The Importance of the Diaphragm in Neuromotor Function in the Patient with Chronic Obstructive Pulmonary Disease

Abstract

Bruno Bordoni,1 Allan Escher,2 Elena Compalati,1 Luca Mapelli,1 Anastasia Toccafondi1 1Department of Cardiology, Institute of Hospitalization and Care with Scientific Address, Foundation Don Carlo Gnocchi IRCCS S Maria Nascente, Milano, Italy; 2Anesthesiology/Pain Medicine, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USACorrespondence: Bruno Bordoni, Email [email protected]: Chronic obstructive pulmonary disease (COPD) is a constant and chronic narrowing of the respiratory airways, with numerous associated symptoms, not always related to the pathological adaptation of the lungs. Statistical projections show that COPD could become the third leading cause of death globally by 2030, with a significant increase in deaths by 2060. Skeletal muscle dysfunction, including the diaphragm, is one of the causes linked to the increase in mortality and hospitalization. Little emphasis is given by the scientific literature to the importance of the diaphragm towards functional neuromotor pathological expressions. The article reviews the adaptation of the skeletal muscles, with greater attention to the adaptations of the diaphragm, thereby highlighting the non-physiological variations that the main respiratory muscle undergoes and the neuromotor impairment found in COPD. The text could be an important reflection from a clinical and rehabilitation point of view, to direct greater attention to the function and adaptation of the diaphragm muscle.Keywords: diaphragm, COPD, physiotherapy, rehabilitation, pain, fascia, ageing, osteopathic

Keywords

• diaphragm
• copd
• physiotherapy
• rehabilitation
• pain
• fascia
• ageing
• osteopathic