Acute Ventilatory Support During Whole-Body Hybrid Rowing in Patients With High-Level Spinal Cord Injury: A Randomized Controlled Crossover Trial

CHEST, 2020 · DOI: https://doi.org/10.1016/j.chest.2019.10.044 · Published: May 1, 2020

Spinal Cord Injury Pulmonology Rehabilitation

Simple Explanation

High-level spinal cord injury (SCI) can cause breathing limitations during exercise. This study examined if non-invasive ventilation (NIV) could help SCI patients breathe better during a specific type of exercise called FES-rowing. Nineteen SCI patients performed FES-rowing with and without NIV. The researchers measured their breathing and aerobic capacity during the exercise. NIV improved the way patients breathed, making it deeper and slower, but it didn't always increase their peak oxygen consumption. The patients who seemed to benefit the most had cervical SCI and were within a shorter time since their injury.

Study Duration

Not specified

Participants

19 patients with SCI (level of injury ranging from C4 to T8)

Evidence Level

Level 1, Randomized Controlled Crossover Trial

Key Findings

1
NIV increased exercise tidal volume and reduced breathing frequency compared to the sham test, leading to no change in alveolar ventilation.
2
In those who reached peak oxygen consumption criteria, NIV failed to significantly increase VO2peak; however, the range of responses revealed a correlation between changes in peak alveolar ventilation and VO2peak.
3
Those with higher level injuries and shorter time since injury exhibited the greatest increases in VO2peak.

Research Summary

This study investigated the effect of non-invasive ventilation (NIV) on ventilatory and aerobic capacities in SCI patients during FES-rowing exercise. The results showed that NIV improved ventilatory efficiency by increasing tidal volume and reducing breathing frequency, but did not consistently increase peak oxygen consumption. Patients with cervical SCI and a shorter time since injury were more likely to benefit from NIV in terms of increased aerobic capacity.

Practical Implications

Improved Ventilatory Efficiency

NIV can be used to improve breathing patterns during exercise in SCI patients, leading to more efficient ventilation.

Targeted Intervention

Patients with cervical SCI and shorter time since injury are more likely to benefit from NIV during exercise, suggesting a targeted approach.

Potential for Increased Training Intensity

By improving ventilatory capacity, NIV may allow SCI patients to train at higher exercise intensities, leading to improved health outcomes.