Functional and structural impairments of the pulmonary system in middle-aged people with cervical and upper thoracic spinal cord injuries

The Journal of Spinal Cord Medicine, 2023 · DOI: 10.1080/10790268.2022.2031478 · Published: January 1, 2022

Simple Explanation

This study investigates the long-term effects of cervical and upper thoracic spinal cord injuries (SCI) on the pulmonary system of middle-aged individuals. The study compares pulmonary function and structural impairments in people with SCI to a matched control group from the general population to identify differences. The researchers also examined whether the neurological level of injury (NLI) and age are related to pulmonary impairments.

Study Duration

Not specified

Participants

25 people (20% women, mean age 58 years, mean time since injury 28 years, NLIs C2-T6, American Spinal Injury Association Impairment Scale A-C)

Evidence Level

Cross-sectional study with matched controls

Key Findings

1
Pulmonary function was generally worse in participants with SCI compared to the controls.
2
Structural impairments were common in both groups, with no significant differences between the SCI participants and the controls.
3
Higher neurological level of injury (NLI) was significantly related to some functional and structural impairments.

Research Summary

The study describes functional and structural impairments of the pulmonary system in middle-aged people with cervical and upper thoracic SCI and to determine if findings are different from the general population. The results of all functional assessments were generally worse among the participants compared to the matched controls. Middle-aged people with long-term cervical and upper thoracic SCI can have substantial pulmonary functional impairments, whereas structural impairments do not differ considerably from the general population.

Practical Implications

Clinical Management

Detailed assessments of pulmonary function are needed to improve the clinical management of pulmonary dysfunction in cervical and upper thoracic SCI.

Risk Assessment

People ageing with a cervical and upper thoracic SCI may have an increased vulnerability to developing pulmonary structural impairments.

Future Research

Further larger and longitudinal studies are necessary to confirm the hypothesis that people with SCI have more pulmonary structural impairments.

Study Limitations

1
Assessments were not tailored for SCI; important measures, for example, chest anthropometry and maximum inspiratory and expiratory pressure, were therefore not included.
2
A larger sample size and a longitudinal design would have enabled us to make more detailed inferences and to better understand the effects of ageing on pulmonary functional and structural impairments.
3
The limitations of the sample size warrant caution when interpreting the weight of the results.

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