Dyspnea during daily activities in chronic spinal cord injury.
OBJECTIVE
To assess factors associated with breathlessness in chronic spinal cord injury (SCI) during daily activities.


METHODS
Cross-sectional survey.


METHODS
Veterans Affairs SCI service and the community.


METHODS
Four hundred forty-one participants 1 or more years post-SCI, and without acute illness, were recruited between 1994 and 2003 and were categorized according to their ability to walk unassisted, walk with an aid, or to move about by either hand-propelled wheelchair or motorized wheelchair (MWC).


METHODS
Assessment of injury extent, respiratory symptoms, cigarette smoking, comorbid medical conditions, and spirometry.


METHODS
Breathlessness during talking, eating, or dressing.


RESULTS
Breathlessness was more common in MWC users (20/85 users, 24%) than in nonusers (20/356, 6%). The main activity associated with breathlessness in 15 MWC users was talking (18%). In MWC users, the risk of breathlessness was related to lifetime cigarette smoking (odds ratio [OR]=1.02; 95% confidence interval [CI], 1.00-1.03 per pack year), and reports of chronic cough (OR=7.8; 95% CI, 2.0-32.7), and wheeze (OR=3.5; 95% CI, 1.04-13.6). SCI level, percentage of predicted forced vital capacity and forced expiratory volume in 1 second, and maximal inspiratory pressures were not related to breathlessness.


CONCLUSIONS
Breathlessness during selected daily activities (most commonly talking) was greatest in SCI participants who were most impaired with regard to mobility and was associated with reports of coughing, wheezing, and cigarette smoking.
Grandas
Noel F
NF
Physical Medicine and Rehabilitation Service, VA Boston Healthcare System, West Roxbury, MA 02132, USA.
Jain
Nitin B
NB
Denckla
Joan B
JB
Brown
Robert
R
Tun
Carlos G
CG
Gallagher
Mary Ellen
ME
Garshick
Eric
E
D000203:Activities of Daily Living; D016009:Chi-Square Distribution; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004417:Dyspnea / Q000453:epidemiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009511:New England / Q000453:epidemiology; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D013147:Spirometry; D011795:Surveys and Questionnaires; D014728:Veterans; D016138:Walking / Q000502:physiology; D014910:Wheelchairs