Correlation between Respiratory Dysfunction and Dysphagia in Individuals with Acute Traumatic Cervical Spinal Cord Injury

Spine Surg Relat Res, 2023 · DOI: 10.22603/ssrr.2022-0180 · Published: January 12, 2023

Spinal Cord Injury Pulmonology Rehabilitation

Simple Explanation

Aspiration pneumonia is a frequent and life-threatening complication for those with acute traumatic cervical spinal cord injury (CSCI). Respiratory dysfunction and dysphagia often interplay, leading to morbidity and mortality. The study aimed to understand how respiratory dysfunction affects swallowing in individuals with acute traumatic CSCI. The researchers hypothesized that respiratory function and coughing force predict dysphagia. The study found that restrictive ventilatory impairment, poor cough force, and dysphagia are closely related. Evaluating respiratory function is important in evaluating dysphagia in these patients.

Study Duration

3 Months

Participants

54 individuals with acute traumatic cervical spinal cord injury

Evidence Level

Prospective cohort study

Key Findings

1
A significant portion of individuals with acute traumatic CSCI had restrictive ventilatory impairment and severe dysphagia shortly after injury.
2
Respiratory function and swallowing function significantly improved over time during the 12 weeks following the injury.
3
Cough peak flow (CPF), forced expiratory volume in 1 second (FEV1.0), and percent vital capacity (%VC) were significantly correlated with the severity of dysphagia during each period.

Research Summary

This study investigated the correlation between respiratory dysfunction and dysphagia in individuals with acute traumatic cervical spinal cord injury (CSCI). It found a significant relationship between restrictive ventilatory impairment, poor cough force, and dysphagia. The study prospectively evaluated 54 individuals with acute traumatic CSCI, assessing dysphagia using the Dysphagia Severity Scale (DSS) and the Functional Oral Intake Scale (FOIS), and respiratory function through cough peak flow (CPF), forced expiratory volume (FEV1.0), and vital capacity (%VC). The findings suggest that evaluating respiratory function is crucial in assessing dysphagia and that improved respiratory function and effective coughing may lead to improved swallowing function in individuals with acute CSCI.

Practical Implications

Clinical Assessment

Respiratory function should be thoroughly assessed in individuals with acute CSCI to evaluate the risk and severity of dysphagia.

Rehabilitation Strategies

Rehabilitation programs should focus on improving both respiratory and swallowing functions to prevent aspiration and respiratory complications.

Improved Swallowing

Enhancing respiratory function and coughing effectiveness may lead to better swallowing function in individuals with acute CSCI.

Study Limitations

1
The study could not examine respiratory or swallowing function upon admission.
2
The study could not fully evaluate factors such as drugs that could affect swallowing and respiratory function.
3
The study acknowledges the inability to fully eliminate confounding biases from factors like ASIA score improvement and neurologic recovery.

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