Utilizing Pulmonary Function Parameters to Predict Dysphagia in Individuals With Cervical Spinal Cord Injuries

Objective To utilize pulmonary function parameters as predictive factors for dysphagia in individuals with cervical spinal cord injuries (CSCIs).Methods Medical records of 78 individuals with CSCIs were retrospectively reviewed. The pulmonary function was evaluated using spirometry and peak flow meter, whereas the swallowing function was assessed using a videofluoroscopic swallowing study. Participants were divided into the non-penetration-aspiration group (score 1 on the Penetration-Aspiration Scale [PAS]) and penetration-aspiration group (scores 2–8 on the PAS). Individuals with pharyngeal residue grade scores >1 were included in the pharyngeal residue group.Results The mean age was significantly higher in the penetration-aspiration and pharyngeal residue groups. In this study, individuals with clinical features, such as advanced age, history of tracheostomy, anterior surgical approach, and higher neurological level of injury, had significantly more penetration-aspiration or pharyngeal residue. Individuals in the penetration-aspiration group had significantly lower peak cough flow (PCF) levels. Individuals in the pharyngeal residue group had a significantly lower forced expiratory volume in 1 second (FEV1). According to the receiver operating characteristic curve analysis of PCF and FEV1 on the PAS, the cutoff value was 140 L/min and 37.5% of the predicted value, respectively.Conclusion Low PCF and FEV1 values may predict the risk of dysphagia in individuals with CSCIs. In these individuals, active evaluation of swallowing is recommended to confirm dysphagia.

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Preoperative predictors of dysphagia after transoral surgery

International Journal of Clinical Oncology ◽

10.1007/s10147-021-01860-9 ◽

2021 ◽

Author(s):

Kazunori Fujiwara ◽

Kenkichiro Taira ◽

Ryohei Donishi ◽

Satoshi Koyama ◽

Tsuyoshi Morisaki ◽

...

Keyword(s):

Head And Neck ◽

Forced Expiratory Volume ◽

Transoral Surgery ◽

Postoperative Dysphagia ◽

Swallowing Function ◽

History Of ◽

Group A ◽

Low Bmi ◽

Head And Neck Radiotherapy

Abstract Background Transoral surgery (TOS) has been used to remove pharyngeal and laryngeal cancers with the objective of improving functional without worsening survival. However, there is a risk of postoperative dysphagia, which can severely impair quality of life. The aim of this study was to evaluate the preoperative predictive factors for postoperative dysphagia in patients undergoing TOS. Methods One hundred and twenty patients who underwent TOS were evaluated in this study. The degree of dysphagia was evaluated using the Functional Outcome Swallowing Scale (FOSS) both preoperatively and 3 months postoperatively. Those whose FOSS stage was maintained postoperatively were classified into the FOSS-M group, while those with increased FOSS stage postopratively were classified into the FOSS-I group. The following parameters were assessed before surgery: age, weight, height, body mass index (BMI), forced expiratory volume in 1 s, and history of head and neck radiotherapy. Videofluoroscopy (VF) was performed preoperatively to evaluate swallowing function using the Penetration-Aspiration Scale (PAS). Results The BMI of the FOSS-M group was significantly higher than that of the FOSS-I group. A history of radiotherapy was significantly more common in the FOSS-I group than in the FOSS-M group. Finally, preoperative PAS in the FOSS-M group was lower than that in the FOSS-I group. Conclusion This study suggested that patients with preoperative aspiration detected using VF might develop postoperative dysphagia severely. In addition, preoperative low BMI and a history of previous radiotherapy for head and neck cancer were associated with postoperative dysphagia. Objective examinations such as VF should be performed preoperatively.

