Effects of partial isothermic immersion on the spirometry parameters of tetraplegic patients.
OBJECTIVE
Our objective was to compare under controlled conditions the effect of immersion on spirometry parameters of patients with tetraplegia vs those of normal individuals.


METHODS
Twenty-three otherwise well tetraplegic subjects were compared to a control group of 11 similar healthy subjects before and during 5 to 15 min of isothermal immersion in water to shoulder level.


RESULTS
Measured at baseline, tetraplegic subjects exhibited significant pulmonary restriction, characterized by a mean FVC of 54.9 +/- 14.6% of the predicted value (range, 23.2 to 80.4%), whereas all controls subjects had > 80% of predicted values. Immersion increased the FVC of tetraplegic patients an average of 18.4 +/- 18.7% above basal measurements, while that of the control group worsened (DeltaFVC, - 8.8 +/- 4.4%). Among the tetraplegic patients, the lower the preimmersion vital capacity, the greater the percentage of improvement following immersion (r = 0.79; 95% confidence interval, - 0.91 to - 0.56; p < 0.0001). No relationship was found between the time elapsed since cervical cord injury or its level and the degree of improvement.


CONCLUSIONS
Water activities play an important role in the rehabilitation of patients with spinal cord injury. Immersion in isothermal water at shoulder level, under strictly controlled experimental conditions, reduces the vital capacity of normal individuals, while it improves in a group of patients with tetraplegia. The observed phenomenon seems to be mediated by an improvement in breathing mechanics, impaired by cervical cord injury.
Hospital SARAH, SQuadra 501, Conjunto A, Brasília-DF, 70 000-150 Brazil. thoran@bsb.sarah.br
Sérgio
S
Thomaz
Paulo
P
Beraldo
Sergio
S
Mateus
Thomas
T
Horan
Josevan Cerqueira
JC
Leal
D000328:Adult; D000704:Analysis of Variance; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007101:Immersion; D008168:Lung / Q000503:physiopathology*; D008297:Male; D011782:Quadriplegia / Q000503:physiopathology*; D012129:Respiratory Function Tests; D015656:Respiratory Mechanics; D013147:Spirometry; D014797:Vital Capacity / Q000502:physiology