Impact of a structured pulmonary rehabilitation program on respiratory function in patients with spinal cord injuries and correlates

Background: A structured pulmonary rehabilitation protocol can have favorable effect on the respiratory dysfunction in patients with spinal cord injuries (SCI) of different duration. Methods: In a pre-post quasi-experimental study patients with traumatic and nontraumatic SCI admitted in the unit for inpatient rehabilitation were assessed with pulmonary function tests (PFT) on day 1 and after 2 weeks of training (24 sessions). A structured pulmonary rehabilitation program was provided to all the recruited patients. Parameters like tidal volume (VT), vital capacity (VC), forced vital capacity (FVC), forced expiratory flow at 1sec (FEV1), FEV1/FVC ratio, peak expiratory flow (PEF), and chest expansion were recorded and compared pretraining and posttraining. Results: Thirty-four patients (21 males) completed the training with ages ranging from 18 to 65 years (mean: 39.3, SD: 14.2). Nineteen had nontraumatic SCI and duration of lesion less than 12 weeks. Thirteen patients had complete motor and 21 had incomplete motor lesions. Chest expansion (22.2 vs 29.9 mm) and VC (1.7 vs 2.11 L) showed significant improvement posttraining ( P < 0.001). SBC and FVC showed significant improvement posttraining in lower cervical and dorsal but not in upper cervical lesions. No significant posttraining effect was observed according to severity or duration of SCI ( P > 0.05). Conclusions: A well-structured pulmonary rehabilitation program has a positive effect on respiratory function, which in turn improves SCI patients' endurance, independence, and quality of life, and decreases the risk of pulmonary complications.