Motor and Sensory Function as a Predictor of Respiratory Function Associated With Ventilator Weaning After High Cervical Cord Injury
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Objective To analyze the respiratory function of high cervical cord injury according to ventilator dependence and to examine the correlations between diaphragm movement found on fluoroscopy and sensory and motor functions.Methods A total of 67 patients with high cervical spinal cord injury (SCI), admitted to our hospital were enrolled in the study. One rehabilitation physician performed sensory and motor examinations on all patients while each patient was in the supine position on the American Spinal Injury Association (ASIA) standard. In addition, fluoroscopic diaphragm movement studies and bedside spirometry were performed.Results Bedside spirometry and diaphragm fluoroscopic tests were analyzed according to ventilator dependence. Forced vital capacity and maximal inspiratory pressure were significantly higher in the ventilator weaned group. Natural breathing during the fluoroscopic diaphragm examinations and ventilator weaning showed statistical significance with the movement on the right, while deep breathing showed statistical significance with the movement on both sides. Deep breathing movement has correlation with the C5 key muscle. Diaphragm movement has correlation with right C3 and bilateral C4 sensory functions.Conclusion The present expansion study showed that, through simple bedside physical examinations, rehabilitation physicians could relatively easily predict diaphragm movement and respiratory function recovery, which showed significance with ventilator weaning in patients with high cervical SCI.
Abstract
Objective To analyze the respiratory function of high cervical cord injury according to ventilator dependence and to examine the correlations between diaphragm movement found on fluoroscopy and sensory and motor functions.Methods A total of 67 patients with high cervical spinal cord injury (SCI), admitted to our hospital were enrolled in the study. One rehabilitation physician performed sensory and motor examinations on all patients while each patient was in the supine position on the American Spinal Injury Association (ASIA) standard. In addition, fluoroscopic diaphragm movement studies and bedside spirometry were performed.Results Bedside spirometry and diaphragm fluoroscopic tests were analyzed according to ventilator dependence. Forced vital capacity and maximal inspiratory pressure were significantly higher in the ventilator weaned group. Natural breathing during the fluoroscopic diaphragm examinations and ventilator weaning showed statistical significance with the movement on the right, while deep breathing showed statistical significance with the movement on both sides. Deep breathing movement has correlation with the C5 key muscle. Diaphragm movement has correlation with right C3 and bilateral C4 sensory functions.Conclusion The present expansion study showed that, through simple bedside physical examinations, rehabilitation physicians could relatively easily predict diaphragm movement and respiratory function recovery, which showed significance with ventilator weaning in patients with high cervical SCI.
참고문헌 (22)
- Brown R, "Respiratory dysfunction and management in spinal cord injury", Respir Care, 51, pp.853~870 (2006)
- Galeiras Vazquez R, "Respiratory management in the patient with spinal cord injury", Biomed Res Int, 2013, pp.168757~ (2013)
- Shavelle RM, "Long-term survival of persons ventilator dependent after spinal cord injury", J Spinal Cord Med, 29, pp.511~519 (2006)[DOI]
- Jackson AB, "Incidence of respiratory complications following spinal cord injury", Arch Phys Med Rehabil, 75, pp.270~275 (1994)[DOI]
- Ditunno JF Jr, "Functional outcomes in spinal cord injury (SCI): quality care versus cost containment", J Spinal Cord Med, 20, pp.1~7 (1997)[DOI]
- Oo T, "Delayed diaphragm recovery in 12 patients after high cervical spinal cord injury: a retrospective review of the diaphragm status of 107 patients ventilated after acute spinal cord injury", Spinal Cord, 37, pp.117~122 (1999)[DOI]
- Berlly M, "Respiratory management during the first five days after spinal cord injury", J Spinal Cord Med, 30, pp.309~318 (2007)[DOI]
- Chiodo AE, "Predictors of ventilator weaning in individuals with high cervical spinal cord injury", J Spinal Cord Med, 31, pp.72~77 (2008)[DOI]
- Yi LC, "Reliability of an analysis method for measuring diaphragm excursion by means of direct visualization with videofluoroscopy", Arch Bronconeumol, 47, pp.310~314 (2011)
- Wicks AB, "Long-term outlook in quadriplegic patients with initial ventilator dependency", Chest, 90, pp.406~410 (1986)[DOI]
- Ditunno JF Jr, "Motor recovery of the upper extremities in traumatic quadriplegia: a multicenter study", Arch Phys Med Rehabil, 73, pp.431~436 (1992)
- Waters RL, "Motor and sensory recovery following complete tetraplegia", Arch Phys Med Rehabil, 74, pp.242~247 (1993)
- Scanlon PD, "Respiratory mechanics in acute quadriplegia: lung and chest wall compliance and dimensional changes during respiratory maneuvers", Am Rev Respir Dis, 139, pp.615~620 (1989)[DOI]
- Urmey W, "Upper and lower rib cage deformation during breathing in quadriplegics", J Appl Physiol (1985), 60, pp.618~622 (1986)[DOI]
- Mortola JP, "Motion of the rib cage and the abdomen in tetraplegic patients", Clin Sci Mol Med, 54, pp.25~32 (1978)
- Houston JG, "Technical report: quantitative assessment of diaphragmatic movement. A reproducible method using ultrasound", Clin Radiol, 46, pp.405~407 (1992)[DOI]
- Steier J, "Sleep-disordered breathing in unilateral diaphragm paralysis or severe weakness", Eur Respir J, 32, pp.1479~1487 (2008)[DOI]
- Kolar P, "Analysis of diaphragm movement during tidal breathing and during its activation while breath holding using MRI synchronized with spirometry", Physiol Res, 58, pp.383~392 (2009)
- Stephens RE, "Videofluoroscopy of the diaphragm during voluntary and reflex cough in humans", Am J Phys Med Rehabil, 82, pp.384~ (2003)
- Chen CF, "Respiratory function in patients with spinal cord injuries: effects of posture", Paraplegia, 28, pp.81~86 (1990)
- Estenne M, "Mechanism of the postural dependence of vital capacity in tetraplegic subjects", Am Rev Respir Dis, 135, pp.367~371 (1987)
- Maeda CJ, "The effect of the halovest and body position on pulmonary function in quadriplegia", J Spinal Disord, 3, pp.47~51 (1990)