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Metrizamide Myelography for Cervical Spinal Cord Injuries

Radiology ◽

10.1148/129.3.707 ◽

1978 ◽

Vol 129 (3) ◽

pp. 707-711 ◽

Cited By ~ 12

Author(s):

Jin S. Leo ◽

R. Thomas Bergeron ◽

Irvin I. Kricheff ◽

M. Vallo Benjamin

Keyword(s):

Spinal Cord ◽

Spinal Cord Injuries ◽

Cervical Spinal Cord

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Pneumonia as a modifiable risk factor of mechanical ventilation in cervical spinal cord injuries

Canadian Journal of Respiratory Critical Care and Sleep Medicine ◽

10.1080/24745332.2018.1467741 ◽

2018 ◽

Vol 2 (4) ◽

pp. 213-217

Author(s):

Han Ting Wang ◽

David Williamson ◽

Mary Francispillai ◽

Andréanne Richard-Denis ◽

Martin Albert

Keyword(s):

Spinal Cord ◽

Mechanical Ventilation ◽

Risk Factor ◽

Spinal Cord Injuries ◽

Cervical Spinal Cord ◽

Modifiable Risk Factor

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Smart-device environmental control systems: experiences of people with cervical spinal cord injuries

Disability and Rehabilitation Assistive Technology ◽

10.1080/17483107.2017.1369591 ◽

2017 ◽

Vol 13 (8) ◽

pp. 724-730

Author(s):

Bethany Hooper ◽

Michele Verdonck ◽

Delena Amsters ◽

Michelle Myburg ◽

Emily Allan

Keyword(s):

Spinal Cord ◽

Control Systems ◽

Spinal Cord Injuries ◽

Environmental Control ◽

Cervical Spinal Cord ◽

Smart Device

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Disorder of Serum Electrolyte Concentrations in acute Cervical Spinal Cord Injuries

Orthopedics & Traumatology ◽

10.5035/nishiseisai.34.284 ◽

1985 ◽

Vol 34 (1) ◽

pp. 284-288

Author(s):

Motofumi Komori ◽

Kunio Sasaki ◽

Keiichiro Shiba ◽

Koichiro Yamano ◽

Takayoshi Ueta ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injuries ◽

Cervical Spinal Cord ◽

Serum Electrolyte

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Effect of Heparin Following Cervical Spinal Cord Injuries in Rats

Neurosurgery ◽

10.1227/neu.0b013e3182241f3b ◽

2011 ◽

Vol 69 (4) ◽

pp. 930-941 ◽

Cited By ~ 1

Author(s):

Yiyan Zheng ◽

Yi Ping Zhang ◽

Lisa B E Shields ◽

Yongjie Zhang ◽

Marcus W Siu ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injuries ◽

Cervical Spinal Cord

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Exoskeleton-assisted walking improves pulmonary function and walking parameters among individuals with spinal cord injury: a randomized controlled pilot study

10.21203/rs.3.rs-158028/v1 ◽

2021 ◽

Author(s):

