Speech Breathing in Individuals with Cervical Spinal Cord Injury

1990 ◽  
Vol 33 (4) ◽  
pp. 798-807 ◽  
Author(s):  
Jeannette D. Hoit ◽  
Robert B. Banzett ◽  
Robert Brown ◽  
Stephen H. Loring
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Chest Wall ◽  
Cervical Spinal Cord ◽  
Abdominal Muscle ◽  
Cervical Spinal Cord Injury ◽  
Breathing Patterns ◽  
Lung Volumes ◽  
Cord Injury ◽  
Speech Breathing

Ten men with cervical spinal cord injury were studied using magnetometers to record surface motions of the chest wall during speech breathing. Individual speech breathing patterns reflected inspiratory and expiratory muscular sparing. Subjects compensated for expiratory muscle impairment by speaking at large lung volumes, presumably to take advantage of the higher recoil pressures available at those volumes. Similarly, subjects used larger lung volumes to increase loudness. Abnormal chest wall behavior was attributed in large part to loss of abdominal muscle function. Because of this, speech breathing in individuals with cervical spinal cord injury may be improved by the use of abdominal binders.

scholarly journals Effect of abdominal binding on respiratory mechanics during exercise in athletes with cervical spinal cord injury

2014 ◽  
Vol 117 (1) ◽  
pp. 36-45 ◽  
Author(s):  
Christopher R. West ◽  
Victoria L. Goosey-Tolfrey ◽  
Ian G. Campbell ◽  
Lee M. Romer
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Blood Lactate ◽  
Respiratory Mechanics ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Flow Limitation ◽  
Lung Volumes ◽  
Gastric Pressure ◽  
Cord Injury

We asked whether elastic binding of the abdomen influences respiratory mechanics during wheelchair propulsion in athletes with cervical spinal cord injury (SCI). Eight Paralympic wheelchair rugby players with motor-complete SCI (C5-C7) performed submaximal and maximal incremental exercise tests on a treadmill, both with and without abdominal binding. Measurements included pulmonary function, pressure-derived indices of respiratory mechanics, operating lung volumes, tidal flow-volume data, gas exchange, blood lactate, and symptoms. Residual volume and functional residual capacity were reduced with binding (77 ± 18 and 81 ± 11% of unbound, P < 0.05), vital capacity was increased (114 ± 9%, P < 0.05), whereas total lung capacity was relatively well preserved (99 ± 5%). During exercise, binding introduced a passive increase in transdiaphragmatic pressure, due primarily to an increase in gastric pressure. Active pressures during inspiration were similar across conditions. A sudden, sustained rise in operating lung volumes was evident in the unbound condition, and these volumes were shifted downward with binding. Expiratory flow limitation did not occur in any subject and there was substantial reserve to increase flow and volume in both conditions. V̇o2 was elevated with binding during the final stages of exercise (8–12%, P < 0.05), whereas blood lactate concentration was reduced (16–19%, P < 0.05). V̇o2/heart rate slopes were less steep with binding (62 ± 35 vs. 47 ± 24 ml/beat, P < 0.05). Ventilation, symptoms, and work rates were similar across conditions. The results suggest that abdominal binding shifts tidal breathing to lower lung volumes without influencing flow limitation, symptoms, or exercise tolerance. Changes in respiratory mechanics with binding may benefit O2 transport capacity by an improvement in central circulatory function.

scholarly journals An Inertial Measurement Unit-Based Wireless System for Shoulder Motion Assessment in Patients with Cervical Spinal Cord Injury: A Validation Pilot Study in a Clinical Setting

Sensors ◽  
2021 ◽  
Vol 21 (4) ◽  
pp. 1057
Author(s):  
Riccardo Bravi ◽  
Stefano Caputo ◽  
Sara Jayousi ◽  
Alessio Martinelli ◽  
Lorenzo Biotti ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Setting ◽  
Cervical Spinal Cord ◽  
Wearable Sensors ◽  
Cervical Spinal Cord Injury ◽  
Measurement Unit ◽  
Innovative Technology ◽  
Inertial Measurement ◽  
Cord Injury

