title: 'Instead of popping pills, perhaps you should add frog breathing': experiences of glossopharyngeal insufflation/breathing for people with cervical spinal cord injury.
abstract: People with cervical spinal cord injury have impaired function of the respiratory muscles, which results in reduced ventilation. Glossopharyngeal insufflation/breathing increases total lung capacity and improves cough function, however, knowledge of the experiences regarding learning and practicing glossopharyngeal insufflation in everyday life is missing.
  
  
  
  To describe and explore the experiences of learning and practicing glossopharyngeal insufflation among people with cervical spinal cord injury.
  
  
  
  Twenty six individuals with cervical spinal cord injury, who had participated in a previous intervention study on glossopharyngeal insufflation, were interviewed. Semi-structured telephone interviews were analyzed with qualitative content analysis.
  
  
  
  An overall theme and seven categories emerged. Glossopharyngeal insufflation was perceived as a possibility to make a difference in one's life by improving respiratory function, both immediately and for time ahead and thereby ease everyday activities, and by increasing participation, independence, and overall health. The participants with cervical spinal cord injury described that they could learn glossopharyngeal insufflation, but it could be perceived as difficult. However, the use of glossopharyngeal insufflation could be experienced by the individual as being different, and there were sometimes doubts about its effectiveness.
  
  
  
  Use of glossopharyngeal insufflation can enable people with cervical spinal cord injury to increasingly participate in everyday activities. Increased autonomy might lead to improved self-esteem and provide well-being. However, ambivalence about the usefulness of glossopharyngeal insufflation may arise and the technique can be difficult to learn. Therefore, individualized information and instructions from health professionals are required. Implications for Rehabilitation Practicing glossopharyngeal insufflation leads to increased participation in everyday activities for people with cervical spinal cord injuries and provides the individual hope to influence future life situation. People with cervical spinal cord injuries therefore need support from health care professionals in order to be motivated to learn and then use the glossopharyngeal insufflation technique also as health promotion Glossopharyngeal insufflation can improve respiratory function and also increase awareness of breathing; health professionals should therefore be able to assess which patients who can benefit from glossopharyngeal insufflation in order to make the technique become an important part of the rehabilitation. The technique can be difficult to perform perfectly and is sometimes perceived as uncomfortable. It may also cause unpleasant side effects and therefore individualized information and instructions regarding glossopharyngeal insufflation are required.
authors.affiliation: a Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy , Karolinska Institutet , Huddinge , Sweden.|b Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function , Karolinska University Hospital , Stockholm , Sweden.
authors.forename: Malin
authors.identifier: 0000-0001-6731-8468
authors.initials: M
authors.lastname: Nygren-Bonnier
authors.affiliation: b Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function , Karolinska University Hospital , Stockholm , Sweden.
authors.forename: Jens
authors.initials: J
authors.lastname: Werner
authors.affiliation: a Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy , Karolinska Institutet , Huddinge , Sweden.
authors.forename: Gabriele
authors.identifier: 0000-0003-3659-4536
authors.initials: G
authors.lastname: Biguet
authors.affiliation: a Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy , Karolinska Institutet , Huddinge , Sweden.|b Functional Area Occupational Therapy & Physiotherapy, Allied Health Professionals Function , Karolinska University Hospital , Stockholm , Sweden.
authors.forename: Sverker
authors.identifier: 0000-0002-8654-5962
authors.initials: S
authors.lastname: Johansson
mesh_terms: D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001945:Breathing Exercises; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026684:Personal Autonomy; D012132:Respiratory Muscles / Q000503:physiopathology; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D014797:Vital Capacity / Q000502:physiology; D055815:Young Adult
keywords: Breathing exercise; experiences; glossopharyngeal insufflation; lung function; physiotherapy; qualitative method