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Evaluation of Respiratory Muscle Activation Using Respiratory Motor Control Assessment (RMCA) in Individuals with Chronic Spinal Cord Injury
Published on: July 19, 2013
Respiratory dysfunction and management in spinal cord injury
Robert Brown1, Anthony F DiMarco, Jeannette D Hoit
1Pulmonary and Critical Care Unit, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. rbrown5@partners.org
Respiratory Care
|July 27, 2006
Summary
Spinal cord injury (SCI) severely impacts respiratory function and speech. Innovations like phrenic nerve pacing and improved ventilator strategies enhance breathing and communication for those with SCI.
Area of Science:
- Neurology
- Pulmonology
- Rehabilitation Medicine
Background:
- Spinal cord injury (SCI) frequently leads to respiratory dysfunction, impacting morbidity and mortality.
- Impaired respiratory muscles, reduced vital capacity, and ineffective cough are common in SCI patients.
- Assisted ventilation in severe SCI can compromise speech production.
Purpose of the Study:
- To review current understanding and management of respiratory dysfunction in spinal cord injury.
- To explore advancements in respiratory support and speech production for SCI patients.
- To identify factors influencing mortality and improve clinical care for SCI.
Main Methods:
- Literature review of respiratory management in spinal cord injury.
- Analysis of spontaneous recovery and rehabilitation techniques for respiratory muscles.
- Evaluation of novel interventions like phrenic nerve pacing and ventilator adjustments for speech.
Main Results:
- Phrenic nerve pacing and external intercostal muscle pacing can liberate patients from mechanical ventilation.
- Respiratory muscle training and abdominal binders improve respiratory muscle performance and speech quality.
- Diabetes, heart disease, smoking, and reduced forced expiratory volume predict mortality in SCI.
Conclusions:
- Improved care has potentially reduced mortality directly related to SCI level and age.
- Effective management of respiratory and speech issues is crucial for SCI patient outcomes.
- Emerging techniques like epidural electrical stimulation show promise for future respiratory muscle activation.
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