title: Acute effects of glossopharyngeal insufflation in people with cervical spinal cord injury.
abstract: To evaluate acute effects of glossopharyngeal insufflation (GI) on lung function, airway pressure (Paw), blood pressure and heart rate (HR) in people with cervical spinal cord injury (CSCI).
  
  
  
  Case-control design.
  
  
  
  Karolinska Institutet, Stockholm, Sweden.
  
  
  
  Ten participants with CSCI suffering from lesions between C4 and C8, and ASIA classification of A or B were recruited. Ten healthy particpants familiar with GI were recruited as a reference group.
  
  
  
  Spirometry, mean arterial blood pressure (MAP), Paw,and HR were measured in a sitting and a supine position before, during, and after GI.
  
  
  
  GI in the study group in a sitting position increased total lung capacity (TLC) by 712 ml: P < 0.001, vital capacity (VC) by 587 ml: P < 0.0001, Pawby 13 cm H2O: P < 0.01, and HR by 10 beats/min: P < 0.001. MAP decreased by 25 mmHg, P < 0.0001. Significant differences were observed between groups comparing baseline with GI. The reference group had a higher increase in; TLC (P < 0.01), VC (P < 0.001), Paw(P < 0.001) and HR (P < 0.05) and a higher decrease in MAP (P < 0.001). With GI in a sitting compared to a supine position, TLC, MAP, HR, Pawremained unchanged in the study group, while residual volume decreased in the supine position (P < 0.01).
  
  
  
  There was a difference between the groups in the increase in TLC; VC; Paw,HR and in the decrease in MAP with GI, however MAP, HR and Pawresponded in similar way in both groups in a sitting as well as a supine position. If performed correctly, the risks of GI resulting in clinically significant hemodynamic changes is low, although syncope may still occur.
authors.affiliation: a Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, and Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function , Karolinska University Hospital , Huddinge , Sweden.
authors.forename: Malin
authors.identifier: 0000-0001-6731-8468
authors.initials: M
authors.lastname: Nygren-Bonnier
authors.affiliation: b Department of Physiology and Pharmacology , Karolinska Institutet , Stockholm , Sweden.
authors.forename: Tomas A
authors.initials: TA
authors.lastname: Schiffer
authors.affiliation: b Department of Physiology and Pharmacology , Karolinska Institutet , Stockholm , Sweden.
authors.forename: Peter
authors.identifier: 0000-0002-0840-9244
authors.initials: P
authors.lastname: Lindholm
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001794:Blood Pressure; D001945:Breathing Exercises / Q000009:adverse effects / Q000379:methods*; D016022:Case-Control Studies; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D005930:Glossopharyngeal Nerve / Q000503:physiopathology; D006339:Heart Rate; D006801:Humans; D007327:Insufflation / Q000009:adverse effects / Q000379:methods*; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012131:Respiratory Insufficiency / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation
keywords: Airway pressure; Blood pressure; Glossopharyngeal breathing; Lung function; Physiotherapy