Skip to main content
NCBI home page
Thorax logoLink to Thorax
. 1997 May;52(5):472–475. doi: 10.1136/thx.52.5.472

Diaphragm thickness and inspiratory strength in patients with Duchenne muscular dystrophy

P F De Bruin, J Ueki, A Bush, Y Khan, A Watson, N B Pride
PMCID: PMC1758554  PMID: 9176541

Abstract

BACKGROUND: There is little information on the morphometric characteristics of the diaphragm in patients with Duchenne muscular dystrophy. METHODS: The thickness of the diaphragm was measured at the zone of apposition using B mode ultrasonography in 10 boys with Duchenne muscular dystrophy of mean (SD) age 10.3 (1.3) years and 12 normal controls of mean (SD) age 11.3 (2.0) years during relaxation (DiTrelax) and during maximum effort inspiratory manoeuvres (DiTPimax) at functional residual capacity. RESULTS: DiTrelax was greater in the patients with Duchenne muscular dystrophy (1.74 (0.21) mm) than in controls (1.48 (0.20) mm), mean difference (95% CI) 0.26 (0.08 to 0.44), despite considerable impairment of maximum effort inspiratory mouth pressure (Pimax) (patients with Duchenne muscular dystrophy -37 (8) cm H2O, controls -80 (33) cm H2O), mean difference (95% CI) 43 (65 to 20). During a Pimax manoeuvre, compared with measurements taken during relaxation, the diaphragm thickened 1.6 times in patients with Duchenne muscular dystrophy and 2.3 times in controls (DiTPimax 2.62 (0.7) mm and 3.5 (0.85) mm, respectively), mean difference (95% CI) - 0.88 (-1.58 to -0.18). CONCLUSIONS: Resting diaphragm thickness is increased in young patients with Duchenne muscular dystrophy with impaired respiratory muscle force. This finding could be analogous to the pseudo-hypertrophy that is observed in some limb muscle groups. 




Full Text

The Full Text of this article is available as a PDF (134.4 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Gandevia S. C., McKenzie D. K., Plassman B. L. Activation of human respiratory muscles during different voluntary manoeuvres. J Physiol. 1990 Sep;428:387–403. doi: 10.1113/jphysiol.1990.sp018218. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Heckmatt J. Z., Dubowitz V., Leeman S. Detection of pathological change in dystrophic muscle with B-scan ultrasound imaging. Lancet. 1980 Jun 28;1(8183):1389–1390. doi: 10.1016/s0140-6736(80)92656-2. [DOI] [PubMed] [Google Scholar]
  3. Heckmatt J. Z., Pier N., Dubowitz V. Real-time ultrasound imaging of muscles. Muscle Nerve. 1988 Jan;11(1):56–65. doi: 10.1002/mus.880110110. [DOI] [PubMed] [Google Scholar]
  4. Inkley S. R., Oldenburg F. C., Vignos P. J., Jr Pulmonary function in Duchenne muscular dystrophy related to stage of disease. Am J Med. 1974 Mar;56(3):297–306. doi: 10.1016/0002-9343(74)90611-1. [DOI] [PubMed] [Google Scholar]
  5. Jones D. A., Round J. M., Edwards R. H., Grindwood S. R., Tofts P. S. Size and composition of the calf and quadriceps muscles in Duchenne muscular dystrophy. A tomographic and histochemical study. J Neurol Sci. 1983 Aug;60(2):307–322. doi: 10.1016/0022-510x(83)90071-0. [DOI] [PubMed] [Google Scholar]
  6. Newsom-Davis J. The respiratory system in muscular dystrophy. Br Med Bull. 1980 May;36(2):135–138. doi: 10.1093/oxfordjournals.bmb.a071628. [DOI] [PubMed] [Google Scholar]
  7. Smith P. E., Calverley P. M., Edwards R. H., Evans G. A., Campbell E. J. Practical problems in the respiratory care of patients with muscular dystrophy. N Engl J Med. 1987 May 7;316(19):1197–1205. doi: 10.1056/NEJM198705073161906. [DOI] [PubMed] [Google Scholar]
  8. Stern L. Z., Payne C. M., Gruener R., Anderson R. M., Hannapel L. K. Intercostal muscle biopsy in human neuromuscular disease. Histochemical and electron microscopic studies. J Neurol Neurosurg Psychiatry. 1975 Sep;38(9):900–910. doi: 10.1136/jnnp.38.9.900. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Ueki J., De Bruin P. F., Pride N. B. In vivo assessment of diaphragm contraction by ultrasound in normal subjects. Thorax. 1995 Nov;50(11):1157–1161. doi: 10.1136/thx.50.11.1157. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Wait J. L., Nahormek P. A., Yost W. T., Rochester D. P. Diaphragmatic thickness-lung volume relationship in vivo. J Appl Physiol (1985) 1989 Oct;67(4):1560–1568. doi: 10.1152/jappl.1989.67.4.1560. [DOI] [PubMed] [Google Scholar]
  11. Wilson S. H., Cooke N. T., Edwards R. H., Spiro S. G. Predicted normal values for maximal respiratory pressures in caucasian adults and children. Thorax. 1984 Jul;39(7):535–538. doi: 10.1136/thx.39.7.535. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Young A., Stokes M., Crowe M. Size and strength of the quadriceps muscles of old and young women. Eur J Clin Invest. 1984 Aug;14(4):282–287. doi: 10.1111/j.1365-2362.1984.tb01182.x. [DOI] [PubMed] [Google Scholar]

Articles from Thorax are provided here courtesy of BMJ Publishing Group

RESOURCES