Community exercise for individuals with spinal cord injury with inspiratory muscle training: A pilot study

Abstract

Context/Objective: Respiratory disorders are a common cause of rehospitalization, and premature death in individuals with spinal cord injuries (SCI). Respiratory training combined with community exercise programs may be a method to reduce secondary complications in this population.Objective: The present study explores the inclusion of inspiratory muscle training (IMT) in an existing community exercise program.Design: Case series.Setting: Community.Participants: Participants (N = 6) completed the exercise program. Five were male and one was female; four reported incomplete injuries, and two reported complete injuries; four had cervical injuries, and two had thoracic injuries. The average age was 33 years (SD = 18.6) and time since injury was 7 years (SD = 4.0).Interventions: Participants completed an 8-week program, once-per-week for 4 h that included a circuit of resistance training, aerobic exercise, trunk stability, and education. IMT was completed as a home exercise program.Outcome Measures: Transfer test, T-shirt test, four-directional reach, four-directional trunk strength, weekly training diaries, and a subjective interview.Results: Twenty-eight training logs were collected. All measures improved: transfer test (mean = -14.62, SD = 7.00 s), T-shirt test (mean = -7.83, SD = 13.88 s), four-directional reach (mean = 3.75, SD = 8.06 in) and hand-held dynamometer (mean = 6.73, SD = 8.02 kg). Individuals reported a positive impact of the program.Conclusions: This pilot study demonstrated community exercise with IMT use may have positive impact on functional measures for people with SCI who are vulnerable to respiratory compromise. Continued education may increase successful health outcomes.Trial Registration: NCT03743077.

Keywords: Community program; Daily function; Exercise; Respiratory training; Spinal cord injury.

Figures

Figure 1

Modified Functional Reach (mFR) Test diagram. The subject was seated on a mat table with hips and knees at 90 degrees, and feet flat on the floor. For each direction, the right arm was designated the measured arm, and had a visual marker at wrist (red line) to measure reach. When reaching to the left the left arm was the measured arm. Excursion in each direction was measured in centimeters against a board with a meter stick affixed at shoulder height (blue line). Four directions were tested: anterior (1), lateral left (2), lateral right (2), and posterior (3).

Figure 1

Modified Functional Reach (mFR) Test diagram. The subject was seated on a mat table with hips and knees at 90 degrees, and feet flat on the floor. For each direction, the right arm was designated the measured arm, and had a visual marker at wrist (red line) to measure reach. When reaching to the left the left arm was the measured arm. Excursion in each direction was measured in centimeters against a board with a meter stick affixed at shoulder height (blue line). Four directions were tested: anterior (1), lateral left (2), lateral right (2), and posterior (3).

Figure 2

Results by subject, by outcome measure, pre- and post-intervention. Data were removed from subject 4, and subject 5 for the T-shirt Test (TST) and the Timed Transfer Test (TTT) respectively. Results for multidirectional reach (MFR) and four direction trunk strength (HHD) have all subjects included in analysis.

Figure 2

Results by subject, by outcome measure, pre- and post-intervention. Data were removed from subject 4, and subject 5 for the T-shirt Test (TST) and the Timed Transfer Test (TTT) respectively. Results for multidirectional reach (MFR) and four direction trunk strength (HHD) have all subjects included in analysis.