Physiotherapy rehabilitation of respiratory system and the factors which facilitate its plasticity after Spinal Cord Injury
Keywords:
spinal cord injury, respiratory physiotherapy, respiratory muscle trainingAbstract
Spinal cord injury (SCI) is quite common and can occur either as an acute injury after an accident or a fall, or as the result of other pathological conditions. SCI results in important loss of functionality, which apart from the kinetic affects multiple physiological systems, such as the respiratory system. The aim of this study was to review the methods of respiratory physiotherapy rehabilitation in patients with SCI. For this reason, a review of the current literature was performed by using the online PUBMED database and the following keywords: spinal cord injury; respiratory physiotherapy; respiratory muscle training. Inclusion criteria in the review were: primary studies in humans with SCI, published after 2000 in English language. Twenty-one studies were finally included in the review. Currently, many respiratory physiotherapy protocols are available aiming at the strengthening of respiratory and abdominal muscles, respiration training and phrenic nerve stimulation. The respiratory and abdominal muscles strengthening interventions improve respiratory function and cough production capacity and decrease the frequency of respiratory infections. Phrenic nerve stimulation constitutes a promising technique, as it promotes cough production, decreases respiratory infections and is more cost- effective compared with other respiratory physiotherapy interventions.
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References
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17. Laffont, I., Bensmail, D., Lortat-Jacob, S., Falaize, L., Hutin, C., Le Bomin, E., ... & Lofaso, F. (2008). Intermittent positive-pressure breathing effects in patients with high spinal cord injury. Archives of physical medicine and rehabilitation, 89(8), 1575-1579.
18. Liaw, M. Y., Lin, M. C., Cheng, P. T., Wong, M. K. A., & Tang, F. T. (2000). Resistive inspiratory muscle training: its effectiveness in patients with acute complete cervical cord injury. Archives of physical medicine and rehabilitation, 81(6), 752-756.
19. Litchke, L. G., Russian, C. J., Lloyd, L. K., Schmidt, E. A., Price, L., & Walker, J. L. (2008). Effects of respiratory resistance training with a concurrent flow device on wheelchair athletes. The journal of spinal cord medicine, 31(1), 65-71.
20. McBain, R. A., Boswell-Ruys, C. L., Lee, B. B., Gandevia, S. C., & Butler, J. E. (2013). Abdominal muscle training can enhance cough after spinal cord injury. Neurorehabilitation and neural repair, 27(9), 834-843.
21. McCaughey, E. J., Berry, H. R., McLean, A. N., Allan, D. B., & Gollee, H. (2015). Abdominal functional electrical stimulation to assist ventilator weaning in acute tetraplegia: a cohort study. PloS one, 10(6), e0128589.
22. McKinley W.O., Jackson A.B., Cardenas D.D., DeVivo M.J. (1999). Long-term medical complications after traumatic spinal cord injury: a regional model systems analysis. Archives of physical medicine and rehabilitation, 80(11): 1402-10.
23. Pillastrini, P., Bordini, S., Bazzocchi, G., Belloni, G., & Menarini, M. (2006). Study of the effectiveness of bronchial clearance in subjects with upper spinal cord injuries: examination of a rehabilitation programme involving mechanical insufflation and exsufflation. Spinal cord, 44(10), 614-616.
24. Pizzolato, C., Gunduz, M. A., Palipana, D., Wu, J., Grant, G., Hall, S., ... & Teng, Y. D. (2021). Non-Invasive Approaches to Functional Recovery after Spinal Cord Injury: Therapeutic Targets and Multimodal Device Interventions. Experimental Neurology, 113612.
25. Postma, K., Haisma, J. A., Hopman, M. T., Bergen, M. P., Stam, H. J., & Bussmann, J. B. (2014). Resistive inspiratory muscle training in people with spinal cord injury during inpatient rehabilitation: a randomized controlled trial. Physical therapy, 94(12), 1709-1719.
26. Postma, K., Vlemmix, L. Y., Haisma, J. A., De Groot, S., Sluis, T. A., Stam, H. J., & Bussmann, J. B. (2015). Longitudinal association between respiratory muscle strength and cough capacity in persons with spinal cord injury: an explorative analysis of data from a randomized controlled trial. Journal of rehabilitation medicine, 47(8), 722-726.
