Respiratory System Responses to Exercise in Spinal Cord Injury

Abstract

In the previous half-century, outcomes for people with spinal cord injury (SCI) have dramatically improved. Nevertheless, respiratory complications are still frequently observed, especially in those with cervical SCI. In this chapter, we synthesize current knowledge regarding the changes in pulmonary and respiratory muscle function that occur after SCI, and emphasise the respiratory responses to exercise. We do not provide extensive background on respiratory function in the acute period post-SCI or discuss clinical pulmonary complications such as cough and sleep disordered breathing. Data are presented for both trained and untrained individuals with SCI and, when available, by level of injury. However, since the majority of respiratory complications are present only in those with cervical and high-thoracic SCI, most studies are delimited to these levels of injury. Finally, despite the well-appreciated sex-based differences in respiratory function that exist in able-bodied individuals, no studies have stratified respiratory outcomes by sex; this is likely due to the fivefold higher incidence of SCI in men vs. women. Thus, the focus of this chapter is on the respiratory responses to SCI at rest and during exercise in men with high-level SCI.