Article

OBJECTIVE: To describe changes in pulmonary function (PF) during the 5 years
after inpatient rehabilitation in persons with spinal cord injury (SCI) and to
study potential determinants of change. DESIGN: Prospective cohort study.
SETTING: Eight rehabilitation centers with specialized SCI units. PARTICIPANTS:
Persons with SCI (N=180). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES:
PF was determined by forced vital capacity (FVC) and forced expiratory volume in
1 second (FEV1) as a percentage of the predicted value, at the start of
rehabilitation, at discharge, and 1 and 5 years after discharge from inpatient
rehabilitation. The population was divided into 3 subgroups on the basis of
whether their PF declined, stabilized, or improved. RESULTS: FVC improved on
average 5.1% over the whole period between discharge of inpatient rehabilitation
and 5 years thereafter, but changes differed largely between persons. FVC
declined in 14.9% of the population during the first year after discharge. During
this year, body mass index, inspiratory muscle strength, change in peak power
output, and change in peak oxygen uptake differed significantly between
subgroups. FVC declined in 28.3% of the population during the following 4 years,
but no differences were found between the subgroups for this period. Subgroups
based on changes in FEV1 differed only with respect to change in peak oxygen
uptake the first year after discharge. CONCLUSIONS: In our study, many persons
with SCI showed a decline in PF, larger than the normal age-related decline,
during the 5 years after inpatient rehabilitation. Results suggest that a decline
in PF during the first year after inpatient rehabilitation is associated with
higher body mass index, lower inspiratory muscle strength, and declined physical fitness.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS