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"Sunhan Son"

Original Articles

Geriatric Rehabilitation

Association of Diaphragm Thickness and Respiratory Muscle Strength With Indices of Sarcopenia
Yookyung Lee, Sunhan Son, Don-Kyu Kim, Myung Woo Park
Ann Rehabil Med 2023;47(4):307-314.   Published online August 28, 2023
DOI: https://doi.org/10.5535/arm.23081
Objective
To evaluate the relationship between respiratory muscle strength, diaphragm thickness (DT), and indices of sarcopenia.
Methods
This study included 45 healthy elderly volunteers (21 male and 24 female) aged 65 years or older. Sarcopenia indices, including hand grip strength (HGS) and body mass index-adjusted appendicular skeletal muscle (ASM/BMI), were measured using a hand grip dynamometer and bioimpedance analysis, respectively. Calf circumference (CC) and gait speed were also measured. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were obtained using a spirometer, as a measure of respiratory muscle strength. DT was evaluated through ultrasonography. The association between indices of sarcopenia, respiratory muscle strength, and DT was evaluated using Spearman’s rank correlation test, and univariate and multiple regression analysis.
Results
ASM/BMI (r=0.609, p<0.01), CC (r=0.499, p<0.01), HGS (r=0.759, p<0.01), and gait speed (r=0.319, p<0.05) were significantly correlated with DT. In the univariate linear regression analysis, MIP was significantly associated with age (p=0.003), DT (p<0.001), HGS (p=0.002), CC (p=0.013), and gait speed (p=0.026). MEP was significantly associated with sex (p=0.001), BMI (p=0.033), ASM/BMI (p=0.003), DT (p<0.001), HGS (p<0.001), CC (p=0.001) and gait speed (p=0.004). In the multiple linear regression analysis, age (p=0.001), DT (p<0.001), and ASM/BMI (p=0.008) showed significant association with MIP. DT (p<0.001) and gait speed (p=0.050) were associated with MEP.
Conclusion
Our findings suggest that respiratory muscle strength is associated with DT and indices of sarcopenia. Further prospective studies with larger sample sizes are needed to confirm these findings.

