Article

OBJECTIVE: To investigate the effects of respiratory motor training (RMT) on
pulmonary function and orthostatic stress-mediated cardiovascular and autonomic
responses in individuals with chronic spinal cord injury (SCI). DESIGN: Before-after intervention case-controlled clinical study. SETTING: SCI research
center and outpatient rehabilitation unit. PARTICIPANTS:
A sample of (N=21)
individuals with chronic SCI ranging from C3 to T2 diagnosed with orthostatic
hypotension (OH) (n=11) and healthy, noninjured controls
(n=10). INTERVENTIONS: A
total of 21+/-2 sessions of pressure threshold inspiratory-expiratory RMT
performed 5d/wk during a 1-month period. MAIN OUTCOME MEASURES: Standard
pulmonary function test: forced vital capacity, forced expiratory volume in one
second, maximal inspiratory pressure, maximal expiratory pressure, beat-to-beat
arterial blood pressure, heart rate, and respiratory rate were acquired during
the orthostatic sit-up stress test before and after the RMT program. RESULTS:
Completion of RMT intervention abolished OH in 7 of 11 individuals. Forced vital
capacity, low-frequency component of power spectral density of blood pressure and
heart rate oscillations, baroreflex effectiveness, and cross-correlations between
blood pressure, heart rate, and respiratory rate during the orthostatic challenge
were significantly improved, approaching levels observed in noninjured
individuals. These findings indicate increased sympathetic activation and
baroreflex effectiveness in association with improved respiratory-cardiovascular
interactions in response to the sudden decrease in blood pressure. CONCLUSIONS:
Respiratory training increases respiratory capacity and improves orthostatic
stress-mediated respiratory, cardiovascular, and autonomic responses, suggesting
that this intervention can be an efficacious therapy for managing OH after SCI.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS