OBJECTIVE: To investigate the effect of an elasticated abdominal binder on respiratory, voice and blood pressure outcomes for people with a motor complete acute tetraplegia during the first year after injury. DESIGN: Randomized cross over study. SETTING: Large university-affiliated referral hospital. PARTICIPANTS: Consenting participants (n = 14, 13 men and 1 woman) with recent, motor complete, C3 to T1 spinal cord injury. INTERVENTIONS: Abdominal binder on/off with participant seated in upright wheelchair, with three repeated measures at six weeks, three months, and six months after commencing daily use of an upright wheelchair. MAIN OUTCOME MEASURES: Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were measured. Mean arterial pressure (MAP), maximum sustained vowel (MSV) time and sound pressure level (SPL) were also measured. RESULTS: Overall an abdominal binder resulted in a statistically significant improvement in FVC (weighted mean difference 0.34litres (95%CI 0.10 to 0.58) p = 0.005), FEV1 (0.25litres (95%CI -0.01 to 0.51) p = 0.05), PEF (0.81L/sec (95%CI 0.13 to 1.48) p = 0.02), MIP (7.40cmH2O (95%CI 1.64 to 13.14) p = 0.01) and MSV (3.75seconds (95% CI 0.90 to 6.60) p = 0.01). There was no statistically significant improvement in MEP (5.37cmH2O (95%CI -1.15 to 11.90) p = 0.11), MAP (4.41mmHg (95%CI -6.15 to 14.97) p = 0.41) or SPL (1.14dB (95% CI -1.31 to 3.58) p = 0.36). CONCLUSIONS: An individually fitted abdominal binder significantly improved FVC, FEV1, PEF, MIP and MSV in people with newly acquired tetraplegia. Further study is needed into the effect of the long term use of the abdominal binder on breathing mechanics, functional residual capacity, total lung capacity and respiratory health.

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