Citations

Citations to this article as recorded by  
  • The Role of Diaphragmatic Ultrasound in Identifying Sarcopenia in COPD Patients: A Cross-Sectional Study
    Nur Aleyna Yetkin, Sibel Akın, Derya Kocaslan, Burcu Baran, Bilal Rabahoglu, Fatma Sema Oymak, Nuri Tutar, İnci Gulmez
    International Journal of Chronic Obstructive Pulmonary Disease.2025; Volume 20: 1.     CrossRef
  • Relationship Between Diaphragm Function and Sarcopenia Assessed by Ultrasound: A Cross-Sectional Study
    Takahiro Shinohara, Toru Yamada, Shuji Ouchi, Suguru Mabuchi, Ryoichi Hanazawa, Kazuharu Nakagawa, Kanako Yoshimi, Tatsuya Mayama, Ayane Horike, Kenji Toyoshima, Yoshiaki Tamura, Atsushi Araki, Haruka Tohara, Akihiro Hirakawa, Takuma Kimura, Takeshi Ishid
    Diagnostics.2025; 15(1): 90.     CrossRef
  • Descriptive Epidemiology and Prognostic Significance of Diaphragm Thickness in the General Population: The Nagahama Study
    Yasuharu Tabara, Takeshi Matsumoto, Kimihiko Murase, Takahisa Kawaguchi, Kazuya Setoh, Tomoko Wakamura, Toyohiro Hirai, Kazuo Chin, Fumihiko Matsuda
    Journal of Cachexia, Sarcopenia and Muscle.2025;[Epub]     CrossRef
  • Diaphragm thickness and ICU admission risk in elderly COVID-19 patients: a CT-based analysis
    Mercan Tastemur, Cagla Ozdemir, Esin Olcucuoğlu, Gunes Arik, Ihsan Ates, Kamile Silay
    BMC Pulmonary Medicine.2025;[Epub]     CrossRef
  • Relationship Between Handgrip Strength and Lung Function in Adults: The Role of Sex and Age
    Shiqi Deng, Urme Binte Sayeed, Yukiko Wagatsuma
    Cureus.2025;[Epub]     CrossRef
  • Effects of simultaneous aerobic and inspiratory muscle training on diaphragm function, respiratory muscle strength, endurance, and fatigue index: randomized-controlled trial
    Zeliha Çelik, Nevin A. Güzel, Seriyye Allahverdiyeva, Halit Nahit Şendur, Mahi Nur Cerit
    European Journal of Applied Physiology.2025; 125(12): 3769.     CrossRef
  • Association between diaphragm excursion and whole-body muscle mass in older adults: an observational study
    Shuji Ouchi, Toru Yamada, Takahiro Shinohara, Suguru Mabuchi, Kazuharu Nakagawa, Kanako Yoshimi, Ayane Horike, Tatsuya Mayama, Kenji Toyoshima, Yoshiaki Tamura, Atsushi Araki, Ryoichi Hanazawa, Akihiro Hirakawa, Hiroyuki Ichige, Takeshi Ishida, Takuma Kim
    Scientific Reports.2025;[Epub]     CrossRef
  • Short-term resistance training enhances functional and physiological markers in older women: implications for biomechanical and health interventions in aging
    Mine Akkuş Uçar, Coşkun Yılmaz, Hakan Hüseyin Soylu, Barış Sarıakçalı, Cemalettin Budak, Korhan Kavuran, Mehmet Vakif Durmuşoğlu, Levent Ceylan
    Frontiers in Public Health.2025;[Epub]     CrossRef
  • Association between diaphragm thickness and postoperative complications in elderly patients with non-small-cell lung cancer
    Shoji Kuriyama, Motoko Konno, Naoko Mori, Sumire Shibano, Shinogu Takashima, Tsubasa Matsuo, Yusuke Sato, Kyoko Nomura, Yoshihiro Minamiya, Kazuhiro Imai
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    Revista Brasileira de Geriatria e Gerontologia.2025;[Epub]     CrossRef
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    Revista Brasileira de Geriatria e Gerontologia.2025;[Epub]     CrossRef
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  • Effects of Tai Chi combined with Dynamic Neuromuscular Stabilization on postural control and balance in post-stroke patients with sarcopenia: protocol for a randomised single-blind controlled trial
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    Frontline Gastroenterology.2025; : flgastro-2025-103374.     CrossRef
  • Definition, diagnosis, and treatment of respiratory sarcopenia
    Shinjiro Miyazaki, Akira Tamaki, Hidetaka Wakabayashi, Hidenori Arai
    Current Opinion in Clinical Nutrition & Metabolic Care.2024; 27(3): 210.     CrossRef
  • Diaphragm Ultrasound in Different Clinical Scenarios: A Review with a Focus on Older Patients
    Carmine Siniscalchi, Antonio Nouvenne, Nicoletta Cerundolo, Tiziana Meschi, Andrea Ticinesi
    Geriatrics.2024; 9(3): 70.     CrossRef
  • Appropriate body position and site for diaphragm ultrasound: Comparison with inspiratory mouth pressure
    Kazunori Okada, Akiko Kamiya, Yusuke Yanagi, Masahiro Nakabachi, Yasuhiro Hayashi, Michito Murayama, Sanae Kaga
    WFUMB Ultrasound Open.2024; 2(2): 100052.     CrossRef
  • Evaluation of the Functional Reserve and Exercise Tolerance in Patients with CHF in Clinical Trials (Consent Document of the Editorial board of the Journal of Cardiology, the Board of the Society of Specialists in Heart Failure (SSHF) and Working Group “N
    Yu. L. Begrambekova, G. P. Arutynov, M. G. Glezer, N. A. Karanadze, E. A. Kolesnikova, T. A. Lelyavina, A. S. Lishuta, Ya. A. Orlova, Yu. N. Belenkov
    Kardiologiia.2024; 64(7): 4.     CrossRef
  • Validating respiratory sarcopenia diagnostic criteria by mortality based on a position paper by four professional organizations: Insights from the Otassha study
    Takeshi Kera, Hisashi Kawai, Manami Ejiri, Keigo Imamura, Hirohiko Hirano, Yoshinori Fujiwara, Kazushige Ihara, Shuichi Obuchi
    Geriatrics & Gerontology International.2024; 24(9): 948.     CrossRef
  • Evaluating Respiratory Muscle Strength in Sarcopenia Screening among Older Men in South Korea: A Retrospective Analysis
    Tae Sung Park, Sa-Eun Park, Ki-Hun Kim, Sang Hun Kim, Myung Hun Jang, Myung-Jun Shin, Yun Kyung Jeon
    The World Journal of Men's Health.2024; 42(4): 890.     CrossRef
  • Tongue pressure, respiratory muscle and limb strength and functional exercise capacity in oesophageal cancer
    Takuya Fukushima, Makoto Yamasaki, Nobuyuki Yamamoto, Yasuaki Arima, Takashi Harino, Soshi Hori, Yuki Hashimoto, Masaya Kotsuka, Kentaro Inoue, Kimitaka Hase, Jiro Nakano
    BMJ Supportive & Palliative Care.2024; 14(4): 434.     CrossRef
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Relation Between Respiratory Muscle Strength and Skeletal Muscle Mass and Hand Grip Strength in the Healthy Elderly
Hyun iee Shin, Don-Kyu Kim, Kyung Mook Seo, Si Hyun Kang, Sang Yoon Lee, Sunhan Son
Ann Rehabil Med 2017;41(4):686-692.   Published online August 31, 2017
DOI: https://doi.org/10.5535/arm.2017.41.4.686
Objective

To evaluate sarcopenic indices in relation to respiratory muscle strength (RMS) in elderly people.

Methods

This study included 65 volunteers over the age of 60 (30 men and 35 women). The skeletal muscle mass index (SMI) was measured using bioimpedance analysis. Limb muscle function was assessed by handgrip strength (HGS), the Short Physical Performance Battery (SPPB), and gait speed. RMS was addressed by maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) using a spirometer. The relationships between RMS and other sarcopenic indices were investigated using the Pearson correlation coefficients and multiple regression analysis adjusted for age, HGS, and SPPB.

Results

Both MIP and MEP were positively correlated with SMI (r=0.451 and r=0.388, respectively, p<0.05 in both). HGS showed a significant correlation with both MIP and MEP (r=0.560, p<0.01 and r=0.393, p<0.05, respectively). There was no significant correlation between gait speed and either MIP or MEP. The SPPB was positively correlated with MEP (r=0.436, p<0.05). In the multiple regression analysis, MIP was significantly associated with HGS and SMI (p<0.001 and p<0.05, respectively), while MEP was related only with HGS (p<0.05).

Conclusion

This study suggests that respiratory muscles, especially inspiratory muscles, are significantly related to limb muscle strength and skeletal muscle mass. The clinical significance of MIP and MEP should be further investigated with prospective studies.

Citations

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