Improvement in Pulmonary Function with Short-term Rehabilitation Treatment in Spinal Cord Injury Patients

Scientific Reports, 2019 · DOI: 10.1038/s41598-019-52526-6 · Published: October 15, 2019

Spinal Cord Injury Pulmonology Rehabilitation

Simple Explanation

Cervical and upper thoracic spinal cord injury causes impairments in respiratory muscle performance, leading to variable degrees of pulmonary dysfunction and rendering deep breathing difficult for affected individuals. This study investigated the effects of self-directed respiratory muscle training by assessing pulmonary function relative to spinal cord injury characteristics. Short-term self-directed respiratory muscle training should be incorporated into all spinal cord injury rehabilitation regimens, especially for patients with tetraplegia and subacute spinal cord injury, as well as those with chronic spinal cord injury.

Study Duration

4–8 weeks

Participants

104 spinal cord injury patients (tetraplegia/paraplegia; 65/39, acute/subacute/chronic; 14/42/48)

Evidence Level

Not specified

Key Findings

1
Initial evaluation revealed a compromised pulmonary function with a percentage of predicted value of 62.0 and 57.5 in forced vital capacity in supine and forced vital capacity in sitting positions, respectively.
2
The percentage of predicted value of forced vital capacity in supine and sitting position improved overall on average by 11.7% and 12.7%, respectively. The peak cough flow improved by 22.7%.
3
All assessed pulmonary function parameters improved significantly in all subgroups, with the greatest improvements found in patients with tetraplegia and subacute spinal cord injury.

Research Summary

This retrospective study involved 178 SCI patients who were admitted to the tertiary university hospital for a short-term (4–8 weeks) rehabilitation treatment between December 2016 and November 2017. Following the short-term rehabilitation treatment with self-directed RMT, the absolute values of FVCsup, FVCsit, and PCF had significantly improved in all subgroups regardless of the injury level and severity, as well as disease duration In conclusion, short-term rehabilitation treatment with self-directed RMT resulted in the improvement of PF in all SCI groups.

Practical Implications

Clinical Practice

Short-term self-directed respiratory muscle training should be incorporated into all spinal cord injury rehabilitation regimens.

Targeted Intervention

The greatest improvements were found in patients with tetraplegia and subacute spinal cord injury, indicating these groups may benefit most from RMT.

Home Programs

Self-directed RMT program may be used as a standard model to maintain or improve the PF not only for in-patients, but also for out-patients who have difficulties visiting a hospital.

Study Limitations

1
It does not assess the effects of improved PF on the level of physical function.
2
Due to the absence of a control group, this study could not distinguish the improvement in PF contributed by RMT from that conferred by neurological recovery.
3
The history of smoking, presence of tracheostomy, or use of mechanical ventilator was not considered in this study.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury