title: Use of air stacking and abdominal compression for cough assistance in people with complete tetraplegia.
abstract: METHODS
  Cross-sectional.
  
  
  OBJECTIVE
  To assess cough using air stacking (AS) to assist inspiratory volume with abdominal compression (AC) during expiration in patients with American Spinal Injury Association Impairment Scale (AIS) A.
  
  
  METHODS
  Large tertiary hospital in Chile.
  
  
  METHODS
  Peak cough flow (PCF) was measured during four different interventions: spontaneous maximal expiratory effort (MEE); MEE while receiving AC (MEE-AC); MEE after AS with a manual resuscitation bag (AS-MEE); and MEE with AS and AC (AS-MEE-AC).
  
  
  RESULTS
  Fifteen in-patients with complete tetraplegia (C4-C6) were included. Median age was 33 years (16-56). PCF during the different interventions was PCF for MEE was 183±90 l min(-1); PCF for MEE-AC was 273±119  l  min(-1); PCF for AS-MEE was 278±106  l  min(-1) and PCF for AS-MEE-AC was 368±129  l  min(-1). We observed significant differences in PCF while applying MEE-AC and AS-MEE compared with MEE (P=0.0001). However, the difference in PCF value was greater using the AS-MEE-AC technique (P=0.00001).
  
  
  CONCLUSIONS
  Patients with spinal cord injury (SCI) presented an ineffective cough that constitutes a risk factor for developing respiratory complications. The application of combined techniques (AS-MEE-AC) can reach near normal PCF values. This is a low-cost, simple and easily applied intervention that could be introduced to all patients with tetraplegia.
authors.affiliation: 1] Escuela de Kinesiología, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile [2] Equipo de Rehabilitación Respiratoria, Clínica Los Coihues, Santiago de Chile, Chile.
authors.forename: R
authors.initials: R
authors.lastname: Torres-Castro
authors.affiliation: Facultad de Ciencias de la Salud Blanquerna, Grupo de Investigación en Fisioterapia (GReFis), Universidad Ramon Llull, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Vilaró
authors.affiliation: Escuela de Kinesiología, Facultad de Medicina, Universidad de Chile, Santiago de Chile, Chile.
authors.forename: R
authors.initials: R
authors.lastname: Vera-Uribe
authors.affiliation: Equipo de Rehabilitación Respiratoria, Clínica Los Coihues, Santiago de Chile, Chile.
authors.forename: G
authors.initials: G
authors.lastname: Monge
authors.affiliation: Equipo de Rehabilitación Respiratoria, Clínica Los Coihues, Santiago de Chile, Chile.
authors.forename: P
authors.initials: P
authors.lastname: Avilés
authors.affiliation: Equipo de Rehabilitación Respiratoria, Clínica Los Coihues, Santiago de Chile, Chile.
authors.forename: C
authors.initials: C
authors.lastname: Suranyi
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D035641:Chest Wall Oscillation / Q000379:methods*; D002677:Chile; D003371:Cough / Q000209:etiology* / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010366:Peak Expiratory Flow Rate; D011782:Quadriplegia / Q000150:complications*; D012121:Respiration, Artificial / Q000295:instrumentation; D012138:Respiratory Therapy / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors; D055815:Young Adult