Impact of respiratory muscle training on respiratory muscle strength, respiratory function and quality of life in individuals with tetraplegia: a randomised clinical trial

BackgroundRespiratory complications remain a leading cause of morbidity and mortality in people with acute and chronic tetraplegia. Respiratory muscle weakness following spinal cord injury-induced tetraplegia impairs lung function and the ability to cough. In particular, inspiratory muscle strength...

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Bibliographic Details
Published in:Thorax 2020-03, Vol.75 (3), p.279-288
Main Authors: Boswell-Ruys, Claire L, Lewis, Chaminda R H, Wijeysuriya, Nirupama S, McBain, Rachel A, Lee, Bonsan Bonne, McKenzie, David K, Gandevia, Simon C, Butler, Jane E
Format: Article
Language:English
Subjects:
Adult
Aged
Asthma
Breathing Exercises
Double-Blind Method
Dyspnea - etiology
exercise
Female
Humans
Infections
Inhalation
Lung - physiopathology
Male
Maximal Respiratory Pressures
Middle Aged
Morbidity
Mortality
Muscle Strength
perception of asthma/breathlessness
Pneumonia
pulmonary rehabilitation
Quadriplegia - complications
Quadriplegia - physiopathology
Quadriplegia - rehabilitation
Quality of Life
respiratory infection
respiratory measurement
respiratory muscles
Respiratory Muscles - physiopathology
Respiratory research
Spinal cord injuries
Symptom Assessment
Training
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Summary:BackgroundRespiratory complications remain a leading cause of morbidity and mortality in people with acute and chronic tetraplegia. Respiratory muscle weakness following spinal cord injury-induced tetraplegia impairs lung function and the ability to cough. In particular, inspiratory muscle strength has been identified as the best predictor of the likelihood of developing pneumonia in individuals with tetraplegia. We hypothesised that 6 weeks of progressive respiratory muscle training (RMT) increases respiratory muscle strength with improvements in lung function, quality of life and respiratory health.MethodsSixty-two adults with tetraplegia participated in a double-blind randomised controlled trial. Active or sham RMT was performed twice daily for 6 weeks. Inspiratory muscle strength, measured as maximal inspiratory pressure (PImax) was the primary outcome. Secondary outcomes included lung function, quality of life and respiratory health. Between-group comparisons were obtained with linear models adjusting for baseline values of the outcomes.ResultsAfter 6 weeks, there was a greater improvement in PImax in the active group than in the sham group (mean difference 11.5 cmH2O (95% CI 5.6 to 17.4), p
ISSN:0040-6376
1468-3296
DOI:10.1136/thoraxjnl-2019-213917