Article

Respiratory complications are major causes of morbidity and mortality
in persons with a spinal cord injury, partly because of respiratory muscle
paralysis. Earlier investigation has demonstrated that functional magnetic
stimulation (FMS) can be used as a noninvasive technology for activating
expiratory muscles, thus producing useful expiratory functions (simulated cough)
in subjects with spinal cord injury. OBJECTIVE: To evaluate the effectiveness of
FMS for conditioning inspiratory and expiratory muscles in persons with
tetraplegia. DESIGN: A prospective before and after trial. SETTING: FMS
Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH.
PARTICIPANTS: Six persons with tetraplegia. METHOD: Each subject participated in
a 6-week FMS protocol for conditioning the inspiratory and expiratory muscles. A
magnetic stimulator was used with the center of a magnetic coil placed at the
C7-T1 and T9-T10 spinous processes, respectively. Pulmonary function tests were
performed before, during, and after the protocol. MAIN OUTCOME MEASUREMENTS:
Respiratory variables included maximal inspiratory pressure (MIP), inspiratory
reserve volume (IRV), peak inspiratory flow (PIF), maximal expiratory pressure
(MEP), expiratory reserve volume (ERV), and peak expiratory flow (PEF). RESULTS:
After 6 weeks of conditioning, the main outcome measurements (mean +/- standard
error) were as follows: MIP, 89.6 +/- 7.3 cm H2O; IRV, 1.90 +/- 0.34 L; PIF,
302.4 +/- 36.3 L/min; MEP, 67.4 +/- 11.1 cm H2O; ERV, 0.40 +/- 0.06 L; and PEF,
372.4 +/- 31.9 L/min. These values corresponded to 117%, 107%, 136%, 109%, 130%,
and 124% of pre-FMS conditioning values, respectively. Significant improvements
were observed in MIP (P = .022), PIF (P = .0001), and PEF (P = .0006),
respectively. When FMS was discontinued for 4 weeks, these values showed
decreases from their values at the end of the conditioning protocol, which
suggests that continual FMS may be necessary to maintain improved respiratory
functions. CONCLUSION: FMS conditioning of the inspiratory and expiratory muscles
improved voluntary inspiratory and expiratory functions. FMS may be a noninvasive
technology for respiratory muscle training in persons with tetraplegia.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS