title: Short-term effects of respiratory muscle training combined with the abdominal drawing-in maneuver on the decreased pulmonary function of individuals with chronic spinal cord injury: A pilot randomized controlled trial.
abstract: To investigate the effects of respiratory muscle training (RMT) combined with the abdominal drawing-in maneuver (ADIM) on the pulmonary function in patients with chronic spinal cord injury (SCI).
  
  
  
  Thirty-seven subjects with SCI (level of injury: C4-T6, time since injury: 4-5 years) were randomly allocated to three groups; the integrated training group (ITG), the RMT group (RMTG), and the control group (CG). The ITG performed RMT using an incentive respiratory spirometer (IRS) and the ADIM using a stabilizer. The RMTG received only RMT using an IRS. Subjects in the CG received alternative and routine physical therapy or usual care. The interventions were conducted over an eight-week period. Pulmonary function was evaluated using spirometry to measure the forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1).
  
  
  
  The differences between the pre- and post-test values for FVC (0.47 ± 0.05 versus 0.15 ± 0.06 versus -0.03 ± 0.01) and FEV1(0.74 ± 0.07 versus 0.27 ± 0.17 versus 0.02 ± 0.67)were significant among the groups. Post-test, in the ITG, the FVC and FEV1values showed significant differences from those in the RMTG and CG (F = 11.48 and 11.49, P = 0.002 and 0.001). Furthermore, following the 8-week intervention, the change ratio values of the FVC and FEV1of the ITG were increased further by an average of 9.75% and 7.91%, respectively, compared with those of the RMTG.
  
  
  
  These findings suggest positive evidence that RMT with additional ADIM training can improve pulmonary function in SCI pulmonary rehabilitation.
authors.affiliation: a Department of Health Science , The Graduate School, Korea University , Seoul , Republic of Korea.
authors.forename: Chang-Yong
authors.initials: CY
authors.lastname: Kim
authors.affiliation: b Department of Epidemiology and Health Informatics , The Graduate School of Public Health, Korea University , Seoul , Republic of Korea.
authors.forename: Jung-Sun
authors.initials: JS
authors.lastname: Lee
authors.affiliation: c Department of Physical Therapy , College of Health Science, Korea University , Seoul , Republic of Korea.
authors.forename: Hyeong-Dong
authors.initials: HD
authors.lastname: Kim
authors.affiliation: d Department of Physical Therapy , Gwangju Health University , Gwangju , Republic of Korea.
authors.forename: Dong-Jin
authors.initials: DJ
authors.lastname: Lee
mesh_terms: D000009:Abdominal Muscles / Q000502:physiology* / Q000503:physiopathology; D000328:Adult; D005081:Exercise Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D012132:Respiratory Muscles / Q000502:physiology* / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000534:rehabilitation* / Q000628:therapy; D014109:Total Lung Capacity
keywords: Abdominal drawing-in maneuver; Incentive respiratory spirometer; Pulmonary function; Respiratory muscle training; Spinal cord injury