Correlation Between Ultrasound-Derived Diaphragmatic Thickness, Inspiratory Muscle Strength and Peak Expiratory Flow in Institutionalized Older Adults: A Cross-Sectional Exploratory Study.
7 affiliations
- 1Physiotherapy and Disability Research Group, Biomedical Research Institute of Murcia Pascual Parrilla-IMIB, 30120 Murcia, Spain.
- 2Department of Physical Therapy, University of Murcia, 30120 Murcia, Spain.
- 3Health, Disability, Dependency and Well-Being PhD Program, University of Murcia, 30120 Murcia, Spain.
- 4Faculty of Nursing, Catholic University of Murcia, 30107 Murcia, Spain.
- 5Faculty of Physiotherapy, Occupational Therapy and Podiatry, UCAM Catholic University of Murcia, 30107 Murcia, Spain.
- 6Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14071 Córdoba, Spain.
- 7Intensive Care Unit, Santa Lucía University General Hospital, 30202 Cartagena, Spain.
Abstract
Background: Diaphragm thickness may affect both inspiratory and expiratory function. The ultrasound assessment of diaphragm thickness could be a valuable tool for respiratory muscle evaluation in older adults, although additional research is needed to clarify its association with respiratory functional parameters. Objectives: The primary objective was to explore the relationship between diaphragm thickness (DT), maximal inspiratory pressure (MIP), and peak expiratory flow (PEF) in institutionalized older adults. A secondary objective was to compare MIP and PEF values between participants with normal and thin diaphragm thickness. Methods: A cross-sectional exploratory study was conducted among older adults (n = 36) residing in long-term care facilities (LTCFs) in Spain. DT was measured at the end of maximum inspiration (DTi) and at the end of expiration at rest (DTe) in the supine position. The diaphragm thickening difference (DTD) and diaphragm fraction (DTF) were calculated. A thin diaphragm was defined as a diaphragm thickness (DTe) <1.6 mm in men and <1.4 mm in women. The maximum inspiratory pressure (MIP) was measured using a Powerbreath KH1 device, and the peak expiratory flow (PEF) was measured using Datospir Peak-10. Spearman's rank correlation coefficient and linear regression models were used to explore the association between diaphragm thickness and respiratory muscle function. Statistical analysis was performed using IBM SPSS Statistics 22.0. Results: The mean age of the participants was 82.4 ± 7.9 years (24 females-12 males). Significant correlations were observed among most ultrasound-derived measures. DTi was positively associated with MIP (ρ = 0.403, 95% CI 0.065-0.658; q = 0.033) and PEF (ρ = 0.534, 95% CI 0.235-0.741; q = 0.003), DTe with MIP (ρ = 0.445, 95% CI 0.116-0.686; q = 0.020), and DTD with PEF (ρ = 0.475, 95% CI 0.158-0.703; q = 0.012). Compared with participants with normal diaphragm thickness, those with a thin diaphragm exhibited lower MIP (β = -18.43, 95% CI: -32.76 to -4.18; p = 0.013). Conclusions: Diaphragm thickness was positively associated with inspiratory muscle strength and peak expiratory flow. Participants with a thin diaphragm demonstrated lower respiratory muscle performance than those with normal diaphragm thickness. However, these findings should be interpreted with caution, and additional studies are needed to confirm these associations.
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BibTeX
@article{oliveirasousa2026correlation,
title = {{Correlation Between Ultrasound-Derived Diaphragmatic Thickness, Inspiratory Muscle Strength and Peak Expiratory Flow in Institutionalized Older Adults: A Cross-Sectional Exploratory Study.}},
author = {Silvana L Oliveira-Sousa and Felipe J Portillo-Castaño and Luis Fernández-Azorín and Felipe León-Morillas and Antonio T Ríos-Cortés and Adriana C de Souza Oliveira},
journal = {Geriatrics (Basel, Switzerland)},
year = {2026},
month = oct,
doi = {10.3390/geriatrics11050151},
url = {https://europepmc.org/article/MED/42930030},
note = {CC BY},
}
RIS
TY - JOUR
TI - Correlation Between Ultrasound-Derived Diaphragmatic Thickness, Inspiratory Muscle Strength and Peak Expiratory Flow in Institutionalized Older Adults: A Cross-Sectional Exploratory Study.
AU - Silvana L Oliveira-Sousa
AU - Felipe J Portillo-Castaño
AU - Luis Fernández-Azorín
AU - Felipe León-Morillas
AU - Antonio T Ríos-Cortés
AU - Adriana C de Souza Oliveira
PY - 2026
DA - 2026/10/21
JO - Geriatrics (Basel, Switzerland)
DO - 10.3390/geriatrics11050151
UR - https://europepmc.org/article/MED/42930030
AB - Background: Diaphragm thickness may affect both inspiratory and expiratory function. The ultrasound assessment of diaphragm thickness could be a valuable tool for respiratory muscle evaluation in older adults, although additional research is needed to clarify its association with respiratory functional parameters. Objectives: The primary objective was to explore the relationship between diaphragm thickness (DT), maximal inspiratory pressure (MIP), and peak expiratory flow (PEF) in institutionalized older adults. A secondary objective was to compare MIP and PEF values between participants with normal and thin diaphragm thickness. Methods: A cross-sectional exploratory study was conducted among older adults (n = 36) residing in long-term care facilities (LTCFs) in Spain. DT was measured at the end of maximum inspiration (DTi) and at the end of expiration at rest (DTe) in the supine position. The diaphragm thickening difference (DTD) and diaphragm fraction (DTF) were calculated. A thin diaphragm was defined as a diaphragm thickness (DTe) <1.6 mm in men and <1.4 mm in women. The maximum inspiratory pressure (MIP) was measured using a Powerbreath KH1 device, and the peak expiratory flow (PEF) was measured using Datospir Peak-10. Spearman's rank correlation coefficient and linear regression models were used to explore the association between diaphragm thickness and respiratory muscle function. Statistical analysis was performed using IBM SPSS Statistics 22.0. Results: The mean age of the participants was 82.4 ± 7.9 years (24 females-12 males). Significant correlations were observed among most ultrasound-derived measures. DTi was positively associated with MIP (ρ = 0.403, 95% CI 0.065-0.658; q = 0.033) and PEF (ρ = 0.534, 95% CI 0.235-0.741; q = 0.003), DTe with MIP (ρ = 0.445, 95% CI 0.116-0.686; q = 0.020), and DTD with PEF (ρ = 0.475, 95% CI 0.158-0.703; q = 0.012). Compared with participants with normal diaphragm thickness, those with a thin diaphragm exhibited lower MIP (β = -18.43, 95% CI: -32.76 to -4.18; p = 0.013). Conclusions: Diaphragm thickness was positively associated with inspiratory muscle strength and peak expiratory flow. Participants with a thin diaphragm demonstrated lower respiratory muscle performance than those with normal diaphragm thickness. However, these findings should be interpreted with caution, and additional studies are needed to confirm these associations.
SN - 2308-3417
ER -