27. Raab, A. M., Krebs, J., Pfister, M., Perret, C., Hopman, M., & Mueller, G. (2019). Respiratory muscle training in individuals with spinal cord injury: effect of training intensity and-volume on improvements in respiratory muscle strength. Spinal cord, 57(6), 482-489.
28. Roth, E. J., Stenson, K. W., Powley, S., Oken, J., Primack, S., Nussbaum, S. B., & Berkowitz, M. (2010). Expiratory muscle training in spinal cord injury: a randomized controlled trial. Archives of physical medicine and rehabilitation, 91(6), 857-861.
29. Sutbeyaz, S. T., Koseoglu, B. F., & Gokkaya, N. K. (2005). The combined effects of controlled breathing techniques and ventilatory and upper extremity muscle exercise on cardiopulmonary responses in patients with spinal cord injury. International Journal of Rehabilitation Research, 28(3), 273-276.
30. Tamplin, J., Baker, F. A., Buttifant, M., & Berlowitz, D. J. (2014). The effect of singing training on voice quality for people with quadriplegia. Journal of Voice, 28(1), 128-e19.
31. Tester, N. J., Fuller, D. D., Fromm, J. S., Spiess, M. R., Behrman, A. L., & Mateika, J. H. (2014). Long-term facilitation of ventilation in humans with chronic spinal cord injury. American journal of respiratory and critical care medicine, 189(1), 57-65.
32. Van Houtte, S., Vanlandewijck, Y., Kiekens, C., Spengler, C. M., & Gosselink, R. (2008). Patients with acute spinal cord injury benefit from normocapnic hyperpnoea training. Journal of rehabilitation medicine, 40(2), 119-125.
33. Wadsworth, B. M., Haines, T. P., Cornwell, P. L., Rodwell, L. T., & Paratz, J. D. (2012). Abdominal binder improves lung volumes and voice in people with tetraplegic spinal cord injury. Archives of physical medicine and rehabilitation, 93(12), 2189-2197.
34. Warren, P. M., & Alilain, W. J. (2014). The challenges of respiratory motor system recovery following cervical spinal cord injury. Progress in brain research, 212, 173-220.
35. Xi, J., Jiang, H., Zhang, N., Wang, J., Zhang, B., Cao, H., ... & Zhao, Z. (2019). Respiratory muscle endurance training with normocapnic hyperpnoea for patients with chronic spinal cord injury: a pilot short-term randomized controlled trial. Journal of rehabilitation medicine, 51(8), 616-620.
2. Andrade, M. J., Quintas, F. L., Silva, A. M., & Cruz, P. (2021). Is autonomic dysreflexia a cause of respiratory dysfunction after spinal cord injury?. Spinal Cord Series and Cases, 7(1), 1-4.
3. Boswell-Ruys, C. L., Lewis, C. R., Wijeysuriya, N. S., McBain, R. A., Lee, B. B., McKenzie, D. K., ... & Butler, J. E. (2020). Impact of respiratory muscle training on respiratory muscle strength, respiratory function and quality of life in individuals with tetraplegia: a randomised clinical trial. Thorax, 75(3), 279-288.
4. Bryce, T. N., Huang, V., & Escalon, M. X. (2021). Spinal cord injury. In Braddom’s Physical Medicine and Rehabilitation (pp. 1049-1100). Elsevier.
5. Creasey G.H., Chester H.,H., Triolo R.,J., Gater D. R., DiMarco A.F., Bogie K.M., Keith M.W. (2004). Clinical applications of electrical stimulation after spinal cord injury. Journey of spinal cord medicine, 27(4): 365-75.
6. DeVivo M.J, Krause J.S., Lammertse D.P, (1999). Recent trends in mortality and causes of death among persons with spinal cord injury. Archives of physical medicine & rehabilitation, 80(11): 1411-9.
7. DiMarco, A. F., Geertman, R. T., Tabbaa, K., & Kowalski, K. E. (2019). Complete restoration of respiratory muscle function in three subjects with spinal cord injury: pilot interventional clinical trial. American journal of physical medicine & rehabilitation, 98(1), 43-50.
