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Respiratory effects of combined truncal and abdominal support in patients with spinal cord injury
Hart N, Laffont I, de la Sota AP, Lejaille M, Macadou G, Polkey MI, Denys P, Lofaso F
Archives of Physical Medicine and Rehabilitation 2005 Jul;86(7):1447-1451
clinical trial
4/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To determine whether a custom girdle, designed to provide truncal stability and abdominal support, will improve pulmonary function, enhance inspiratory muscle activity, and reduce the sensation of respiratory effort in patients with spinal cord injury (SCI). DESIGN: Pulmonary function, transdiaphragmatic pressure time product (PTPdi), twitch (TwPdi) and maximal transdiaphragmatic pressures (Pdi), and perception of respiratory effort (Borg Rating of Perceived Exertion score) were measured with and without an abdominal girdle in a seated position. SETTING: Rehabilitation hospital. PARTICIPANTS: Ten patients with posttrauma SCI (injury level C5 to T6). INTERVENTION: Application of the abdominal girdle. MAIN OUTCOME MEASURES: Borg score and measures of lung volumes, dynamic abdominal compliance, and TwPdi and maximal Pdi. RESULTS: Wearing of the girdle was associated with a lower Borg score (p = 0.002) and reduced functional residual capacity (p = 0.006) but increased inspiratory capacity (p = 0.02) and forced vital capacity (p = 0.02). Although there was a decrease in dynamic abdominal compliance (p < 0.001) and an increase in PTPdi (p = 0.02), this was accompanied by an increase in both TwPdi (p = 0.02) and maximal Pdi (p = 0.03). CONCLUSIONS The custom girdle reduced the sensation of respiratory effort in patients with SCI by optimizing the operating lung volumes and decreasing abdominal compliance, which enhanced diaphragm performance.

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