Outcomes of physical therapy program on respiratory and phrenic nerve functions in cervical disc compression

Introduction Pulmonary compromise may result in further comorbidities and increased mortality among spinal cord lesion patients. The current study was designed to evaluate the planned physical therapy protocol’s efficacy on pulmonary function and phrenic nerve activities in cervical disc lesions. Methods Thirty participants from the spinal unit – Al Salam International Hospital had an acute fifth and/or upper cervical compressed disc. The mean age range was 43.17 ± 2.90 years. Pulmonary functional tests of vital capacity (VC), forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), maximum voluntary ventilation (MVV), and peak expiratory flow rate (PEF) were measured via spirometry, diaphragmatic excursion via ultrasound, and phrenic amplitude and distal latency (PNL) via electromyography at baseline and 3 months later. The treatment protocol involved a hot pack, cervical traction, and ultrasound, in addition to diaphragmatic breathing exercise training. Results The obtained results revealed remarkable improvement in all measured outcomes compared to the mean values of pre- and post-treatment. Highly statistically significant increases in FEV1, MVV, diaphragmatic excursion, and amplitude of the phrenic nerve were determined (0.0001), along with significantly reduced PNL at post-intervention (0.0001) compared to baseline. Conclusions. The obtained results revealed remarkable improvement in all measured outcomes compared to the mean values of pre- and post-treatment. Highly statistically significant increases in FEV1, MVV, diaphragmatic excursion, and amplitude of the phrenic nerve were determined (0.0001), along with significantly reduced PNL at post-intervention (0.0001) compared to baseline. Conclusions The improvement obtained in all measured parameters may be attributed to the effect of the intensive treatment program, which led to controlling pain and increasing respiratory muscle strength.