Pulmonary dysfunction in patients after cervical spinal cord injury: serial follow-up measurement within the first year post-injury.
OBJECTIVE
Respiratory complications are most common cause of morbidity/mortality in patients with cervical spinal cord injury (cSCI) due to respiratory muscle weakness and lower diaphragm position resulting in limited availability of inspiration, reduced thorax mobility and limited forced expiration. Differences in respiratory dysfunctions (RDs) in patients with motor complete versus incomplete cSCI were assessed.


METHODS
Prospective longitudinal study, serial measurement.


METHODS
University hospital and ambulatory departments.


METHODS
Twenty two patients with acute cSCI were recruited. Neurological level of injury and severity according to ISNCSCI were used as criteria for recruitment. Patients were divided into two groups - motor complete and incomplete. Standardized pulmonary function tests (PFT) were used - spirometry and respiratory muscle strength (RMS) measurement. Motor score of key muscles assessments for upper (UEMS) and lower (LEMS) limbs were used. Tests were performed in 5 measurement sessions starting on (medians) 14.5 days (M1), then 6.7 weeks, 3.2 months, 6.3 months and 1.0 year (M5).


RESULTS
Significant differences in measurement sessions M2-M5 between groups in forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), expiratory reserve volume (ERV), maximal static inspiratory/expiratory pressures (MIP, MEP) and UEMS were proved. Consequently, prominent differences in courses of particular parameters were found. No intergroup changes in UEMS were found during study.


CONCLUSIONS
Obvious differences in parameters of spirometry, respiratory muscles and limb muscles strength between motor complete and incomplete group were found. Carefull monitoring of RDs by functional assessments (i.e., PFT and UEMS/LEMS tests) within one year after SCI seems to be clinically important.
Department of Rehabilitation and Sport Medicine, Charles University, 2nd Medical School, University Hospital Motol, Prague, Czech Republic.
Jan
J
Sulc
Department of Rehabilitation and Sport Medicine, Charles University, 2nd Medical School, University Hospital Motol, Prague, Czech Republic.
Krystof
K
Slaby
Department of Rehabilitation and Sport Medicine, Charles University, 2nd Medical School, University Hospital Motol, Prague, Czech Republic.
Zuzana
Z
Hlinkova
Department of Rehabilitation and Sport Medicine, Charles University, 2nd Medical School, University Hospital Motol, Prague, Czech Republic.
Pavel
P
Kolar
Department of Pain Research and Treatment, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czech Republic.
Jiri
J
Kozak
Department of Rehabilitation and Sport Medicine, Charles University, 2nd Medical School, University Hospital Motol, Prague, Czech Republic.
Jiri
J
Kriz
D000328:Adult; D066193:Cervical Cord / Q000293:injuries*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008171:Lung Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D011446:Prospective Studies; D011782:Quadriplegia / Q000209:etiology; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000150:complications*; D013147:Spirometry