Abdominal Binder Improves Lung Volumes and Voice in People With Tetraplegic Spinal Cord Injury

作者：Wadsworth Brooke M^*; Haines Terry P; Cornwell Petrea L; Rodwell Leanne T; Paratz Jennifer D

来源：Archives of Physical Medicine and Rehabilitation, 2012, 93(12): 2189-2197.

DOI：10.1016/j.apmr.2012.06.010

• Orthostatic hypotension
• Pulmonary function
• Rehabilitation
• Respiration
• Speech
• Spinal cord injuries

Abdominal binder improves lung volumes and voice in people with tetraplegic spinal cord injury. Arch Phys Med Rehabil 2012;93:2189-97. %26lt;br%26gt;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. %26lt;br%26gt;Design: Randomized crossover study. %26lt;br%26gt;Setting: Large university-affiliated referral hospital. %26lt;br%26gt;Participants: Consenting participants (N=14, 13 men and 1 woman) with recent, motor complete, C3-T1 spinal cord injury. %26lt;br%26gt;Interventions: Abdominal binder on/off with participant seated in upright wheelchair, with 3 repeated measures at 6 weeks, 3 months, and 6 months after commencing daily use of an upright wheelchair. %26lt;br%26gt;Main Outcome Measures: Forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow, maximal inspiratory pressure, and maximal expiratory pressure were measured. Mean arterial pressure, maximum sustained vowel time, and sound pressure level were also measured. %26lt;br%26gt;Results: Overall, an abdominal binder resulted in a statistically significant improvement in forced vital capacity (weighted mean difference .34L [95% confidence interval (CI).10-.58], P=.005), forced expiratory volume in 1 second (.25L [95% CI -.01 to .51], P=.05), peak expiratory flow (.81L/s [95% CI .13-1.48], P=.02), maximal inspiratory pressure (7.40cmH(2)O [95% CI 1.64-13.14], P=.01), and maximum sustained vowel time (3.75s [95% CI .90-6.60], P=.01). There was no statistically significant improvement in maximal expiratory pressure (5.37cmH(2)O [95% CI -1.15 to 11.90], P=.11), mean arterial pressure (4.41mmHg [95% CI -6.15 to 14.97], P=.41), or sound pressure level (1.14dB [95% CI -1.31 to 3.58], P=.36). %26lt;br%26gt;Conclusions: An individually fitted abdominal binder significantly improved forced vital capacity, forced expiratory volume in I second, peak expiratory flow, maximal inspiratory pressure, and maximum sustained vowel time 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.

• 出版日期2012-12