Reliability and accuracy of motion of the lower ribs and diaphragmatic mobility by radiographic method in patients after spinal cord injury
Abstract
Diaphragmatic evaluation is crucial in clinical practice and almost no studies notified comprehensive evaluation of diaphragmatic mobility and movement of the lower ribs by radiographic method (X-ray). The goal of this research was to analyze the reliability of radiographic measurements as a method for evaluating the mobility of diaphragm and lower ribs. 15 persons with chronic spinal cord injury were evaluated by X-ray where the mobility of diaphragm and lower rib movement were observed and measured during inspiration.
Statistical measurements: paired t - test, statistical significance level set at p LESS-THAN OR EQUAL TO 0,05, using mean (M) and standard deviation (SD), applied calculating of Cohen's coefficient d effect size. Probands were doing the respiratory exercise for 6 months to prove the change in diaphragm mobility and lower ribs movement.
Results: Mobility of the right hemidiaphragm has evidently increased. X-ray examination showed that the difference between the movement of the lower ribs during inhalation and exhalation increased by 49%, i.e. by 6 - 45 mm.
There was a significant increase in the lower ribs movement (M = 18, SD = 11.6) than before using respiratory exercise (M = 11.7, SD = 8.5), p = 0.001. The confidence interval does not include zero (-9.997; -2.463).
Cohen's d proved a medium size effect (d = 0.6). Conclusion: It has been shown that the X-ray is reliable and applicable for the direct evaluation of right hemidiaphragm mobility and lower ribs movement.
This method is easy to be used in clinical practice and provides a reliable method which can measure a range of diaphragmatic mobility and lower ribs movement.