Effect of body position on peak expiratory flow during mechanical insufflation–exsufflation in people with cervical spinal cord injury: a pilot study

Scientific Reports, 2023 · DOI: 10.1038/s41598-023-43256-x · Published: September 21, 2023

Simple Explanation

This study investigated how body position influences PCF during MI-E treatment in individuals with C-SCI. Fifteen participants were recruited and randomized into experimental Group I (n = 8) and Group II (n = 7). Overall, this study revealed that there was no difference in PCF between the supine and reclined positions when MI-E was applied to patients with C-SCI.

Study Duration

Not specified

Participants

15 participants with cervical spinal cord injury (C-SCI)

Evidence Level

Pilot study

Key Findings

1
The study found no significant difference in PCF between supine and reclined positions during MI-E-assisted cough in C-SCI patients.
2
MI-E with additional manual thrust resulted in the most substantial increase, approximately 2.116 [2.005–2.228] L/s, compared to voluntary cough.
3
The generated TIV during cough was important in determining PCF in both positions.

Research Summary

This study aimed to determine whether body position affects peak cough flow (PCF) during mechanical insufflation-exsufflation (MI-E) treatment in people with cervical spinal cord injury (C-SCI). The results indicated that while voluntary cough PCF differed between positions, MI-E assisted cough did not show any change in PCF between applied positions. The study concludes that either the supine or reclined position can be used for C-SCI patients during MI-E, as long as MI-E is performed with manual thrust and sufficient total insufflation volume (TIV) is provided.

Practical Implications

Clinical Practice

Either supine or reclined positions can be used for MI-E in C-SCI patients if manual thrust and sufficient TIV are ensured.

Treatment Strategy

Prioritize MI-E with manual thrust to maximize PCF, regardless of body position.

Pulmonary Hygiene

Focus on achieving sufficient TIV during MI-E to improve cough effectiveness.

Study Limitations

1
The study did not measure the exact amount of eliminated sputum.
2
The study is limited by a small, heterogeneous sample of individuals with varying SCI severities, restricting the generalizability of findings.
3
Comparing MI-E-assisted cough at 60° or 90° sitting position can provide more information about the best position for MI-E in people with C-SCI as well.

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