Evaluation of a clinical implementation of a respiratory muscle training group during spinal cord injury rehabilitation

Raab, Anja; Krebs, Jörg; Perret, Catherine; Pfister, Mirjam; Hopman, Maria T. E.; Mueller, Gabi

doi:10.1038/s41394-018-0069-4

Cited by 7 publications

(7 citation statements)

References 29 publications

(35 reference statements)

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“…Previous studies have focused more on muscle strength compared with muscle endurance. In a retrospective study by Raab et al, inspiratory or combined inspiratory and expiratory muscle training was performed in a group setting with respiratory function measurements before and after the training period (16). They found that the training improved respiratory functions, but the relative improvements in combined respiratory muscle training were comparable with isolated inspiratory muscle training.…”

Section: Discussionmentioning

confidence: 99%

Respiratory muscle endurance training with normocapnic hyperpnoea for patients with chronic spinal cord injury: A pilot short-term randomized controlled trial

Xi¹,

Jiang²,

Zhang³

et al. 2019

J Rehabil Med

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LAY ABSTRACTRespiratory muscle endurance training is beneficial for patients with chronic spinal cord injury. This study measured the effects of respiratory muscle endurance training on lung function and patient-reported outcomes. Eighteen patients with spinal cord injury who were > 24 months post-injury were randomly assigned to either a studied or a control group. The results showed that endurance training may reduce the incidence of respiratory symptoms, improve lung function and quality of life, and reduce depression in patients with chronic spinal cord injury, regardless of their neurological level of injury, even at more than 24 months after injury. Objective: To investigate the effects of normocapnic hyperpnoea training on pulmonary function and patient-reported outcomes in chronic spinal cord injury. Design: Single-centre randomized controlled trial. Patients: Eighteen patients with spinal cord injury > 24 months post-injury and without regular respiratory muscle training prior to the study were included prospectively. Methods: Patients were randomly assigned to either normocapnic hyperpnoea or control groups. The normocapnic hyperpnoea group patients performed training 15-20 min per day, 5 times a week for 4 weeks. The patients hyperventilated through partial re-breathing of ventilated air. The control group received no respiratory muscle training. Other rehabilitative programmes were performed identically in both groups. Lung function testing was performed in the sitting position prior to and after the study. Patient-reported outcomes were assessed using the Patient Health Questionnaire-9, St George's Respiratory Questionnaire, Chronic Obstructive Pulmonary Disease Assessment Test and Borg scores.Results: Significant differences were found in the improvement ratio between the normocapnic hyperpnoea and control groups for all investigated parameters, except total lung capacity and diffusing capacity of the lung for carbon monoxide. Conclusion: Normocapnic hyperpnoea training may reduce the incidence of respiratory symptoms, improve pulmonary function and quality of life, and reduce depression in patients with chronic spinal cord injury, regardless of their neurological level of injury, even at more than 24 months after injury.

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Section: Discussionmentioning

confidence: 99%

Respiratory muscle endurance training with normocapnic hyperpnoea for patients with chronic spinal cord injury: A pilot short-term randomized controlled trial

Xi¹,

Jiang²,

Zhang³

et al. 2019

J Rehabil Med

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“…[63][64][65][66] RST increases inspiratory and expiratory pressure-generating capacity, vital capacity, and maximal voluntary ventilation in adults with SCI. [66][67][68] These gains in respiratory function help protect against potentially life-threatening complications like pneumonia. 69 Examples of RST include resistive training or threshold training for both inspiration and expiration (IMST/EMST) 67 and can successfully be implemented in rehabilitation settings.…”

Section: Training and Treatmentmentioning

confidence: 99%

“…76 These measures are reliable in the SCI population, 77 easy to perform, are relatively low-cost measures, and are necessary to perform regularly to adapt RST goals (Table 3). 68,78 Furthermore, quantitative measurement of respiratory function should be used to guide education needs, home exercise, monitoring frequency, and resource needs after discharge from inpatient rehabilitation. 68,78…”

