Inspiratory muscle training is feasible and safe for patients with acute spinal cord injury

The Journal of Spinal Cord Medicine, 2019 · DOI: 10.1080/10790268.2018.1432307 · Published: March 1, 2019

Spinal Cord Injury Pulmonology Rehabilitation

Simple Explanation

This study looked at whether inspiratory muscle training (IMT) is possible and safe for people with recent spinal cord injuries. IMT involves using a device to make it harder to breathe in, which can strengthen the breathing muscles. The researchers found that IMT was indeed feasible and safe for these patients. Participants were able to complete the training sessions, and there were no negative side effects on their heart rate, blood pressure, or oxygen levels. Some participants also showed improvements in their lung function after IMT, suggesting it could be a helpful tool for improving breathing in people with spinal cord injuries. More research is needed to confirm these findings.

Study Duration

2 years

Participants

Seven adult subjects with an acute complete cervical or thoracic SCI

Evidence Level

Prospective, observational pilot study comprising a series of case reports

Key Findings

1
IMT was feasible, with all 50 planned sessions of IMT able to be delivered.
2
IMT was safe, with stable physiological parameters and no adverse symptoms or events recorded before, during or after IMT.
3
Maximal inspiratory pressure increased for four participants and forced vital capacity increased for three participants over the duration of their IMT sessions.

Research Summary

This pilot study investigated the feasibility and safety of commencing IMT in a series of medically stable adult patients in the acute phase post-cervical or thoracic SCI. For the seven participants, IMT was feasible with all planned sessions of IMT able to be delivered, and safe with stable physiological parameters and no adverse events associated with IMT. A high-resistance, low-repetition program of IMT was feasible with all planned sessions able to be delivered, and safe with no adverse events recorded before, during or after IMT

Practical Implications

Clinical Practice

IMT can be safely implemented in the acute phase post-SCI to potentially improve respiratory muscle strength.

Future Research

Further studies are needed to investigate the efficacy of IMT in the acute phase post-SCI.

Protocol Optimization

Further research is needed to determine if a less conservative IMT program is feasible and safe in the acute phase post-SCI.

Study Limitations

1
The main limitations of this study were the single site, small sample size and uncontrolled design, clearly limiting the generalisability of our results.
2
the slow recruitment rate justifies our choice of study design, particularly given our focus on the feasibility and safety of IMT.
3
While the inclusion of patients with incomplete SCI would have increased our sample size, we believed that it was preferable to focus on those patients with complete SCI

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