Longitudinal Change in FEV1 and FVC in Chronic Spinal Cord Injury

Am J Respir Crit Care Med, 2008 · DOI: 10.1164/rccm.200709-1332OC · Published: April 1, 2008

Simple Explanation

This study examined how lung function changes over time in people with chronic spinal cord injury (SCI). It looked at factors that might influence this change. The researchers found that lung function decline was related to smoking, wheezing, weight gain, and respiratory muscle strength, but not directly to the severity of the SCI. The study suggests that managing weight, stopping smoking, treating wheezing, and improving respiratory muscle strength could help slow down lung function decline in people with SCI.

Study Duration

7.5 years

Participants

174 male participants

Evidence Level

Longitudinal study

Key Findings

1
Longitudinal change in FEV1 and FVC was not directly related to level and severity of SCI.
2
Longitudinal decline in FEV1 was signiﬁcantly related to continued smoking.
3
An increase in BMI was a signiﬁcant predictor of decline in FEV1 and FEV1/FVC.

Research Summary

This study assessed relationships between clinical factors and longitudinal change in FEV1 and FVC in chronic SCI. After adjusting for stature and age, signiﬁcant determinants of longitudinal decline in FEV1 included current smoking, an increase in BMI among persons who were obese or overweight, and wheeze. These results suggest that, in SCI, studies to reduce longitudinal decline in FEV1 and FVC and perhaps improve survival should focus on smoking cessation, weight reduction, recognition and management of wheeze, and improvements in respiratory muscle strength.

Practical Implications

Smoking Cessation

Encouraging smoking cessation can help to reduce the rate of lung function decline in individuals with SCI.

Weight Management

Maintaining a healthy weight or achieving weight reduction, especially for those overweight or obese, is important for preserving lung function.

Respiratory Muscle Training

Improving respiratory muscle strength may help to slow down the decline in lung function in individuals with SCI.

Study Limitations

1
The analysis was limited to white male subjects with SCI who live primarily in New England.
2
We also included test sessions for which persons did not produce three acceptable and two reproducible values for FVC and FEV1.
3
Although some studies have found that self-reported stature may be overestimated, analyses conducted adjusting for whether stature was measured or stated also did not inﬂuence results.

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