Short-term effects of respiratory muscle training combined with the abdominal drawing-in maneuver on the decreased pulmonary function of individuals with chronic spinal cord injury: A pilot randomized controlled trial

Abstract

Objective: To investigate the effects of respiratory muscle training (RMT) combined with the abdominal drawingin maneuver (ADIM) on the pulmonary function in patients with chronic spinal cord injury (SCI). Methods: Thirty-seven subjects with SCI (level of injury: C4-T6, time since injury: 4-5 years) were randomly allocated to three groups; the integrated training group (ITG), the RMT group (RMTG), and the control group (CG). The ITG performed RMT using an incentive respiratory spirometer (IRS) and the ADIM using a stabilizer. The RMTG received only RMT using an IRS. Subjects in the CG received alternative and routine physical therapy or usual care. The interventions were conducted over an eight-week period. Pulmonary function was evaluated using spirometry to measure the forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV 1 ). Results: The differences between the pre-and post-test values for FVC (0.47 ± 0.05 versus 0.15 ± 0.06 versus -0.03 ± 0.01) and FEV 1 (0.74 ± 0.07 versus 0.27 ± 0.17 versus 0.02 ± 0.67)were significant among the groups. Post-test, in the ITG, the FVC and FEV 1 values showed significant differences from those in the RMTG and CG (F = 11.48 and 11.49, P = 0.002 and 0.001). Furthermore, following the 8week intervention, the change ratio values of the FVC and FEV 1 of the ITG were increased further by an average of 9.75% and 7.91%, respectively, compared with those of the RMTG. Conclusion: These findings suggest positive evidence that RMT with additional ADIM training can improve pulmonary function in SCI pulmonary rehabilitation.

Effect of Static Abdominals Training and Incentive Spirometer in Improvement of Pulmonary Function and Abdominal Strength in Spinal Cord Injury Patients- A Comparative Study

“…The increase in FEV1 following intervention may be due to the fact that the subjects became accustomed to RMT and ADIM and had their pulmonary functions measured repeatedly. However, the CG did not show a statistically significant difference, suggesting that there was no learning effect from repeated measurement and testing of pulmonary function [10].…”

“…For patients with SCI who require intensive rehabilitation, ADIM helps these muscles to perform better during aerobic activities requiring endurance, thereby improving the performance of these patients in activities of daily living [10].…”

“…This increases intra-abdominal pressure, facilitating upward movement of the diaphragm, and decreases pleural pressure and lung volume, improving expiratory and sputum discharge abilities [10].…”

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

“…We reasoned that training of muscle endurance might be more suitable for patients with chronic SCI, given the slow progression of hypercapnic respiratory failure, while training of muscle strength might be more suitable for those with acute SCI. The improvement in MVV in the NH group also suggested better endurance compared with the control group (Table II) (5). Their study included patients with SCI with a time post-injury > 3 years.…”

“…Early initiation of RMT after an SCI may have a positive effect on respiratory function and prevent respiratory complications (4). Patients may benefit from RMT even after several years of injury (5). The most widely used type of RMT facilitates flow resistive devices to add additional work on inspiration and/or expiration (3).…”