Chest Wall Motion Analysis in Disease (CWM)

Heart of England NHS Trust

Status: Completed

Conditions: Lung Neoplasms; Empyema, Pleural; Surgery; Pulmonary Disease, Chronic Obstructive; Pectus Carinatum; Cystic Fibrosis; Mesothelioma; Pectus Excavatum

Treatments: Other: Chest wall motion analysis

Study type: Observational

Funder types: Other

Identifiers

NCT02958683

2010109TS

Details and patient eligibility

About

Breathing movements, called chest wall motion, are very complex. The investigators are studying how movement of the abdomen, ribs and diaphragm contribute to breathing and how this differs with different diseases in the chest. Breathing movements may help with diagnosis, assessment of severity or assessing the impact of treatments for chest conditions. The investigators are following people who have a chest disease, measuring their chest wall motion and comparing it to their diagnosis and and how their treatment works.

Chest wall motion can be measured in different ways at rest and whilst exercising. Small stickers on the chest can be used to reflect infra red light or visible squares of light can be shone onto the chest without using stickers.

Full description

Optoelectronic plethysmography (OEP) is based on the analysis during breathing of the trajectories of a series of markers positioned on the thoracic-abdominal surface of the patient. The positions in space of these markers are recorded and processed with mathematical models and algorithms by a computing unit that can accurately measure not only volume variations of the whole thoracic-abdominal wall, but also the variations of the various compartments. This detects, for example, asymmetries in the action of respiratory muscles. The system can accurately measure current volume, vital capacity, respiratory frequency, duration of the phases of inspiration and exhalation, the average inspiration and exhalation flux and the volume variations at the end of exhalation.

Structured Light Plethysmography (SLP) also assesses regional chest wall excursion but does not require markers to be placed on the patient. The system uses visible light shone onto the chest wall in a checkerboard pattern and reflected back by the patient's skin or a tight T shirt.

Images from 4 Microsoft Kinnect Motion Cameras can be used to create a 3D representation of the patient's torso. This system has been shown to correlate well with chest wall measurements recorded by OEP.

These systems are innovative examination instruments, non-invasive, accurate, easy to use and unlike traditional plethysmographic technologies, are not affected by humidity and temperature variations and can easily be used to perform measurements for extended periods of time. They accurately measure the dynamics of the volume variations that occur during breathing in the various sections of the thoracic-abdominal walls (upper, lower and abdominal thoracic area). This data, which is otherwise undetectable, is a useful contribution to the evaluation of patients. We will apply chest wall motion analysis to understanding the physiology of thoracic disease processes as well as assessing potential diagnostic and prognostic (response to treatment) markers that could be used in future clinical practice.

Enrollment: 400 estimated patients

Sex: All

Ages: 16+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Aged 16 or over
• Have thoracic disease or healthy control

Exclusion criteria

• Unable to provide valid informed consent

Trial design

400 participants in 10 patient groups

Pectus excavatum

Description:

Patients with pectus excavatum (funnel chest) condition undergo chest wall motion analysis

Treatment:

Other: Chest wall motion analysis

Pectus carinatum

Description:

Patients with pectus carinatum (pigeon chest) condition undergo chest wall motion analysis

Treatment:

Other: Chest wall motion analysis

Chronic obstructive pulmonary disease

Description:

Patients affected by COPD undergo chest wall motion analysis

Treatment:

Other: Chest wall motion analysis

Diaphragm abnormality

Description:

Patients with abnormal function or structure of the diaphragm. Including diaphragmatic hernia/rupture and diaphragmatic paralysis undergo chest wall motion analysis

Treatment:

Other: Chest wall motion analysis

Healthy control

Description:

People who do not have any diagnosed thoracic condition and who do not have symptoms/signs suggestive of undiagnosed thoracic disease undergo chest wall motion analysis

Treatment:

Other: Chest wall motion analysis

Lung cancer

Description:

Patients with suspected or confirmed lung malignancy of all histological subtypes undergo chest wall motion analysis

Treatment:

Other: Chest wall motion analysis

Pleural disease

Description:

Patients with pleural thickening and/or pleural effusion, pneumothorax, empyema undergo chest wall motion analysis

Treatment:

Other: Chest wall motion analysis

Asthma

Description:

Patients diagnosed with asthma clinically or upon spirometry undergo chest wall motion analysis

Treatment:

Other: Chest wall motion analysis

Cystic fibrosis

Description:

Patients diagnosed with cystic fibrosis clinically or biochemically undergo chest wall motion analysis

Treatment:

Other: Chest wall motion analysis

Rib or sternal disease

Description:

Patients with an abnormality in the chest wall including fractures, osteomyelitis, malignancy of all histological subtypes, chest wall resection/reconstruction undergo chest wall motion analysis

Treatment:

Other: Chest wall motion analysis