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

• Published in: Archives of physical medicine and rehabilitation Vol. 93; no. 12; pp. 2189 - 2197
• Main Authors: Wadsworth, Brooke M., BSc Phty, Haines, Terry P., PhD, Cornwell, Petrea L., PhD, Rodwell, Leanne T., PhD, Paratz, Jennifer D., PhD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.12.2012; Elsevier
• Subjects: Abdomen; Adolescent; Adult; Aged; Biological and medical sciences; Blood pressure; Cross-Over Studies; Diseases of the osteoarticular system; Exhalation; Female; Hemodynamics; Hospitals, University; Humans; Hypotension, Orthostatic - prevention & control; Investigative techniques of respiratory function; Investigative techniques, diagnostic techniques (general aspects); Lung Volume Measurements; Male; Medical sciences; Middle Aged; Miscellaneous; Orthostatic hypotension; Physical Medicine and Rehabilitation; Pulmonary function; Quadriplegia - etiology; Quadriplegia - rehabilitation; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Rehabilitation; Respiration; Respiratory Function Tests; Respiratory Mechanics; Self-Help Devices; Speech; Spinal cord injuries; Spinal Cord Injuries - complications; Spinal Cord Injuries - rehabilitation; Wheelchairs; Young Adult; maximum expiratory pressure; forced vital capacity; SPL; peak expiratory flow; maximum sustained vowel; OH; forced expiratory volume in 1 second; Orthostatic hypotension; spinal cord injury; AB; mean arterial pressure; sound pressure level; maximum inspiratory pressure; PEF; MSV; FVC; FEV 1; Pulmonary function; MIP; SCI; Speech; abdominal binder; MEP; Spinal cord injuries; Rehabilitation; Respiration; MAP; FEV1; Nervous system diseases; Lung; Cardiovascular disease; Abdomen; Lung volume; Postural hypotension; Reeducation; Arterial hypotension; Orthopedics; Spinal cord trauma; Diseases of the autonomic nervous system; Central nervous system disease; Spinal cord disease
• ISSN: 0003-9993; 1532-821X
• DOI: 10.1016/j.apmr.2012.06.010

Abstract Abdominal binder improves lung volumes and voice in people with tetraplegic spinal cord injury. 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 crossover study. Setting Large university-affiliated referral hospital. Participants Consenting participants (N=14, 13 men and 1 woman) with recent, motor complete, C3-T1 spinal cord injury. 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. 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. 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 (7.40cmH2 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 (5.37cmH2 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). Conclusions An individually fitted abdominal binder significantly improved forced vital capacity, forced expiratory volume in 1 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.