Authors (including presenting author) :
Chan KNH(1), Law JCF(1), Tsui AYC(1), Siu EHK(1)
Affiliation :
(1)Physiotherapy Department, Prince of Wales Hospital
Introduction :
Spinal cord injury (SCI) related respiratory dysfunction is a leading cause of mortality and illness. Approximately 40% of SCI cases affect the upper cervical segments, leading to neurological impairment of the phrenic system and reduced activation of the diaphragm (Gu et al., 2020). Diaphragmatic pacing (DP) is a promising approach to assist patients in weaning of mechanical ventilation and counteract its negative impacts. There are accumulating studies recommending the need for incorporating respiratory training in chronic SCI patients with DP as a rehabilitative strategy to increase motor output and enhance respiratory function and recovery in chronic SCI patients (Cavka et al., 2021). This case report explores the effectiveness of inspiratory muscle training for chronic cervical SCI patients with recent implementation of DP, which has not been researched before.
Objectives :
To share the local experience and evaluate the effectiveness of inspiratory muscle training with the use of incentive spirometer on respiratory function in a chronic cervical SCI patients with recent implementation of DP.
Methodology :
A 62-year-old man with tetraplegia following cervical SCI resulting from a construction accident underwent DP at 6 years post- injury to improve respiratory function. 8 weeks of inspiratory muscle training using an incentive spirometer (CliniFLO) was implemented. The primary outcome measure was maximal inspiratory pressure (MIP). Secondary outcome measures including ventilator weaning time, inspiratory flow and amount and colour of sputum were evaluated.
Result & Outcome :
Implementation of CliniFLO treatment resulted in an average improvements in maximal inspiratory pressure (MIP; from 13cmH2O to 22cmH2O), inspiratory flow (from 300mL/s to 500mL/s) and amount of sputum production (from moderate to fair). These findings contribute to the limited evidence available and highlight the advantages of inspiratory muscle training with the use of incentive spirometer in individuals with tetraplegia following cervical SCI who has undergone DP.
