Vital capacity in tetraplegics twenty years and beyond

Abstract

Objectives: To observe the trends in vital capacity (VC) over time in tetraplegics 20 years and more after injury, the e ects of age at injury, severity of injury and gender on this trend. Methods: The medical records of all spinal cord injured persons admitted to a regional spinal injury center from January 1960 to December 1996 were reviewed. Fifty-seven patients had documented post-rehabilitation VC (mean 1.3+1.1 years) and VC at 10 (mean 11.8+2.69) and 20 (20.60+2.67) years post injury and beyond. Results: The mean age at injury was 23.2+9.1 years. Severity of injury when classi®ed according the system proposed by Coll et al were: Group 1: C1 ± 4 Frankel A injury: 11.6%, Group 2: C5 ± 8 Frankel A injury: 55.6%, Group 3: C2 ± 8 Frankel B and C: 29.8% and Group 4: C2 ± 8 Frankel D: 3.5% respectively. The mean VC at initial, 10 and 20 years post injury was 2586+948, 2803+940 and 2525+818 cc respectively. Multivariate analysis of variance revealed that there was signi®cant di erence in VC over a 20 year period, (F(2,54)=8.43, P50.05). The di erence between VC at 10 years and VC at 20 years accounted for the 19.8% of the variance in VC over time (F(1,55)=12.35, P50.05). Age at injury, gender and severity of injury did not have a signi®cant in¯uence on the rate of decline in VC. Analysis of a subset of 26 patients who were followed up more than 20 years post injury (range 22 to 34.5 years) revealed similar,

Respiration following spinal cord injury: Evidence for human neuroplasticity

“…In a small series of 12 patients with complete diaphragm paralysis after upper cervical SCI, spontaneous recovery of diaphragmatic activity was seen between 40 and 569 days after SCI, with 7 of the 12 achieving ventilator independence (Oo et al, 1999). In another study, improvement in certain pulmonary function measures were seen as late as 10 years after SCI (Tow et al, 2001), although this finding has not been universally observed (Fugl-Meyer, 1971). …”

Respiratory muscle training in persons with spinal cord injury: A systematic review

“…Respiratory complications, quality of life and exercise performance Although subjects with SCI have an impaired pulmonary function 3,4,[8][9][10] and are at higher risk for respiratory complications 2,13-15 and mortality, 2,15 only one study 19 reported changes in resting dyspnea. Also in patients with chronic obstructive pulmonary disease RMT already resulted in relieve of dyspnea and improved quality of life.…”

“…[5][6][7] This results in a decreased efficiency of breathing, a reduction in maximal static respiratory pressures and in reduced pulmonary volumes. 3,4,[8][9][10][11] Moreover, decreased ability to sigh, ineffective coughing and development of mucus hypersecretion will result in inadequate clearance of mucus. 12 All of the foregoing factors contribute to high prevalence of mucus retention, atelectasis, pneumonia and respiratory failure.…”

The Management of Secondary Complications Following Spinal Cord Injury

“…Pulmonary function can be followed over time using parameters such as serial vital capacities (VCs) and negative inspiratory forces (NIFs). As an individual ages following an SCI, pulmonary function can be expected to decline, 60 and these parameters can alert the clinician to impending respiratory insufficiency. Parameters can be assessed annually, with the goal of identifying early deterioration in pulmonary function before it becomes clinically urgent.…”