Assessment of Airway Caliber and Bronchodilator Responsiveness in Subjects With Spinal Cord Injury

Schilero, Gregory J.; Grimm, David R.; Bauman, William A.; Lenner, Roberta; Lesser, Marvin

doi:10.1378/chest.127.1.149

Cited by 50 publications

(37 citation statements)

References 34 publications

(26 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…53 However, it is suggested that with loss of the sympathetic influence from the upper six thoracic segments, the parasympathetic bronchoconstriction remains unopposed. 55,58,59 This, together with airway obstruction following possible mucus collection, may result in additional obstructive problems. 64 The variability found in outcome in tetraplegia may be attributed to population differences.…”

Section: Level Of Respiratory Functionmentioning

confidence: 99%

Physical capacity in wheelchair-dependent persons with a spinal cord injury: a critical review of the literature

et al. 2006

View full text Add to dashboard Cite

Study design: Review of publications. Objective: To assess the level of physical capacity (peak oxygen uptake, peak power output, muscle strength of the upper extremity and respiratory function) in wheelchair-dependent persons with a spinal cord injury (SCI). Setting: Erasmus MC, University Medical Centre Rotterdam, The Netherlands. Methods: Pubmed (Medline) search of publications from 1980 onwards. Studies were systematically assessed. Weighted means were calculated for baseline values. Results: In tetraplegia, the weighted mean for peak oxygen uptake was 0.89 l/min for the wheelchair exercise test (WCE) and 0.87 l/min for arm-cranking or hand-cycling (ACE). The peak power output was 26 W (WCE) and 40 W (ACE). In paraplegia, the peak oxygen uptake was 2.10 l/min (WCE) and 1.51 l/min (ACE), whereas the peak power output was 74 W (ACE) and 85 W (WCE). In paraplegia, muscle strength of the upper extremity and respiratory function were comparable to that in the able-bodied population. In tetraplegia muscle strength varied greatly, and respiratory function was reduced to 55-59% of the predicted values for an age-, gender-and height-matched able-bodied population. Conclusions: Physical capacity is reduced and varies in SCI. The variation between results is caused by population and methodological differences. Standardized measurement of physical capacity is needed to further develop comparative values for clinical practice and rehabilitation research.

show abstract

Section: Level Of Respiratory Functionmentioning

confidence: 99%

Physical capacity in wheelchair-dependent persons with a spinal cord injury: a critical review of the literature

et al. 2006

View full text Add to dashboard Cite

show abstract

“…The study of Schilero et al, 8 in 2004, using metaproterenol sulfate demonstrated an average increase in conductance of 134%. A year later, using ipratropium bromide, the same research group 9 showed an average increase of 135%. This evidence reinforces the hypothesis of vagal dominance on resting bronchomotor tone in these patients.…”

Section: Discussionmentioning

confidence: 96%

“…Recently, it was demonstrated that conductance improves in these subjects when nebulized with metaproterenol sulfate 8 and ipratropium bromide. 9 The aim of the present study is to further define cholinergic bronchomotor tone in patients with cervical SCI. The use of spirometric forced expiratory flows is not sensitive as a marker of airway size nor for the detection of airway patency.…”

