Chest Wall Kinematics and Respiratory Muscle Action During Supine Breathing in Individuals With and Without Spinal Cord Injury (SCI)

March 9, 2010 updated by: National Taiwan University Hospital

Phase 0 Study of Chest Wall Kinematics and Respiratory Muscle Action During Supine Breathing in Individuals With and Without Spinal Cord Injury.

Objective: To investigate the movement strategy of breathing based on three-compartment model measured by optoelectronic plethysmography (OEP) and electromyography (EMG ) among individuals with and without spinal cord injury in supine posture during deep inspiration.

Design: cross sectional repeated-measure with age matched control group. Setting: Motion Analysis Laboratory Participants: Seven tetraplegic and five paraplegic subjects and twelve age matched healthy controls were recruited.

Intervention: Not applicable.

Study Overview

Status

Completed

Conditions

Spinal Cord Injury

Detailed Description

Main Outcome Measures: The volume changes of chest wall and respiratory electromyographic ( EMG ) muscle activity were measured simultaneously by OEP and surface EMG. The variables included volume changes (ΔV ), ratio of volume changes (ΔVr ), peak velocity of volume changes ( PV ), the percentage of peak velocity occurs ( PPV ) in three compartments (upper thorax, UT; lower thorax, LT; and abdominal compartment, AB), and Root Mean Square EMG ( RMS EMG ) of sternocleidomastoid and diaphragm (combined with intercostalmuscles).

Results: Ttetraplegic individuals had smallerΔVUT andΔVLT than those of control subjects(P< .006 and .006, respectively). Furthermore, the ΔVr of AB was greater than those of UT and LT( P< .006, .006, respectively), PVAB was smaller than PVLT ( P< .006), PPVUT was greater than PPVLT and PPVAB ( P< .008, .008, respectively ). The paraplegic subjects had smallerΔVLT than that of control subjects ( P< .006 ). ΔVr of UT was greater than that of LT, and both PVUT and PVAB were greater than PVLT ( P< .006 and .006, respectively). However, the paraplegic subjects preferred to all three compartments to achieve the maximal inspiration, like control group. In control group, onlyΔVAB was comparable with other compartments. ΔVr of UT was greater than LT, and PVUT was greater than PVLT and PVAB ( P<.006 and .006, respectively). For the RMS EMG, it demonstrated that average RMS EMG of two muscles in both tetraplegic and paraplegic group were greater than that in control group (P< .017 and .017, respectively).

Conclusion: The results applied the three-compartment model of chest wall to investigate the breathing pattern by OEP in individuals with and without SCI during inspiration of vital capacity breathing in supine posture. There were some interesting findings that (1) the tetraplegic subjects used AB contributed most volume changes, they can expand the AB more easily, and the UT took the responsibility to performed the final adjust during the inspiration; (2) the paraplegic subjects used UT contributed the most volume changes, they expanded the both UT and AB more easily, and all three compartment moved together during the inspiration; (3) the control subjects used UT to increase the most volume changes, they can expand UT more than the others, and all three compartments moved together during the inspiration phase, (4) the results of RMS EMG showed that the central neural drive in both tetraplegic and paraplegic subjects were greater than control group.

Study Type

Observational

Enrollment (Anticipated)

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

Taiwan
- - Taipei, Taiwan, 100
    - School and Graduate Institute of Physical Therapy

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

20 years to 60 years (Adult)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

Male

Sampling Method

Non-Probability Sample

Study Population

community sample

Description

Inclusion Criteria:

(1) motor complete loss below level of injury with American Spinal Injury Association Classification (ASIA) class A or B19;
(2) post-injury duration at least 0.5 year;
(3) male subject due to high incidence rate in Taiwan20and the necessity of total exposure of the chest wall during the data collection.

Exclusion Criteria:

(1) with any traumatic history of the chest wall,
(2) with any respiratory disease and musculoskeletal problem that interfered with the experimental protocol;
(3) having infections during the data collection period.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

Number of groups / cohorts

Cohorts and Interventions

Group / Cohort
Healthy group control subjects
Paraplegic group Paraplegic subjects
Tetraplegic group tetraplegic subjects

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Chest wall motion Time Frame: 6 months after spinal cord injury	6 months after spinal cord injury

Secondary Outcome Measures

Outcome Measure	Time Frame
ultrasonography Time Frame: 6 months after spinal cord injury	6 months after spinal cord injury

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

National Taiwan University Hospital

Collaborators

National Science Council, Taiwan

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

July 1, 2005

Primary Completion (Actual)

July 1, 2008

Study Completion (Actual)