What question did this study set out to answer?

This research aims to evaluate the feasibility, validity, and reliability of a method that combines ultrasound and manometry for assessing diaphragm contractile function.

February 20, 2026Open Access

Combined multi‐metric assessment of diaphragm contractile function in healthy humans: Feasibility, validity and reliability

Key Points

This research aims to evaluate the feasibility, validity, and reliability of a method that combines ultrasound and manometry for assessing diaphragm contractile function.
Two experiments conducted with independent cohorts of healthy adults.
Experiment 1 involved measuring diaphragm function during magnetic phrenic nerve stimulation and maximal sniffs.
Experiment 2 measured diaphragm function during progressive CO2 rebreathing.
Measurements included diaphragm excursion and transdiaphragmatic pressure.
Reliability was tested with repeat measurements after a 20-min rest.
Excursion and pressure measurements had >95% successful analysis rates.
Potentiated twitches showed greater diaphragm pressure and power than non-potentiated ones.
Reliability was moderate to excellent for peak responses during certain tasks.
Strong correlations were found between diaphragm metrics and tidal volume during CO2 rebreathing.

Abstract

Abstract The combined use of subcostal ultrasonography and respiratory manometry represents a novel, integrative method for quantifying diaphragm contractile function (force, velocity and power). We evaluated the technical feasibility, construct validity and within‐day test–retest reliability of this method during non‐volitional, volitional and reflexive respiratory perturbations in healthy adults. Two independent cohorts were studied. In Experiment 1 ( n = 10), diaphragm excursion (subcostal ultrasonography) and transdiaphragmatic pressure ( P di , manometry) were measured during unilateral magnetic phrenic nerve stimulation (non‐potentiated and potentiated twitches, paired stimuli at 10–100 Hz) and maximal sniffs. In Experiment 2 ( n = 8), the same measurements were obtained during progressive CO 2 rebreathing. All protocols were repeated after 20 min of rest. Diaphragm velocity and power were calculated as excursion/time and P di × velocity, respectively. Ultrasound analysis was successful in >95% of cases. Potentiated twitches elicited greater P di , excursion and power than non‐potentiated twitches, with responses increasing at higher stimulation frequencies. Reliability improved with potentiation and high‐frequency stimulation and was moderate to excellent for peak responses during sniffs and CO 2 rebreathing (ICC 3, k = 0.70–0.94) but poor for slope‐based measures (ICC 3, k ≤ 0.20). During CO 2 rebreathing, excursion and velocity correlated strongly with inspiratory tidal volume ( r = 0.83, P < 0.001) and mean inspiratory flow ( r = 0.69, P < 0.001), respectively. These findings demonstrate that subcostal ultrasonography combined with manometry is a feasible, valid and reliable method for assessing diaphragm contractile function across non‐volitional, volitional and reflexive perturbations. With further refinement, this integrated method has translational potential for mechanistic research and clinical application.

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Cite This Study

Illidi et al. (Wed,) studied this question.

synapsesocial.com/papers/6997f9ddad1d9b11b3452b57 https://doi.org/https://doi.org/10.1113/ep093294

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