Extract
A 55-year-old man was referred to the outpatient pulmonary department of our hospital because of dyspnoea during exertion and when bending forward, which had been present for at least 6 months. He reported experiencing severe symptoms of breathlessness and many of his daily activities had to be adapted or interrupt due to symptoms (as documented by the Baseline Dyspnea Index (BDI)) (table 1). Recent infectious episodes or episodes of neck or shoulder pain were absent. His medical history included systemic arterial hypertension, obesity (body mass index (BMI) 36 kg·m−2), and obstructive sleep apnoea for which he was treated with night-time continuous positive airway pressure therapy (8 cmH2O). He was a former smoker (18 pack-years) who quit smoking 15 years ago. 8 months ago, he underwent abdominal surgery (transabdominal epigastric hernia repair). The presence of cardiopulmonary disease and other aetiologies, such as neuromuscular disease, was excluded. Chest radiograph showed an elevated left hemidiaphragm and impaired left phrenic nerve conduction (i.e. increased latency and compound muscle action potential (CMAP) duration) after electrical stimulation (table 1) [1].
Abstract
Patients with diaphragm dysfunction experience exertional dyspnoea. Respiratory muscle function assessments can identify breathing abnormalities and IMT might help to reduce symptoms (mostly via improvements in non-diaphragmatic muscles). http://bit.ly/2QdxNFP
Footnotes
Author contributions D. Langer, R. Gosselink, D. Testelmans and M. Caleffi Pereira contributed to the concept and writing of the manuscript. S. Dacha contributed to the acquisition and data analysis. All authors approved the final manuscript.
Conflict of interest: M. Caleffi Pereira has nothing to disclose.
Conflict of interest: S. Dacha has nothing to disclose.
Conflict of interest: D. Testelmans has nothing to disclose.
Conflict of interest: R. Gosselink has nothing to disclose.
Conflict of interest: D. Langer has nothing to disclose.
Support statement This study was financed by Research Foundation – Flanders (FWO) (grant GOA4516N) and KU Leuven (grant C22/15/035) and, in part, by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance code 001.
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