Respiratory Effects of Combined Truncal and Abdominal Support in Patients With Spinal Cord Injury

Abstract

Hart N, Laffont I, Perez de La Sota A, Lejaille M, Macadou G, Polkey MI, Denys P, Lofaso F. Respiratory effects of combined truncal and abdominal support in patients with spinal cord injury. Objective To determine whether a custom girdle, designed to provide truncal stability and abdominal support, will improve pulmonary function, enhance inspiratory muscle activity, and reduce the sensation of respiratory effort in patients with spinal cord injury (SCI). Design Pulmonary function, transdiaphragmatic pressure time product (PTP di), twitch (Tw Pdi) and maximal transdiaphragmatic pressures (Pdi), and perception of respiratory effort (Borg Rating of Perceived Exertion score) were measured with and without an abdominal girdle in a seated position. Setting Rehabilitation hospital. Participants Ten patients with posttrauma SCI (injury level, C5–T6). Intervention Application of the abdominal girdle. Main Outcome Measures Borg score and measures of lung volumes, dynamic abdominal compliance, and Tw Pdi and maximal Pdi. Results Wearing of the girdle was associated with a lower Borg score ( P=.002) and reduced functional residual capacity ( P=.006) but increased inspiratory capacity ( P=.02) and forced vital capacity ( P=.02). Although there was a decrease in dynamic abdominal compliance ( P<.001) and an increase in PTP di ( P=.02), this was accompanied by an increase in both Tw Pdi ( P=.02) and maximal Pdi ( P=.03). Conclusions The custom girdle reduced the sensation of respiratory effort in patients with SCI by optimizing the operating lung volumes and decreasing abdominal compliance, which enhanced diaphragm performance.