Rehabilitation of the diaphragm – An opportunity

Disability of the diaphragm after SCI is well recognized; the consequences of this disability are known; but a timely correction of the disability is seldom attempted. The diaphragm is disabled due to paralysis of the abdominal musculature, which normally resists the descent of the contracting diaphragm and serves as a fulcrum against which the diaphragm raises and expands the chest. The physiological consequences of the disabled diaphragm are impaired ventilation of the lungs and reduced venous return, the determinant of cardiac output.

• 1
  Diaphragm atrophies due to paralysis of abdominal muscles after SCI, leading to impaired lung ventilation and reduced venous return.
• 2
  Applying an abdominal binder can improve breathing parameters in individuals with tetraplegia, but improvements have been marginal.
• 3
  Early application of an abdominal binder might prevent diaphragm deconditioning or shorten reconditioning time.