Inspiratory Muscle Training for Individuals with Cervical Spinal Cord Injury or Chronic Obstructive Pulmonary Disease: A Survey of Canadian Physical Therapists

Abstract

Purpose: The objective of this study was to describe the current practice of Canadian physical therapists (PTs) using inspiratory muscle training (IMT) in the management of patients with cervical spinal cord injury (CSCI) or chronic obstructive pulmonary disease (COPD). Method: A postal survey was sent to all Canadian acute-care hospitals (. 250 beds) and to all centres providing rehabilitation for patients with CSCI or COPD. PTs were asked whether they used IMT and, if so, to describe patients for whom IMT was appropriate, as well as the devices and training protocols used. They were asked to list any contraindications to IMT. Results: One hundred nineteen questionnaires were sent to PTs treating patients with CSCI and 145 to PTs treating patients with COPD. The response rates were 70.6 per cent (CSCI) and 65.5 per cent (COPD). The rates of IMT use were 17.4 per cent (CSCI) and 4.7 per cent (COPD). The reasons for non-use included no knowledge about or training in IMT, a lack of resources, patients who were inappropriate for this treatment and no evidence of effectiveness. Conclusions: Few PTs are using IMT for patients with either CSCI or COPD. Little evidence exists of the effectiveness of IMT with CSCI patients, with stronger evidence of effectiveness in patients with COPD. A potentially effective modality for patients with COPD and CSCI, IMT appears to be underused by Canadian PTs.