الفهرس 
Chronic Obstructive Pulmonary DiseaseOnly 14 pages are availabe for public view
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Abstract
Background: chronic obstructive pulmonary disease (COPD) affects all skeletal muscles including the diaphragm as an extra pulmonary complication. Diaphragmatic mobility improves by pulmonary rehabilitation (PR). Chest ultrasound can be used in assessment of diaphragmatic mobility. Aim of the work: Evaluation of chest ultrasound as a simple, non-invasive tool in assessment of diaphragmatic mobility in COPD patients undergoing PR and its correlation with maximal inspiratory pressure (Pi MAX), six- minute walk test (6MWT) and clinical COPD questionnaire (CCQ). Patients and Methods: This study was conducted upon 30 COPD male patients aged 54.50±8.81years old. All patients were recruited in to a PR program including 16 sessions over 8 weeks. The program included upper limb exercise, lower limb exercise and inspiratory muscle training. Baseline spirometry, Pi MAX, modified medical research council (mMRC) dyspnea scale, CCQ, 6MWT and sonographic assessment of diaphragmatic excursion and thickness were done. Follow up sonographic evaluation of the diaphragm, CCQ and mMRC every 2 weeks was done. Reevaluation after the program by the same baseline parameters was done. Results: There was statistically significant improvement in diaphragmatic excursion and thickness after PR program as evidenced by chest ultrasound. There was also significant functional improvement evidenced by 6MWT and Pi MAX. Also, there was significant improvement in mMRC and CCQ, but PR didn’t significantly affect spirometric parameters as FEV1% ,FEV1value in (L) or FEV1/FVC. Conclusion: Chest ultrasound is a beneficial tool in diaphragmatic assessment in COPD patients undergoing pulmonary rehabilitation.