Section: Associated With Cervical Spinal Cord Injury (Sci)mentioning

confidence: 99%

Cholinergic bronchomotor tone and airway caliber in tetraplegic patients

2005

View full text Add to dashboard Cite

Study design: Case-control study. Objectives: To evaluate the resting airway caliber in subjects with tetraplegia; to define the participation of cholinergic innervation in this condition; and to determine if baclofen modifies this pattern. Setting: A rehabilitation hospital, Brası´lia, Brazil. Methods: We studied 18 tetraplegic patients, with complete motor loss between C4 and C8, and 18 healthy control subjects by measuring airway conductance, before and after inhaled ipratropium bromide. Results: At baseline, the pulmonary function parameters revealed mild-to-moderate restrictive impairment in tetraplegic patients as defined by decreases in total lung capacity and predicted percent of slow vital capacity. The average baseline specific airway conductance (sGaw) was less in tetraplegic patients (0.2570.11) than in the control group (0.4170.10 l/s/cm H 2 O) (Po0.0001). All patients had improved postbronchodilator sGaw X40% compared with only four of the 18 controls (Po0.001). The average increase for tetraplegic patients was 235% (793) versus 25% (724) for controls (Po0.0001). Analysis of variance for repeated measurements showed significant difference in sGaw between the control and spinal cord injury (SCI) groups (Po0.0001) following bronchodilator challenge, but found no difference for total gas volume. No difference for mean basal sGaw and bronchodilator challenge was encountered comparing tetraplegic patients using baclofen to those not using it. Conclusions:Cervical SCI patients have a reduced baseline conductance compared to controls. Marked improvement occurs after an inhaled anticholinergic drug. This behavior was not affected by the use of baclofen. The study adds support to the hypothesis of an increased cholinergic bronchomotor tone in tetraplegic patients.

show abstract

“…presumably because of heightened vagal tone due to loss of sympathetic innervations of the lungs) compared to subjects with paraplegia or able-bodied controls. 12 It is reasonable to assume that IOS lacks the sensitivity of body plethysmography in the assessment of airway caliber in tetraplegia; airway resistance as measured by forced oscillation techniques includes contributions from large and small airways, chest wall, and lung tissue, 2 whereas airway resistance quantitated by body plethysmography primarily represents the dynamics of airway caliber. However, previous findings of significant decreases in R5 and R20 among subjects with tetraplegia following inhalation of ipratropium bromide demonstrated that the IOS was a sensitive method for Figure 3 The percent change from seated to supine position (mean ± standard deviation) for R5 ( § P < 0.05 tetra versus para and controls) and R20 ( ‡ P < 0.01 tetra versus para and controls).…”

Section: Discussionmentioning

confidence: 99%

Reproducibility and effect of posture on impulse oscillation parameters in persons with spinal cord injury

Cirnigliaro

Lesser

Moyer

et al. 2012

The Journal of Spinal Cord Medicine

Self Cite

View full text Add to dashboard Cite

Background: The impulse oscillation system (IOS) offers significant value in the assessment of airway dynamics in persons with spinal cord injury (SCI) because of minimal patient effort but measurement reproducibility in SCI is unknown. Objective: To evaluate between-day reproducibility and the effect of posture on airway resistance [respiratory resistances at 5 Hz (R5) and 20 Hz (R20)] in subjects with tetraplegia, paraplegia and able-bodied controls. Methods: Ten subjects with tetraplegia, 10 subjects with paraplegia and 11 able-bodied individuals were evaluated using IOS. Three 30 second trials were obtained in each while in the seated and supine position on Day 1, and repeated on Day 2. Results: The within-day coefficient of variation (CV%) for R5 and R20 were comparable in the 3 study groups in the seated and supine positions. Compared to controls, the between-day CV% for the combined data was higher in subjects with tetraplegia and paraplegia for R5 seated, and was higher in subjects with tetraplegia for R5 supine. Conclusions: IOS has applicability to the study of within-day respiratory resistance in SCI. However, performing longer-term studies in subjects with tetraplegia and paraplegia may be problematic because of the greater variability for R5 when compared to able-bodied individuals.

show abstract

Assessment of Airway Caliber and Bronchodilator Responsiveness in Subjects With Spinal Cord Injury

Cited by 50 publications

References 34 publications

Physical capacity in wheelchair-dependent persons with a spinal cord injury: a critical review of the literature

Physical capacity in wheelchair-dependent persons with a spinal cord injury: a critical review of the literature

Cholinergic bronchomotor tone and airway caliber in tetraplegic patients

Reproducibility and effect of posture on impulse oscillation parameters in persons with spinal cord injury

Contact Info

Product

Resources

About