Evaluation of a clinical implementation of a respiratory muscle training group during spinal cord injury rehabilitation

Spinal Cord Series and Cases, 2018 · DOI: https://doi.org/10.1038/s41394-018-0069-4 · Published: March 19, 2018

Spinal Cord Injury Pulmonology Rehabilitation

Simple Explanation

After a spinal cord injury (SCI), respiratory function is impaired and the degree of impairment depends upon the lesion level. Due to the complete or partial paralysis of the respiratory muscles, the effectiveness of coughing is reduced and the clearance of airway secretions is insufficient. This retention of secretions may increase the airway resistance and may cause respiratory complications such as atelectasis or pneumonia. As a result of high airway resistance, respiratory work increases and may cause respiratory failure and subsequent complications in SCI individuals. Respiratory muscle training improved respiratory function of individuals with acute spinal cord injury. Even if the combined respiratory muscle training was performed with more repetitions per training and nearly twice as long, relative improvements of respiratory function parameters were comparable with isolated inspiratory muscle training.

Study Duration

October 2010 to August 2015

Participants

79 individuals with complete or incomplete SCI lesions, level C4–T12

Evidence Level

Retrospective cohort study

Key Findings

1
Inspiratory muscle training for 7 weeks improved respiratory muscle strength by 18–68% and lung function by 11–31%.
2
Combined respiratory muscle training for 13 weeks improved respiratory muscle strength by 14–51% and lung function by 15–34%.
3
Relative improvements in respiratory function were comparable between isolated inspiratory muscle training and combined respiratory muscle training, despite higher training volumes in the combined regime.

Research Summary

This study evaluated the clinical implementation of respiratory muscle training during rehabilitation of individuals with spinal cord injury, analyzing the effects of inspiratory and combined in- and expiratory training regimes. Both inspiratory and combined in- and expiratory muscle training increased lung function and respiratory muscle strength on median by 27%. Even if the combined training regime was conducted with much higher training volumes (repetions per training session and number of weeks) compared to the inspiratory muscle training, relative improvements did not differ substantially between the two training regimes. The study concludes that respiratory muscle training is effective in improving respiratory function in individuals with SCI and suggests future research should focus on the effects of training intensity.

Practical Implications

Clinical Practice

Respiratory muscle training should be an integral part of therapy for individuals with SCI.

Assessment and Adaptation

Repeated measurements of respiratory function are needed to assess and adapt individual respiratory muscle training.

Pneumonia Reduction

Respiratory muscle training may reduce the rate of pneumonia due to improvements in PImax.

Study Limitations

1
No control group was included and no systematic group allocation was performed.
2
Spontaneous improvement of the respiratory function parameters occurs.
3
Respiratory muscle strength is affected by both in- and expiratory muscle training.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury