Improvement in Pulmonary Function with Short-term Rehabilitation Treatment in Spinal Cord Injury Patients

AbstractCervical and upper thoracic spinal cord injury causes impairments in respiratory muscle performance, leading to variable degrees of pulmonary dysfunction and rendering deep breathing difficult for affected individuals. In this retrospective study, we investigated the effects of self-directed respiratory muscle training in this context by assessing pulmonary function relative to spinal cord injury characteristics. A total of 104 spinal cord injury patients (tetraplegia/paraplegia; 65/39, acute/subacute/chronic; 14/42/48) were admitted for short-term (4–8 weeks) in-patient clinical rehabilitation. Initial evaluation revealed a compromised pulmonary function with a percentage of predicted value of 62.0 and 57.5 in forced vital capacity in supine and forced vital capacity in sitting positions, respectively. Tetraplegic patients had more compromised pulmonary function compared with paraplegic patients. At follow-up evaluation, the percentage of predicted value of forced vital capacity in supine and sitting position improved overall on average by 11.7% and 12.7%, respectively. The peak cough flow improved by 22.7%. All assessed pulmonary function parameters improved significantly in all subgroups, with the greatest improvements found in patients with tetraplegia and subacute spinal cord injury. Therefore, short-term self-directed respiratory muscle training should be incorporated into all spinal cord injury rehabilitation regimens, especially for patients with tetraplegia and subacute spinal cord injury, as well as those with chronic spinal cord injury.

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Effects of Respiratory Muscle Training on Pulmonary Function in Individuals with Spinal Cord Injury: An Updated Meta-analysis

BioMed Research International ◽

10.1155/2020/7530498 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Xiaojun Wang ◽

Na Zhang ◽

Yubin Xu

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Pulmonary Function ◽

Respiratory Muscle ◽

Vital Capacity ◽

Risk Of Bias ◽

Respiratory Muscle Training ◽

Cochrane Library ◽

Muscle Training ◽

Cord Injury

Objective. To investigate the pulmonary function responses to respiratory muscle training (RMT) in individuals with tetraplegia and provide a systematic review of the included studies. Methods. Computerized retrieval of randomized controlled trials (RCT) in PubMed, Embase, and the Cochrane Library on the improvement of respiratory function in patients with spinal cord injury by RMT was conducted until May 2019. Two researchers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies. Articles were scored for their methodological quality using the Cochrane Collaboration risk of bias assessment tool. Results. Sixteen studies were identified. A significant benefit of RMT was revealed for five outcomes: force vital capacity (FVC, WMD: -0.43, 95% CI -0.84 to -0.03, P=0.037), vital capacity (VC, WMD: -0.40, 95% CI -0.69 to -0.12, P=0.006), maximal voluntary ventilation (MVV, WMD: -5.89, 95% CI -10.63 to -1.14, P=0.015), maximum static inspiratory pressure (MIP, WMD: -13.14, 95% CI -18.01 to -8.27, P<0.001), and maximum static expiratory pressure (MEP, WMD: -13.08, 95% CI -23.78 to -2.37, P=0.017). No effect was found for forced expiratory volume in 1 s (FEV1). Conclusion. Our findings demonstrate that RMT can effectively improve spinal cord injury pulmonary function of the patient, which is marked by increasing respiratory strength, function, and endurance. Limited by the quantity and quality of the included studies, the above conclusion needs to be verified by more high-quality studies.

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