with EILO (n=3) in supine and long-sitting during tidal breathing. Left (L) and right (R) hemidiaphragm excursion and thickness were measured with US. Data are presented as mean±SD or median (IQR 1-3).
Results:
In both groups, an increase in end-expiratory diaphragm thickness was observed in long-sitting (Healthy: L=0.21±0.08, R=0.17±0.05; EILO: L=0.32±0.19, R=0.27±0.13) compared to supine (Healthy: L=0.16±0.06, R=0.14±0.05; EILO: L=0.27±0.16, R=0.20±0.10). An increase in end-inspiratory diaphragm thickness was also observed in long-sitting (Healthy: L= 0.32±0.13, R = 0.23±0.07; EILO: L=0.42±0.22, R=0.36±0.18) compared with supine (Healthy: L=0.22±0.08, R=0.20±0.06; EILO: L=0.40±0.23, R=0.22±0.12). An increase in diaphragm excursion was observed in supine (Healthy: L=1.10(1.01-1.31), R=1.40±0.51; EILO: L=1.31±0.45, R= 1.64±0.19) compared with long sitting (Healthy: L=1.04(0.85-1.72), R=1.07±0.33; EILO: L=0.95±0.12, R=1.0±0.29) in both groups. There was a statistically significant increase in L end-expiratory thickness (p=0.03) in long sitting for healthy adults. In the ELIO group, mean thicknesses bilaterally and supine excursion were larger when compared with healthy adults.
Conclusion:
dUS detected changes in diaphragm thickness and excursion in line with postural change. Diaphragm thickening and excursion behaved similarly in EILO compared with healthy adults in supine and long-sitting. Diaphragm thickness tended to be increased in EILO compared to healthy adults.