Xiao-na Xiang ◽

Hui-yan Zong ◽

Yi Ou ◽

Xi Yu ◽

Hong Cheng ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Pilot Study ◽

Pulmonary Function ◽

Forced Expiratory Volume ◽

Conventional Group ◽

Clinical Trial Registry ◽

Randomized Controlled ◽

Cord Injury ◽

Expiratory Flow

Abstract Background: Exoskeleton-assisted walking (EAW) is expected to improve the gait of spinal cord injury (SCI) individuals. However, few studies reported the changes of pulmonary function (PF) parameters after EAW trainings. Hence, we aimed to explore the effect of EAW on PF parameters, 6-minute walk test (6MWT) and lower extremity motor score (LEMS) in individuals with SCI and to compare those with conventional trainings. Methods: In this prospective, single-center, single-blinded randomized controlled pilot study, 18 SCI participants were randomized into the EAW group (n=9) and conventional group (n=9) and received 16 sessions of 50-60min training (4 days/week, 4 weeks). PF parameters consisting of the forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), forced expiratory flow (FEF), peak expiratory flow, and maximal voluntary ventilation, 6MWT with assisted devices and LEMS were reported pre- and post-training. Results: Values of FVC (p=0.041), predicted FVC% (p=0.012) and FEV 1 (p=0.013) were significantly greater in EAW group (FVC: 3.8±1.1 L; FVC%pred=94.1±24.5%; FEV1: 3.5±1.0 L) compared to conventional group (FVC: 2.8±0.8 L; FVC%pred=65.4±17.6%; FEV1: 2.4±0.6 L) after training. Participants in EAW group completed 6MWT with median 17.3 meters while wearing the exoskeleton. There was no difference in LEMS and no adverse event. Conclusions: The current results suggest that EAW has potential benefits to facilitate PF parameters among individuals with lower thoracic neurological level of SCI compared to conventional trainings. Additionally, robotic exoskeleton helped walking. Trial registration: Registered on 22 May 2020 at Chinese Clinical Trial Registry (ChiCTR2000033166). http://www.chictr.org.cn/edit.aspx?pid=53920&htm=4 Keywords: Spinal Cord, Pulmonary, Exercise, Exoskeleton, 6MWT, Rehabilitation

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Lacrosse Equipment and Cervical Spinal Cord Space During Immobilization: Preliminary Analysis

Journal of Athletic Training ◽

10.4085/1062-6050-45.1.39 ◽

2010 ◽

Vol 45 (1) ◽

pp. 39-43 ◽

Cited By ~ 11

Author(s):

Michael Higgins ◽

Ryan T. Tierney ◽

Jeffrey B. Driban ◽

Steven Edell ◽

Randall Watkins

Keyword(s):

Spinal Cord ◽

Cervical Spine ◽

Repeated Measures ◽

Cervical Spinal Cord ◽

Spine Injury ◽

Imaging Center ◽

Mri Scans ◽

History Of ◽

Magnetic Resonance Imaging Mri ◽

Cervical Spine Alignment

Abstract Context: Removal of the lacrosse helmet to achieve airway access has been discouraged based only on research in which cervical alignment was examined. No researchers have examined the effect of lacrosse equipment on the cervical space available for the spinal cord (SAC). Objective: To determine the effect of lacrosse equipment on the cervical SAC and cervical-thoracic angle (CTA) in the immobilized athlete. Design: Observational study. Setting: Outpatient imaging center. Patients or Other Participants: Ten volunteer lacrosse athletes (age = 20.7 ± 1.87 years, height = 180.3 ± 8.3 cm, mass = 91 ± 12.8 kg) with no history of cervical spine injury or disease and no contraindications to magnetic resonance imaging (MRI). Intervention(s): The lacrosse players were positioned supine on a spine board for all test conditions. An MRI scan was completed for each condition. Main Outcome Measure(s): The independent variables were condition (no equipment, shoulder pads only [SP], and full gear that included helmet and shoulder pads [FG]), and cervical spine level (C3–C7). The dependent variables were the SAC and CTA. The MRI scans were evaluated midsagittally. The average of 3 measures was used as the criterion variable. The SAC data were analyzed using a 3 × 5 analysis of variance (ANOVA) with repeated measures. The CTA data were analyzed with a 1-way repeated-measures ANOVA. Results: We found no equipment × level interaction effect (F3.7,72 = 1.34, P = .279) or equipment main effect (F2,18 = 1.20, P = .325) for the SAC (no equipment = 5.04 ± 1.44 mm, SP = 4.69 ± 1.36 mm, FG = 4.62 ± 1.38 mm). The CTA was greater (ie, more extension; critical P = .0167) during the SP (32.64° ± 3.9°) condition than during the no-equipment (25.34° ± 2.3°; t9 = 7.67, P = .001) or FG (26.81° ± 5.1°; t9 = 4.80, P = .001) condition. Conclusions: Immobilizing healthy lacrosse athletes with shoulder pads and no helmets affected cervical spine alignment but did not affect SAC. Further research is needed to determine and identify appropriate care of the lacrosse athlete with a spine injury.

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