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Published on: January 10, 2013
Respiratory Function in Participants With Spinal Cord Injury in a Rehabilitation Center Using Neuromuscular
Carla Fakih Alves1, Karla Rocha Pithon2, Orcizo Francisco Silvestre3
1Department of Orthopedics, Rheumatology and Traumatology, Clinic Hospital of State University of Campinas (UNICAMP), São Paulo, Brazil; State University of Campinas-UNICAMP, São Paulo, Brazil; Unifaat University Center - Atibaia, 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 spinal cord injury (SCI) (≥10y), tetraplegia or paraplegia, classified as American Spinal Cord Association Impairment Scale A, B, or C. All participants had been enrolled in the NMES rehabilitation program for ≥3 years. Twenty-five individuals were recruited and allocated to 2 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 before SCI.
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 1 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 a mean injury duration of 18±6.7 years. In group B, mean FVC was 90.3%±12.7%, FEV1 was 89.3%±12.4%, and Tiffeneau index was 99%±4.7%, with a mean injury duration of 15±5.8 years. 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 implication of an NMES rehabilitation program is the preservation of respiratory function in individuals with chronic SCI.