Residual motion of upper limbs in individuals who experienced cervical spinal cord injury (CSCI) is vital to achieve functional independence. Several interventions were developed to restore shoulder range of motion (ROM) in CSCI patients. However, shoulder ROM assessment in clinical practice is commonly limited to use of a simple goniometer. Conventional goniometric measurements are operator-dependent and require significant time and effort. Therefore, innovative technology for supporting medical personnel in objectively and reliably measuring the efficacy of treatments for shoulder ROM in CSCI patients would be extremely desirable. This study evaluated the validity of a customized wireless wearable sensors (Inertial Measurement Units—IMUs) system for shoulder ROM assessment in CSCI patients in clinical setting. Eight CSCI patients and eight healthy controls performed four shoulder movements (forward flexion, abduction, and internal and external rotation) with dominant arm. Every movement was evaluated with a goniometer by different testers and with the IMU system at the same time. Validity was evaluated by comparing IMUs and goniometer measurements using Intraclass Correlation Coefficient (ICC) and Limits of Agreement (LOA). inter-tester reliability of IMUs and goniometer measurements was also investigated. Preliminary results provide essential information on the accuracy of the proposed wireless wearable sensors system in acquiring objective measurements of the shoulder movements in CSCI patients.

scholarly journals Permanent diaphragmatic deficits and spontaneous respiratory plasticity in a mouse model of incomplete cervical spinal cord injury

2021 ◽  
Vol 284 ◽  
pp. 103568
Author(s):  
Pauline Michel-Flutot ◽  
Arnaud Mansart ◽  
Therese B. Deramaudt ◽  
Isley Jesus ◽  
Kun-Ze Lee ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mouse Model ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Cord Injury ◽  
Respiratory Plasticity

scholarly journals Trending Racial and Socioeconomic Inequality in the Surgical Management and Outcome of Traumatic Cervical Spinal Cord Injury With Fracture In the USA From 1998 to 2009

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Alexander Dru ◽  
Dan Neal ◽  
W Christopher Fox ◽  
Brian Lim Hoh ◽  
Daniel J Hoh
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Socioeconomic Status ◽  
Hospital Mortality ◽  
Cervical Spinal Cord ◽  
Cervical Spinal Cord Injury ◽  
Lower Odds ◽  
Discharge Disposition ◽  
Treatment Type ◽  
Cord Injury

Abstract INTRODUCTION Advances in treatment of traumatic cervical spinal cord injury with fracture (TCSCIF) have led to significant improvements in clinical outcomes; however, progress in healthcare is seldom ubiquitous across demographic groups. We explored if disparities in treatment and outcome after TCSCIF exist across race and socioeconomic status. METHODS We queried the Nationwide Inpatient Sample database from 1998 to 2009 for TCSCIF hospitalizations. Multivariate analysis was used to identify the correlation between socioeconomic status and race to treatment type and outcome. RESULTS There were 21 985 admissions for TCSCIF. In all 66.9% had a favorable discharge disposition. In-hospital mortality rate was 12.5%. In all 43.7% underwent surgery. Overall, surgery was associated with lower in-hospital mortality (OR 0.30, 95% CI 0.27-0.34, P < .01) and better discharge disposition (OR 0.68, 95% CI 0.62-0.74, P < .01) vs nonsurgical or no intervention. Controlling for race and socioeconomic status demonstrated higher status (HS) non-Caucasians had lower odds of receiving surgery than HS Caucasians (OR 0.89, 95% CI 0.81-0.97, P = .01). LSES non-Caucasians had lower odds of receiving surgery than HS Caucasians (OR 0.83, 95% CI 0.73-0.94, P < .01). HS non-Caucasians had lower odds of receiving surgery than LSES Caucasians (OR 0.87, 95% CI 0.77-0.99, P = .03). LSES non-Caucasians had lower odds of receiving surgery than LSES Caucasians (OR 0.82, 95% CI 0.71-0.94, P = .01). For favorable discharge status HS non-Caucasians, LSES non-Caucasians, and LSES Caucasians all had lower odds of favorable discharge compared to HS Caucasians (OR 0.83, 95% CI 0.73-0.95, P = .01/OR 0.69, 95% CI 0.59-0.81, P < .01/OR 0.75, 95% CI 0.66-0.85, P < .01), respectively. CONCLUSION In our multivariate model that controlled for race and socioeconomic status in the setting of TCSCIF, race (but not socioeconomic status) was a factor in receiving surgery and both race and LSES impacted favorable discharge.

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