8. DiMarco, A. F., Kowalski, K. E., Geertman, R. T., & Hromyak, D. R. (2009). Lower thoracic spinal cord stimulation to restore cough in patients with spinal cord injury: results of a National Institutes of Health–sponsored clinical trial. Part I: methodology and effectiveness of expiratory muscle activation. Archives of physical medicine and rehabilitation, 90(5), 717-725.
9. DiMarco, A. F., Kowalski, K. E., Geertman, R. T., Hromyak, D. R., Frost, F. S., Creasey, G. H., & Nemunaitis, G. A. (2009). Lower thoracic spinal cord stimulation to restore cough in patients with spinal cord injury: results of a National Institutes of Health-Sponsored clinical trial. Part II: clinical outcomes. Archives of physical medicine and rehabilitation, 90 (5), 726–732.
10. Fenton, J. J., Warner, M. L., Lammertse, D., Charlifue, S., Martinez, L., Dannels-McClure, A., ... & Pretz, C. (2016). A comparison of high vs standard tidal volumes in ventilator weaning for individuals with sub-acute spinal cord injuries: a site-specific randomized clinical trial. Spinal cord, 54(3), 234-238.
11. Glenn W.W. (1980). The treatment of respiratory paralysis by diaphragm pacing. The annals of thoracic surgery, 30(2): 106-9.
12. Göhl, O., Walker, D. J., Walterspacher, S., Langer, D., Spengler, C. M., Wanke, T., ... & Kabitz, H. J. (2016). Respiratory muscle training: state of the art. Pneumologie (Stuttgart, Germany), 70(1), 37-48.
13. Haviv, L., Friedman, H., Bierman, U., Glass, I., Plotkin, A., Weissbrod, A., ... & Catz, A. (2017). Using a sniff controller to self-trigger abdominal functional electrical stimulation for assisted coughing following cervical spinal cord lesions. IEEE Transactions on Neural Systems and Rehabilitation Engineering, 25(9), 1461-1471.
14. Hirschfeld, S., Exner, G., Luukkaala, T., & Baer, G. A. (2008). Mechanical ventilation or phrenic nerve stimulation for treatment of spinal cord injury-induced respiratory insufficiency. Spinal Cord, 46(11), 738-742.
15. Hu, X. C., Lu, Y. B., Yang, Y. N., Kang, X. W., Wang, Y. G., Ma, B., & Xing, S. (2021). Progress in clinical trials of cell transplantation for the treatment of spinal cord injury: how many questions remain unanswered?. Neural Regeneration Research, 16(3), 405.
16. Kim, C. Y., Lee, J. S., Kim, H. D., & Lee, D. J. (2017). Short-term effects of respiratory muscle training combined with the abdominal drawing-in maneuver on the decreased pulmonary function of individuals with chronic spinal cord injury: a pilot randomized controlled trial. The journal of spinal cord medicine, 40(1), 17-25.
17. Laffont, I., Bensmail, D., Lortat-Jacob, S., Falaize, L., Hutin, C., Le Bomin, E., ... & Lofaso, F. (2008). Intermittent positive-pressure breathing effects in patients with high spinal cord injury. Archives of physical medicine and rehabilitation, 89(8), 1575-1579.
18. Liaw, M. Y., Lin, M. C., Cheng, P. T., Wong, M. K. A., & Tang, F. T. (2000). Resistive inspiratory muscle training: its effectiveness in patients with acute complete cervical cord injury. Archives of physical medicine and rehabilitation, 81(6), 752-756.
19. Litchke, L. G., Russian, C. J., Lloyd, L. K., Schmidt, E. A., Price, L., & Walker, J. L. (2008). Effects of respiratory resistance training with a concurrent flow device on wheelchair athletes. The journal of spinal cord medicine, 31(1), 65-71.
20. McBain, R. A., Boswell-Ruys, C. L., Lee, B. B., Gandevia, S. C., & Butler, J. E. (2013). Abdominal muscle training can enhance cough after spinal cord injury. Neurorehabilitation and neural repair, 27(9), 834-843.
21. McCaughey, E. J., Berry, H. R., McLean, A. N., Allan, D. B., & Gollee, H. (2015). Abdominal functional electrical stimulation to assist ventilator weaning in acute tetraplegia: a cohort study. PloS one, 10(6), e0128589.
