Respiratory function in patients with spinal cord injuries: effects of posture

The purpose of this study was to evaluate the respiratory function of spinal cord injuries (SCI) during different postures. Measurements were performed with a Fukuda PM 80 spirometer on 31 chronic stable SCI and 22 normal controls. Among the SCI patients, there were 12 quadriplegics and 19 paraplegics. The respiratory parameters, including forced vital capacity (FVC) and forced expiratory volume during first second (FEV1.0) were collected in each subject during supine, sitting and standing postures. The results revealed that SCI patient had impaired FVCs (p less than 0.05), the degree of impairment depending upon the level of cord injury (r = 0.81). The FEV1.0/FVC ratio of SCI was normal. For quadriplegics, the FVC during sitting and standing fell on 30 to 50% of normal values. The FVCs of paraplegics during all postures were around 80% of the predicted values. The FVC in the control group was reduced by 5 to 7% when changing postures from erect to supine. This study concludes that respiratory impairment does occur in SCI. The results obtained display a typical pattern of restrictive pulmonary impairment. The severity of the impairment is affected by the level of cord damage and is posturally dependent.