Section: Quantitative Measurementmentioning

confidence: 99%

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Diaphragm Pacing and a Model for Respiratory Rehabilitation After Spinal Cord Injury

Cavka

Fuller

Tonuzi

et al. 2021

Journal of Neurologic Physical Therapy

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“…The following examinations and assessments were identified as being performed insufficiently often [19] within the time frame recommended by the EMSCI [22] or by the clinic's internal recommendation list [14]: magnetic resonance imaging (MRI) and computed tomography (CT) of the spine during initial treatment (trauma protocol), recommended within eight days after newly acquired spinal cord injury [23]; manual muscle test of the lower extremity, recommended within 28 days after newly acquired spinal cord injury [24]; International Standards For Neurological Classification of Spinal Cord Injury (ISNCSCI), recommended either within eight days after admission to a specialised acute and rehabilitation clinic or within 40 days after newly acquired spinal cord injury [25][26][27]; electrophysiological evaluation of the lower extremity, recommended within 40 days after newly acquired spinal cord injury [28]; urodynamic testing, recommended within 84 days after newly acquired spinal cord injury [18]; and lung function testing, recommended within 40 days after newly acquired spinal cord injury [29].…”

Section: Assessmentsmentioning

confidence: 99%

Examinations and assessments in patients with a newly acquired spinal cord injury – retrospective chart analysis as part of a quality improvement project

Scheel‐Sailer¹,

Sailer²,

Lampart³

et al. 2020

Swiss Med Wkly

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AIMS OF THE STUDY: Examinations and assessments can be used to ensure good quality rehabilitation. Within the framework of a quality improvement project, the aims of the current analysis were: first, to analyse the time points of selected examinations and assessments in the rehabilitation process of patients with a newly acquired spinal cord injury. Second, to identify differences between the subgroups with different aetiologies, levels and completeness of spinal cord injuries. And third, to compare the examinations and assessments performed with the guideline recommendations and to use discrepancies as a starting point for a quality improvement project. METHODS: In this retrospective chart analysis, adult patients with a newly acquired spinal cord injury who were admitted to a single specialised acute care and rehabilitation clinic for their first rehabilitation between December 2013 and December 2014 were included and assessed until discharge. The main objective was to assess the time to examinations or assessments after injury or hospital admission in comparison to the respective recommendations. Analyses were done using time-to-event analysis and represented graphically using Kaplan-Meier plots.RESULTS: Of the 105 patients included in this study (median age 58 years, 29% female), 61% had a traumatic and 39% a non-traumatic spinal cord injury; 39% were paraplegic and 61% were quadriplegic; and 59% had a motor complete and 41% a sensor-motor incomplete spinal cord injury. The percentage of patients for whom the respective assessment or examination was performed and the percentage of these patients for whom it performed within the recommended time were: 90% and 71% for magnetic resonance imaging; 85% and 90% for computed tomography; 87% and 79% for the manual muscle test; 95% and 59% for the International Standards for Neurological Classification of Spinal Cord (ISNCSCI); 84% and 50% for electrophysiological assessment; 73% and 90% for urodynamic testing; and 49% and 53% for lung function testing. CONCLUSIONS: Our data suggest a relevant gap between recommendations and clinical routine for time to some assessments after spinal cord injury. Within the framework of a quality improvement project, the next steps should be to build a national and international consensus on specific time frames for examinations and assessments in patients with a newly acquired spinal cord injury and thereafter, to develop an institutional implementation strategy.

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Evaluation of a clinical implementation of a respiratory muscle training group during spinal cord injury rehabilitation

Cited by 7 publications

References 29 publications

Respiratory muscle endurance training with normocapnic hyperpnoea for patients with chronic spinal cord injury: A pilot short-term randomized controlled trial

Respiratory muscle endurance training with normocapnic hyperpnoea for patients with chronic spinal cord injury: A pilot short-term randomized controlled trial

Diaphragm Pacing and a Model for Respiratory Rehabilitation After Spinal Cord Injury

Examinations and assessments in patients with a newly acquired spinal cord injury – retrospective chart analysis as part of a quality improvement project

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