Time Course of Respiratory Dysfunction and Motor Paralysis for 12 Weeks in Cervical Spinal Cord Injury without Bone Injury

Spine Surg Relat Res, 2019 · DOI: 10.22603/ssrr.2018-0009 · Published: January 1, 2019

Spinal Cord Injury Pulmonology Rehabilitation

Simple Explanation

Cervical spinal cord injury without bone injury (SCIWOBI) is a common injury, especially in older adults, often happening at the C3/C4 level. This injury can lead to respiratory issues because it affects the spinal respiratory center near the C4 segment. The study looked at how respiratory dysfunction and motor function change over 12 weeks in people with cervical SCIWOBI. The goal was to find better ways to help these patients. Patients underwent respiratory muscle training starting the day after they were admitted, regardless of whether they had surgery or not. Lung capacity and motor skills were checked at the start, and then again at 4 and 12 weeks.

Study Duration

12 Weeks

Participants

54 patients (49 men, 5 women; mean age: 65 years old)

Evidence Level

Not specified

Key Findings

1
A large majority of patients (92.6%) experienced restrictive ventilatory impairment upon admission to the study.
2
The study found a correlation between lung capacity (%VC) and motor scores (MS) for both upper and lower limbs at the beginning of the study.
3
Both lung capacity and motor skills in the upper and lower limbs improved significantly by weeks 4 and 12 post-injury.

Research Summary

This study evaluated the time course of respiratory dysfunction (RD) and motor function in patients with cervical spinal cord injury without bone injury (SCIWOBI) over a 12-week period to identify effective medical strategies. The results showed that most patients had restrictive ventilatory impairment at admission, but lung capacity and motor skills improved significantly over the 12 weeks with respiratory muscle training. The study concludes that respiratory rehabilitation should be continued for at least 12 weeks after SCIWOBI to maximize recovery of lung capacity and motor function.

Practical Implications

Prolonged Rehabilitation

Respiratory rehabilitation should be continued for at least 12 weeks after SCIWOBI to maximize recovery.

Early Mobilization

Early mobilization and breathing exercises are crucial for improving respiratory function in SCIWOBI patients.

Assessment of Lower Limb Motor Skills

Evaluating lower-limb motor skills can be a useful way to assess respiratory function improvement.

Study Limitations

1
The study followed cervical SCIWOBI patients for only 12 weeks, and longer follow-up studies are necessary.
2
The lack of correlation between lower-limb MS and respiratory function improvement in the elder group needs further investigation.
3
Individual differences in patients’ motor disorder history, RD, and muscle strength may influence outcomes.

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