Effects of lung volume on diaphragm EMG signal strength during voluntary contractions

The use ofesophageal recordings of the diaphragm electromyogram (EMG) signalstrength to evaluate diaphragm activation during voluntary contractionsin humans has recently been criticized because of a possible artifactcreated by changes in lung volume. Therefore, the first aim of thisstudy was to evaluate whether there is an artifactual influence of lungvolume on the strength of the diaphragm EMG during voluntarycontractions. The second aim was to measure the required changes inactivation for changes in lung volume at a given tension, i.e., thevolume-activation relationship of the diaphragm. Healthy subjects(n = 6) performed contractions of thediaphragm at different transdiaphragmatic pressure (Pdi) targets (range20-160 cmH₂O) whilemaintaining chest wall configuration constant at different lungvolumes. The diaphragm EMG was recorded with a multiple-arrayesophageal electrode, with control of signal contamination andelectrode positioning. The effects of lung volume on the EMG werestudied by comparing the crural diaphragm EMG root mean square (RMS),an index of crural diaphragm activation, with an index of globaldiaphragm activation obtained by normalizing Pdi to the maximum Pdi atthe given muscle length(Pdi/Pdi_max@L) at thedifferent lung volumes. We observed a direct relationship between RMSand Pdi/Pdi_max@L independent of diaphragm length. The volume-activation relationship ofthe diaphragm was equally affected by changes in lung volume as thevolume-Pdi relationship (60% change from functional residual capacityto total lung capacity). We conclude that the RMS of the diaphragm EMGis not artifactually influenced by lung volume and can be used as areliable index of diaphragm activation. The volume-activationrelationship can be used to infer changes in the length-tensionrelationship of the diaphragm at submaximal activation/contractionlevels.