Impact of diaphragm function parameters on balance maintenance

Janusz Kocjan, Bożena Gzik-Zroska, Katarzyna Nowakowska, Michał Burkacki, Sławomir Suchoń, Robert Michnik, Damian Czyżewski, Mariusz Adamek, Janusz Kocjan, Bożena Gzik-Zroska, Katarzyna Nowakowska, Michał Burkacki, Sławomir Suchoń, Robert Michnik, Damian Czyżewski, Mariusz Adamek

Abstract

The diaphragm is well known for its role as the principal muscle of respiration. However, according to previous studies, its role is multifactorial, from breathing through pain perception, regulation of emotional sphere, collaborating in gastroesophageal functions, facilitating the venous and lymphatic return, to an essential role in the maintenance of lumbar spine stability. The purpose of the study was to examine whether diaphragm function parameters (thickness and range of motion) are associated with static balance maintenance. A total of 142 participants were examined and divided into three groups: G1-patients qualified for lung resection due to cancer; G2 -patients after lobe resection; G3 -healthy subjects. Diaphragm thickness and excursion was measured using ultrasonography. Stabilometric parameters of balance were assessed by Zebris FDM-S platform. Greater diaphragm thickening during active breathing and diaphragm thickness fraction were associated with better static balance parameters. Limitation of diaphragm motion during quiet breathing and deep breathing was linked to balance disorders. There was no correlation between diaphragm muscle excursion during sniff maneuvers and balance parameters. Deterioration of diaphragm function observed after thoracic surgery was closely related with deterioration of balance maintenance. Impairment of diaphragm function manifested by decrease of muscle thickness and movement restriction is strongly associated with balance disorders in a clinical sample and among healthy subjects.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1. Preoperative and postoperative values of…
Fig 1. Preoperative and postoperative values of path lenght and ellipse field.
OE: open eyes; CE: close eyes; Subgroup A: diaphragm paralysis; Subgroup B: normal function of diaphragm.
Fig 2. Preoperative and postoperative values of…
Fig 2. Preoperative and postoperative values of back, fore, left and right side loading.
OE: open eyes; CE: close eyes; Subgroup A: diaphragm paralysis; Subgroup B: normal function of diaphragm.

