A Secondary Analysis of Short- and Long-Term Variability of Inspiratory Muscle Performance in People Living With SCI

Top Spinal Cord Inj Rehabil, 2023 · DOI: 10.46292/sci22-00027 · Published: April 1, 2023

Spinal Cord Injury Pulmonology Rehabilitation

Simple Explanation

This study explores how much inspiratory muscle performance (IMP) varies in people with chronic spinal cord injury (SCI) over short and long periods. The researchers measured maximal inspiratory pressure (MIP), sustained MIP (SMIP), and inspiratory duration (ID) to assess IMP. Understanding normal variation can help clinicians identify true changes in respiratory function, leading to better risk stratification and early intervention.

Study Duration

18 months

Participants

22 individuals with chronic SCI (C1-T9, AIS A-C)

Evidence Level

Not specified

Key Findings

1
SMIP was found to be the most reliable measure of inspiratory muscle performance, followed by MIP.
2
Inspiratory duration (ID) was the only measure that showed a significant difference in short-term tests, possibly due to a learning effect.
3
A change in MIP function exceeding 10% is likely a meaningful change, aiding clinicians in identifying individuals at risk for respiratory issues.

Research Summary

This study aimed to assess the reliability of MIP, SMIP, and ID, and to report the expected short-term (ST) and long-term (LT) variability of IMP in individuals with SCI. The results indicated that SMIP was the most reliable assessment, while ID was the least reliable. ST and LT IMP assessments were generally stable, except for ST ID. The study suggests that a 10% change in MIP might represent a clinically meaningful change in respiratory function for people with SCI.

Practical Implications

Clinical Assessment

SMIP and MIP are better options for clinicians to track changes in respiratory function in SCI patients.

Threshold for Change

A 10% change in MIP can be used as a threshold for clinically meaningful change, prompting further investigation.

Future Research

Further research is required to confirm this threshold for MIP and establish a threshold percentage for SMIP to improve respiratory assessment.

Study Limitations

1
The study may not be powered appropriately to find reliable significant differences between short-term and long-term inspiratory performance.
2
The heterogeneous grouping of individuals with a wide range of injury levels and severity may have caused wide confidence intervals.
3
As a secondary analysis, the significance of findings may be less impactful than the percent change reported.

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