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Respiratory effects of combined truncal and abdominal support in patients with spinal cord injury

HART N; LAFFONT I; DELASOTA AP; LEJAILLE M; MACADOU G; POLKEY MI; DENYS P; LOFASO F
ARCH PHYS MED REHABIL , 2005, vol. 86, n° 7, p. 1447-1451
Doc n°: 121111
Localisation : Documentation IRR
Descripteurs : AE21 - ORIGINE TRAUMATIQUE
Article consultable sur : http://www.archives-pmr.org

Objective: To determine whether a custom girdle, designed to provide truncal stability and abdominal support, will improve pulmonary function, enhance inspiratory muscle activity, and reduce the sensation of respiratory effort in patients with spinal cord injury (SCI). Design: Pulmonary function, transdiaphragmatic pressure time product (PTPdi), twitch (Tw Pdi) and maximal transdiaphragmatic pressures (Pdi), and perception of respiratory effort (Borg Rating of Perceived Exertion score) were measured with and without an abdominal girdle in a seated position. Setting: Rehabilitation hospital. Participants: Ten patients with posttrauma SCI (injury level, C5-T6). Intervention: Application of the abdominal girdle. Main Outcome Measures: Borg score and measures of lung volumes, dynamic abdominal compliance, and Tw Pdi and maximal Pdi. Results: Wearing of the girdle was associated with a lower Borg score (P=.002) and reduced functional residual capacity (P=.006) but increased inspiratory capacity (P=.02) and forced vital capacity (P=.02). Although there was a decrease in dynamic abdominal compliance (P <.001) and an increase in PTPdi (P=.02), this was accompanied by an increase in both Tw Pdi (P=.02) and maximal Pdi (P=.03). Conclusions: The custom girdle reduced the sensation of respiratory effort in patients with SCI by optimizing the operating lung volumes and decreasing abdominal compliance, which enhanced diaphragm performance. (c) 2005 by American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.

Langue : ANGLAIS

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