The Effectiveness of Pulmonary Rehabilitation Program on Functional Improvement in Patients with Spinal Cord Injury

ABSTRACT

OBJECTIVE: To investigate the effectiveness of pulmonary rehabilitation program on functional improvement in patients with spinal cord injury and the difference between tetraplegics and paraplegics. METHOD: Twenty one patients without previous history of pulmonary pathology were recruited for this study. Fourteen patients were tetraplegic (12 males, 2 female; mean duration of disease, 42.2+/-7.9 days; mean age, 52.7+/-3.4 years old), seven patients were paraplegic (6 males, 1 female; mean duration of disease, 48.8+/-6.3 days; mean age, 42.1+/-3.7 years old). All patients received pulmonary rehabilitation composed of respiratory muscles strengthening exercise, positive inflation exercise, and breathing exercise with Breather(R) for 30 minutes a session, twice a day, five days per week for 4 weeks. We evaluated arterial blood gas analysis, pulmonary function test (PFT), modified Borg scale (MBS), Spinal Cord Independence Measure (SCIM), and Functional Independence Measure (FIM) as outcome measures at the beginning and 4 weeks after treatment. RESULTS: After the pulmonary rehabilitation program, both of PaO2 and SaO2 increased in tetraplegia and paraplegia groups. MBS improved at rest and on exercise in both of paraplegia and tetraplegia groups (p<0.05). FEV1 and FVC increased in both groups (p<0.05). Both SCIM and FIM scores increased in both groups (p<0.05). The difference of the improvement ratio of PFT, MBS and functional scales between tetraplegia and paraplegia groups was not significant. CONCLUSION: It is suggested that pulmonary rehabilitation program would be useful to improve the functional improvement including of pulmonary function and subjective dyspnea scale in both of tetraplegia and paraplegia groups.