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Published on: January 10, 2013
Respiratory Function in Participants with Spinal Cord Injury of a Rehabilitation Center using Neuromuscular
Carla Fakih Alves1, Karla Rocha Pithon2, Orcizo Francisco Silvestre1
1Clinic Hospital of State University of Campinas (UNICAMP), Department of Orthopedics, Rheumatology and Traumatology. Campinas, São Paulo, Brazil.
Objective:
To observe the respiratory function of individuals participating in a rehabilitation program with neuromuscular electrical stimulation (NMES).
Design:
Cross-sectional study.
Setting:
A tertiary care hospital offering outpatient care.
Participants:
A convenience sample of adults with chronic SCI (≥10 years), tetraplegia or paraplegia, classified as AIS A, B, or C. All participants had been enrolled in the NMES rehabilitation program for at least three years. Twenty-five individuals were recruited and allocated to two groups: group A, individuals with tetraplegia (n=6) and group B, individuals with paraplegia (n= 16). Three individuals were excluded from group B because they had lung disease prior to spinal cord injury.
Interventions:
Not applicable.
Main Outcome Measure:
Measurement of respiratory function using spirometry in individuals with SCI in a rehabilitation program.
Results:
The spirometry was performed, measuring forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and Tiffeneau index. Overall, 77% completed the maneuvers satisfactorily. No participants reported dyspnea during daily activities. In Group A, mean FVC was 51% ±10.9 of predicted, FEV1 was 50.8% ±9.4, and Tiffeneau index was 101% ±3.7, with mean injury duration of 18 years ±6.7. In Group B, mean FVC was 90.3% ±12.7, FEV1 was 89.3% ±12.4, and Tiffeneau index was 99% ±4.7, with mean injury duration of 15 years ±5.8. Significant differences were found in FVC and FEV1 between groups (p < .001).
Conclusions:
Individuals with paraplegia demonstrated spirometric values within the normal range despite long-standing injuries, even at higher neurological levels. The tetraplegic individuals showed values around 50% of predicted. However, no abnormalities were detected on pulmonary auscultation, and no clinical symptoms were reported. These findings suggest that a potential clinical practice implications of NMES rehabilitation program is the preservation of respiratory function in individuals with chronic SCI.
