C.-S. Tsai1, C.-J. Wu2, H.-T. Li1, W.-L. Yang1
1Taoyuan General Hospital, MOHW, Physical Therapy, Taoyuan, Taiwan, 2Taoyuan General Hospital, MOHW, Rehabilitation, Taoyuan, Taiwan
Background: Spinal cord injury (SCI) is a central nervous system disease caused by various accidents such as falling injury. It might lead to not only extremities disability but also respiratory damage Respiratory dysfunction might result in elevated risk of pulmonary complication and it might further result to other morbidity, mortality, and economic burden. Lung function parameters such as total lung capacity (TLC), residual volume (RV), and forced expiratory volume in one second (FEV1) revealed abnormal situation. Hence, the treatment goals of SCI patients’ respiratory function are training their remained parts as complete as possible. Pulmonary rehabilitation composed of respiratory muscle training and cough ability training has been proved necessary and effective for SCI patients. Cervicocranial flexion exercise (CCFE) and superficial neck flexor endurance training have been widely implemented in clinical practice for curing chronic neck pain. Reasonably, Cervicocranial flexion exercise (CCFE) and superficial neck flexor endurance training are also beneficial to pulmonary function due to training the respiratory accessory muscle (scalens and SCM).
Purpose: Cervicocranial flexion exercise (CCFE) and superficial neck flexor endurance training combined with common pulmonary rehabilitation will manifest better outcomes than pulmonary rehabilitation only.
Methods: The subjects included in this study were randomized assigned to experimental group and control group. The randomization orders were decided by computer, and all the contents were concealed into a dark color envelop. Before first treatment, the envelops were opened to determine which treatment protocol were adopted. The treatment of experimental group was consisted of cervicocranial flexion exercise (CCFE) and neck flexor endurance training plus normal cardiopulmonary rehabilitation. The treatment of control group was composed of general neck stretch exercise plus cardiopulmonary rehabilitation. Subsequently, initial measurement was conducted including lung capacity test, dyspnea situation, pain and stiffness of neck. Moreover, lung function such as FVC and FEV1, dyspnea situation, pain and stiffness of neck were also recorded one time in a week as a short-term outcome. Then, the treatment protocols were both executed for 30 minutes, ten times in a month. After completing the treatment process, the final measurement was conducted as the initial treatment. All the outcomes were collected and analyzed by statistically method.
Results: The FVC revealed increasing tendency in experimental group (from 1.72 to 1.85 L), but there is no improvement in FEV1 (1.57 to 1.48 L). No improved result was manifested in control group (FVC:3.70 to 3.66 L FEV1:2.67 to 2.64 L).
Conclusion(s): From these two cases, it can be speculated that case 1(CCFE+cardiopulmonary rehabilitation) revealed better improvement on FVC, Hence, the possible trend might be expected in future results. CCFE and cardiopulmonary rehabilitation might be a potential treatment for the lung function of SCI.
Implications: Most of neck muscles were not innervated by spinal cord. Through the training of Deep neck flexor and respiratory accessory muscle might increase the lung function of these patients.
Funding, acknowledgements: Taoyuan General Hospital, MOHW, Taiwan
Keywords: Spinal cord injury, Cardiopulmonary rehabitiation, Deep neck flexor
Topic: Neurology: spinal cord injury
Did this work require ethics approval? Yes
Institution: Taoyuan General Hospital, MOHW
Committee: The Institutional Review Board, Taoyuan General Hospital
Ethics number: TYGH108045
All authors, affiliations and abstracts have been published as submitted.
