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Phys Ther. 2014 Dec;94(12):1709-19. doi: 10.2522/ptj.20140079. Epub 2014 Jul 31.

Resistive inspiratory muscle training in people with spinal cord injury during inpatient rehabilitation: a randomized controlled trial.

Author information

1
K. Postma, MSc, Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, the Netherlands; and Rijndam Rehabilitation Center, Rotterdam. kpostma@rijndam.nl.
2
J.A. Haisma, MD, PhD, Department of Rehabilitation Medicine, Kennemer Gasthuis, Haarlem, the Netherlands.
3
M.T.E. Hopman, MD, PhD, Department of Physiology, Radboud University Nijmegen Medical Center, Nijmegen, the Netherlands.
4
M.P. Bergen, MD, PhD, Rijndam Rehabilitation Center, Rotterdam.
5
H.J. Stam, MD, PhD, Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam.
6
J.B. Bussmann, MD, PhD, Department of Rehabilitation Medicine, Erasmus MC, University Medical Center Rotterdam.

Abstract

BACKGROUND:

People with spinal cord injury (SCI) may benefit from resistive inspiratory muscle training (RIMT). Current evidence is weak, and little is known about the effect on functional outcomes and long-term effects.

OBJECTIVE:

The purpose of this study was to assess immediate and long-term effects of RIMT in people with SCI.

DESIGN:

This was a single-blinded randomized controlled trial.

SETTING:

The study was conducted at 4 specialized SCI units in the Netherlands.

PATIENTS:

The study participants were 40 people with SCI (15 with motor complete tetraplegia, 16 with incomplete tetraplegia, 8 with motor complete paraplegia, and 1 with incomplete paraplegia) who had impaired pulmonary function and were admitted for initial inpatient rehabilitation.

INTERVENTION:

Study participants were randomized to an RIMT group or a control group. All participants received usual rehabilitation care. In addition, participants in the intervention group performed RIMT with a threshold trainer.

MEASUREMENTS:

Measurements were performed at baseline, after 8 weeks of intervention, 8 weeks later, and 1 year after discharge from inpatient rehabilitation. Primary outcome measures were: respiratory muscle function, lung volumes and flows, and perceived respiratory function. Secondary outcome measures concerned patient functioning, which included health-related quality of life, limitations in daily life due to respiratory problems, and respiratory complications.

RESULTS:

During the intervention period, maximum inspiratory pressure (MIP) improved more in the RIMT group than in the control group (11.7 cm H2O, 95% confidence interval=4.3 to 19.0). At follow-up, this effect was no longer significant. No effect on other primary or secondary outcome measures was found except for an immediate effect on mental health.

LIMITATIONS:

The sample size was insufficient to study effects on respiratory complications.

CONCLUSIONS:

Resistive inspiratory muscle training has a positive short-term effect on inspiratory muscle function in people with SCI who have impaired pulmonary function during inpatient rehabilitation.

PMID:
25082923
DOI:
10.2522/ptj.20140079
[Indexed for MEDLINE]

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