References

    1. Jacobson GP, Newman CW, Kartush JM. Handbook of balance function testing. New York: Mosby; 1992.
    1. Medved V. Measurement of human locomotion. Boca Raton, FL: CRC Press LLC;2001.
    1. Horak FB. Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing. 2006;35(Suppl 2):ii7–ii11.
    1. Tsai LC, Yu B, Mercer VS, Gross MT. Comparison of different structural foot types for measures of standing postural control. J Orthop Sports Phys Ther. 2006; 36(12):942–953. 10.2519/jospt.2006.2336
    1. Davidson BS, Madigan ML, Nussbaum MA. Effects of lumbar extensor fatigue and fatigue rate on postural sway. Eur J Appl Physiol. 2004;93(92):183–189.
    1. Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice. Philadelphia: Lippincott &Williams; 2012.
    1. Peterka RJ. Sensorimotor integration in human postural control. J Neurophysiol. 2002;88: 1097–1018. 10.1152/jn.2002.88.3.1097
    1. Nashner L, Berthoz A. Visual contribution to rapid motor responses during postural control. Brain Res. 1978;150(2):403–407.
    1. Haran FJ, Keshner EA. Sensory reweighting as a method of balance training for labyrinthine loss. J Neurol Phys Ther. 2008;32(4):186–191. 10.1097/NPT.0b013e31818dee39
    1. Assländer L, Peterka RJ. Sensory reweighting dynamics in human postural control. J Neurophysiol. 2014;111(9):1852–1864. 10.1152/jn.00669.2013
    1. Ferrè ER, Walther LE, Haggard P. Multisensory Interactions between Vestibular, Visual and Somatosensory Signals. PLoS ONE. 2015;10(4):e0124573 10.1371/journal.pone.0124573
    1. Snell RS. Clinical anatomy by regions. Philadelphia: Lippincott Williams&Wilkins;2008.
    1. Kocjan J, Adamek M, Gzik-Zroska B, Czyżewski M, Rydel M. Network of breathing. Multifunctional role of the diaphragm: a review. Adv Respir Med. 2017;85(4):224–32. 10.5603/ARM.2017.0037
    1. Bordoni B, Zanier E. Anatomic connections of the diaphragm: influence of respiration on the body system. J Multidiscip Healthc. 2013;6:281–91. 10.2147/JMDH.S45443
    1. Bordoni B, Marelli F, Bordoni G. A review of analgesic and emotive breathing: a multidisciplinary approach. J Multidiscip Healthc. 2016;9:97–102. 10.2147/JMDH.S101208
    1. Hodges PW, Gandevia SC. Activation of the human diaphragm during a repetitive postural task. J Physiol. 2000;522(Pt 1):165–175.
    1. Hodges PW, Butler JE, McKenzie DK, Gandevia SC. Contraction of the human diaphragm during rapid postural adjustments. J Physiol. 1997;505: 539–548.
    1. Hodges PW, Butler JE, McKenzie DK, Gandevia SC. Contraction of the human diaphragm during rapid postural adjustments. J Physiol. 1997;505:539–48.
    1. Gerscovich EO, Cronan M, McGahan JP, Jain K, Jones CD, McDonald C. Ultrasonographic evaluation of diaphragmatic motion. J Ultrasound Med. 2001;20(6):597–604.
    1. Houston JG, Morris AD, Howie CA, Reid JL, McMillan N. Technical report: quantitative assessment of diaphragmatic movement—a reproducible method using ultrasound. Clin Radiol. 1992;46(6):405–7.
    1. Sarwal A, Walker FO, Cartwright MS, Neuromuscular Ultrasound for evaluation of diaphragm. Muscle Nerve 2013;47(3):319–329; 10.1002/mus.23671
    1. Summerhill EM, El-Sameed YA, Glidden TJ, McCool FD. Monitoring recovery from diaphragm paralysis with ultrasound. Chest. 2008;133(3):737–743. 10.1378/chest.07-2200
    1. Mraz M, Sipko T, Godula A. Postural stability in thoracic surgery patients as assessed by posturographic tests. Fizjoterapia Polska. 2005;5(1):72–78
    1. Yates BJ, Bronsteinc AM. The effects of vestibular system lesions on autonomic regulation: Observations, mechanisms, and clinical implications. Journal of Vestibular Research. 2005;15:119–129.
    1. Balaban CD, Beryozkin G. Vestibular nucleus projections to nucleus tractus solitarius and the dorsal motor nucleus of the vagus nerve: potential substrates for vestibulo-autonomic interactions. Exp Brain Res. 1994;98(2):200–212.
    1. Gatzonis SD, Korres S, Balatsouras DG, Stabulis E, Georgakulias N, Singunas E, et al. Influence of vagus nerve stimulation on vestibulo-ocular reflex. ORL J Otorhinolaryngol Relat Spec. 2003;65(4):223–225. 10.1159/000073120
    1. Lehrer PM, Gevirtz R. Heart rate variability biofeedback: how and why does it work? Front. Psychol. 2014;5:756 10.3389/fpsyg.2014.00756
    1. Garssen B, De Reuiter C, Van Dyke R. Breathing retraining: a rational placebo? Clin Psychol Rev. 1992;12:141–153.
    1. Schleifer LM, Ley R, Spalding TW. A hyperventilation theory of job stress and musculoskeletal disorders. Am J Ind Med. 2002;41:420–432. 10.1002/ajim.10061
    1. Sakellari V, Bronstein AM. Hyperventilation effect on postural sway. Arch Phys Med Rehabil. 1997;78:730–736
    1. Sakellari V, Bronstein AM, Corna S, Hammon CA, Jones S, Wolsley CJ, The effects of hyperventilation on postural control mechanisms. Brain. 1997;120:1659–1673
    1. Gandevia SC, McCloskey DI, Burke D. Kinaesthetic signals and muscle contraction. Trends Neurosci. 1992;15:62–65.
    1. Corda M, Von Euler C, Lennerstrand G. Proprioceptive innervation of the diaphragm. J Physiol. 1965;178:161–177.
    1. Yasargill GM. Proprioceptive afferenzen im N. phrenicus der Katze. Helv Physiol Acta. 1962;29:39–58.
    1. Duron B, Jung-Caillol MC, Marlot D. Myelinated nerve fibre supply and muscle spindles in the respiratory muscles of the cat: a quantitative study. Anat Embryol. 1978;152:171–192.
    1. Holt GA, Dalziel DJ, Davenport PW. The transduction properties of diaphragmatic mechanoreceptors. Neurosci Lett. 1991;122(1):117–121.
    1. NHLBI Workshop Summary. Respiratory muscle fatigue: report oft he respiratory muscle fatigue workshop group. AmRev RespirDis. 1990;142:474–480.
    1. Roussos CS, Macklem PT. Diaphragmatic fatigue in man. J Appl Physiol 1977; 43: 189–197. 10.1152/jappl.1977.43.2.189
    1. Hodges PW, Heijnen I, Gandevia SC. Postural activity of the diaphragm is reduced in humans when respiratory demand increases. J Physiol. 2001; 537(Pt 3): 999–1008 10.1111/j.1469-7793.2001.00999.x
    1. Vostatek P, Novák D, Rychnovský T, et al. Diaphragm postural function analysis using magnetic resonance imaging. PLoS One. 2013; 8(3): e56724 10.1371/journal.pone.0056724
    1. Tobin MJ, Guenther SM, Perez W, Mador MJ, Semmens BJ, Allen SJ, et al. The pattern of breathing during successful and unsuccessful trials of weaning from mechanical ventilation. Am Rev Respir Dis. 1986;134:1111–1118 10.1164/arrd.1986.134.6.1111
    1. Janssens L, McConnell AK, Pijnenburg M, Claeys K, Goossens N, Lysens R, Troosters T, et al. Inspiratory muscle training affects proprioceptive use and low back pain. Med Sci Sports Exerc. 2015;47(1):12–19. 10.1249/MSS.0000000000000385

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