The effect of enhanced external contrpulsation on the diaphragm mobility and power of the patient with a combination of bronchial asthma and chronic obstructive pulmonary disease

Abstract

Respiratory muscle weakness is an important factor aggravating pulmonary dysfunction and reducing quality of life in patients with chronic lung diseases. Objective. To evaluate the efficacy of enhanced external counterpulsation as an additional non-pharmacological method aimed at improving respiratory muscle function under optimal drug therapy. Results. A patient with a combination of bronchial asthma and chronic obstructive pulmonary disease showed positive clinical outcomes after a course of 20 enhanced external counterpulsation (EECP) sessions, including a reduction in dyspnea (from grade 4 to 2 on the mMRC scale) and an improvement in exercise tolerance (the 6-minute walk distance increased from 280 m to 316 m). Instrumental examination confirmed a significant improvement in diaphragm function. Ultrasound imaging revealed an extension of diaphragmatic excursion at rest (DEquiet) from 11 mm to 23 mm. Additionally, maximal inspiratory pressure (MIP) rose from 70.7% to 130.5%, and maximal expiratory pressure (MEP) increased from 56.7% to 72.4%, demonstrating enhanced respiratory muscle strength. Body plethysmography revealed a reduction in lung hyperinflation, with functional residual capacity (FRC) declining from 164% to 142% of the predicted value. Additionally, a mitigation of «air trapping» was observed: residual volume (RV) dropped from 174% to 130%, and the RV/FRC ratio fell from 143% to 115%. Conclusion. The obtained data indicate that enhanced external counterpulsation can serve as an effective non-pharmacological rehabilitation method, contributing to improved diaphragmatic function and increased exercise tolerance in patients with chronic lung diseases.