title: Respiratory motor function in seated and supine positions in individuals with chronic spinal cord injury.
abstract: This case-controlled clinical study was undertaken to investigate to what extent pulmonary function in individuals with chronic spinal cord injury (SCI) is affected by posture. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax) were obtained from 27 individuals with chronic motor-complete (n=13, complete group) and motor-incomplete (n=14, incomplete group) C2-T12 SCI in both seated and supine positions. Seated-to-supine changes in spirometrical (FVC and FEV1) and airway pressure (PImax and PEmax) outcome measures had different dynamics when compared in complete and incomplete groups. Patients with motor-complete SCI had tendency to increase spirometrical outcomes in supine position showing significant increase in FVC (p=.007), whereas patients in incomplete group exhibited decrease in these values with significant decreases in FEV1 (p=.002). At the same time, the airway pressure values were decreased in supine position in both groups with significant decrease in PEmax (p=.031) in complete group and significant decrease in PImax (p=.042) in incomplete group. In addition, seated-to-supine percent change of PImax was strongly correlated with neurological level of motor-complete SCI (ρ=-.77, p=.002). These results indicate that postural effects on respiratory performance in patients with SCI can depend on severity and neurological level of SCI, and that these effects differ depending on respiratory tasks. Further studies with adequate sample size are needed to investigate these effects in clinically specific groups and to study the mechanisms of such effects on specific respiratory outcome measures.
authors.affiliation: Department of Health and Sport Sciences, University of Louisville, Louisville, KY, USA.
authors.forename: Daniela G L
authors.initials: DG
authors.lastname: Terson de Paleville
authors.affiliation: Department of Neurological Surgery, University of Louisville, Louisville, KY, USA.
authors.forename: Dimitry G
authors.initials: DG
authors.lastname: Sayenko
authors.affiliation: Department of Neurological Surgery, University of Louisville, Louisville, KY, USA.
authors.forename: Sevda C
authors.initials: SC
authors.lastname: Aslan
authors.affiliation: Department of Medicine: Division of Pulmonary, Critical Care and Sleep Disorders, University of Louisville, Louisville, KY, USA.
authors.forename: Rodney J
authors.initials: RJ
authors.lastname: Folz
authors.affiliation: Hulse Spinal Cord Injury Laboratory, Shepherd Center, Atlanta, GA, USA.
authors.forename: William B
authors.initials: WB
authors.lastname: McKay
authors.affiliation: Department of Neurological Surgery, University of Louisville, Louisville, KY, USA. Electronic address: avovec02@louisville.edu.
authors.forename: Alexander V
authors.initials: AV
authors.lastname: Ovechkin
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002908:Chronic Disease; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D009460:Neurologic Examination; D011187:Posture / Q000502:physiology*; D012119:Respiration; D012129:Respiratory Function Tests; D013119:Spinal Cord Injuries / Q000150:complications*; D013990:Tidal Volume / Q000502:physiology; D013997:Time Factors; D014797:Vital Capacity / Q000502:physiology; D055815:Young Adult
keywords: Posture; Respiratory function; Spinal cord injury