Diaphragmatic Function Description in Stroke Patients
Diaphragmatic Function Description in Stroke Patients
Stroke is the leading cause of adult disability throughout the world. Motor function deficit
 is one of the common consequences. It is usually described for the peripheral muscles that
 there is a cortical representation contralaterale with a crossed cortico-spinal route: the
 consequence is a contralaterale motor disorder on the brain damage.

 The impact of a stroke on diaphragm movements have been described in 6 studies: however, they
 were all observational and transversal studies evaluating diaphragm function.

 Assessment using diaphragm thickness is another technique described in the literature.
 Visualization of diaphragm in the zone of apposition allows to assess diaphragm thickness at
 inspiration and expiration. The impact of a stroke on diaphragm thickening has been reported
 in only one recent observational study.

 It seems that diaphragm would be damaged after a stroke, but unilateral or bilateral
 dysfonction is yet to be confirmed. Moreover, only a few measurements were performed in these
 studies, and not a diaphragm function follow-up.
To our knowledge, no longitudinal study evaluated diaphragm movements and diaphragm thickness
 fraction. This study is a preliminary study which aims to evaluate diaphragm function after a
 stroke and its evaluation within the first months.

 Starting hypothesis is the following: after a stroke, patients with a unilateral motor
 dysfunction have a diaphragm dysfunction predominant on the same side as the motor
 dysfunction. After a few months, retrieval is insufficient and they could benefit from a
 specific reinforcement program.
Inclusion Criteria:

 -  Men and women (age ≥ 18 years), hospitalized in the neuro-vascular or neurology
 department of the Groupe hospitalier Paris Saint-Joseph

 -  First episode of ischemic or hemorrhagic stroke diagnosed in the imaging and
 responsible for a unilateral motor deficit

 -  Minimum National Institute of Health Stroke Score of 5 for the total of items 4, 5 and
 6 (paralysis facial and functioning of upper and lower limbs)

 -  Patient with medical insurance

 -  Francophone

 Exclusion Criteria:

 -  History of neuromusclar pathology

 -  History of severe chronic respiratory pathology

 -  Malformation, chronic lesion or surgery of the diaphragm

 -  Recent thoracic and abdominal surgery

 -  National Institute of Health Stroke Score > 20

 -  Limiting health care or life support patient

 -  Impossibility to understand and to make simple orders (whatever is the cause: change
 of consciousness, cognitive disorders, aphasias, etc...)

 -  Major handicap before stroke (Rankin modified score)

 -  Refusal to participate in the study

 -  Patient under guardianship or curatorship

 -  Patient deprived of liberty