22. McKinley W.O., Jackson A.B., Cardenas D.D., DeVivo M.J. (1999). Long-term medical complications after traumatic spinal cord injury: a regional model systems analysis. Archives of physical medicine and rehabilitation, 80(11): 1402-10.
23. Pillastrini, P., Bordini, S., Bazzocchi, G., Belloni, G., & Menarini, M. (2006). Study of the effectiveness of bronchial clearance in subjects with upper spinal cord injuries: examination of a rehabilitation programme involving mechanical insufflation and exsufflation. Spinal cord, 44(10), 614-616.
24. Pizzolato, C., Gunduz, M. A., Palipana, D., Wu, J., Grant, G., Hall, S., ... & Teng, Y. D. (2021). Non-Invasive Approaches to Functional Recovery after Spinal Cord Injury: Therapeutic Targets and Multimodal Device Interventions. Experimental Neurology, 113612.
25. Postma, K., Haisma, J. A., Hopman, M. T., Bergen, M. P., Stam, H. J., & Bussmann, J. B. (2014). Resistive inspiratory muscle training in people with spinal cord injury during inpatient rehabilitation: a randomized controlled trial. Physical therapy, 94(12), 1709-1719.
26. Postma, K., Vlemmix, L. Y., Haisma, J. A., De Groot, S., Sluis, T. A., Stam, H. J., & Bussmann, J. B. (2015). Longitudinal association between respiratory muscle strength and cough capacity in persons with spinal cord injury: an explorative analysis of data from a randomized controlled trial. Journal of rehabilitation medicine, 47(8), 722-726.
27. Raab, A. M., Krebs, J., Pfister, M., Perret, C., Hopman, M., & Mueller, G. (2019). Respiratory muscle training in individuals with spinal cord injury: effect of training intensity and-volume on improvements in respiratory muscle strength. Spinal cord, 57(6), 482-489.
28. Roth, E. J., Stenson, K. W., Powley, S., Oken, J., Primack, S., Nussbaum, S. B., & Berkowitz, M. (2010). Expiratory muscle training in spinal cord injury: a randomized controlled trial. Archives of physical medicine and rehabilitation, 91(6), 857-861.
29. Sutbeyaz, S. T., Koseoglu, B. F., & Gokkaya, N. K. (2005). The combined effects of controlled breathing techniques and ventilatory and upper extremity muscle exercise on cardiopulmonary responses in patients with spinal cord injury. International Journal of Rehabilitation Research, 28(3), 273-276.
30. Tamplin, J., Baker, F. A., Buttifant, M., & Berlowitz, D. J. (2014). The effect of singing training on voice quality for people with quadriplegia. Journal of Voice, 28(1), 128-e19.
31. Tester, N. J., Fuller, D. D., Fromm, J. S., Spiess, M. R., Behrman, A. L., & Mateika, J. H. (2014). Long-term facilitation of ventilation in humans with chronic spinal cord injury. American journal of respiratory and critical care medicine, 189(1), 57-65.
32. Van Houtte, S., Vanlandewijck, Y., Kiekens, C., Spengler, C. M., & Gosselink, R. (2008). Patients with acute spinal cord injury benefit from normocapnic hyperpnoea training. Journal of rehabilitation medicine, 40(2), 119-125.
33. Wadsworth, B. M., Haines, T. P., Cornwell, P. L., Rodwell, L. T., & Paratz, J. D. (2012). Abdominal binder improves lung volumes and voice in people with tetraplegic spinal cord injury. Archives of physical medicine and rehabilitation, 93(12), 2189-2197.
34. Warren, P. M., & Alilain, W. J. (2014). The challenges of respiratory motor system recovery following cervical spinal cord injury. Progress in brain research, 212, 173-220.
35. Xi, J., Jiang, H., Zhang, N., Wang, J., Zhang, B., Cao, H., ... & Zhao, Z. (2019). Respiratory muscle endurance training with normocapnic hyperpnoea for patients with chronic spinal cord injury: a pilot short-term randomized controlled trial. Journal of rehabilitation medicine, 51(8), 616-620.
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