Physiotherapy Secretion Removal Techniques in People With Spinal Cord Injury: A Systematic Review

J Spinal Cord Med, 2010 · DOI: · Published: October 1, 2010

Spinal Cord Injury Pulmonology Rehabilitation

Simple Explanation

Respiratory complications are a major concern for people with spinal cord injuries, especially those with injuries in the neck area. These complications often arise from the difficulty in clearing mucus from the airways due to weakened respiratory muscles. This review examines various physiotherapy techniques aimed at helping people with spinal cord injuries remove secretions and improve their ability to cough. The focus is on techniques that enhance inspiratory capacity and expiratory strength. The review found limited high-quality evidence supporting specific secretion removal techniques, but it highlights promising results from interventions that increase respiratory muscle strength and improve cough effectiveness.

Study Duration

Not specified

Participants

Varied from 1 to 40 across studies, primarily young males with cervical SCI

Evidence Level

Mostly Level 4 or 5, with only 2 randomized controlled trials

Key Findings

1
Evidence supporting secretion removal techniques in SCI is limited and mostly of low level. Most articles examined related interventions that improve different components of cough.
2
Insufflation combined with manual assisted cough provided the most consistent evidence for improving cough expiratory flow rates.
3
Treatments that increase respiratory muscle force, such as respiratory muscle training and electrical stimulation of expiratory muscles, show promise as effective airway clearance techniques.

Research Summary

This systematic review assessed the effectiveness of physiotherapy secretion removal techniques in people with chronic spinal cord injury (SCI). The review found limited evidence supporting the use of specific secretion removal techniques, but highlighted promising results from interventions that enhance components of cough. Treatments focusing on increasing respiratory muscle force, such as respiratory muscle training and electrical stimulation, showed potential as effective airway clearance techniques for individuals with SCI.

Practical Implications

Clinical Practice

Despite limited high-level evidence, secretion removal techniques are recommended due to the high incidence of pulmonary complications in SCI patients.

Future Research

Further research is needed to investigate other potentially effective secretion removal techniques, such as huffing and positive expiratory pressure devices.

Treatment Strategies

Incorporate treatments that promote respiratory muscle force, such as respiratory muscle training, into airway clearance strategies for SCI patients.

Study Limitations

1
Small number of studies with weak designs and small sample sizes.
2
Heterogeneity of studies, with varied interventions and outcome measures.
3
Lack of studies reporting clinically relevant outcomes such as hospitalizations or quality of life.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury