Evaluation of a clinical implementation of a respiratory muscle training group during spinal cord injury rehabilitation

Study design
Retrospective cohort study.

Objective
To evaluate the clinical implementation of a respiratory muscle training group during rehabilitation of individuals
with spinal cord injury.

Setting
Spinal cord injury rehabilitation center.

Methods
Individuals with complete or incomplete lesions during inpatient rehabilitation, level C4–T12.
Ten or more training sessions of either an inspiratory or a combined in- and expiratory muscle training were performed in a group setting with respiratory function measurements before and after the training period.

Results
Analysis of 79 persons. Inspiratory muscle training was performed for 7 weeks with a median of 3.1 training sessions per week. Median training intensity was at 33% of baseline PImax and 58 repetitions were performed per training session. Respiratory mucle strength parameters improved by 18–68% of baseline values and lung function parameters by 11–31% after inspiratory muscle training. The combined respiratory muscle training was performed for 13 weeks with a median of 2.8 sessions per week and 88 repetitions per training session. Median inspiratory training resistance was at 39% of baseline PImax and median expiratory training resistance was at 27% of baseline PEmax. Respiratory muscle strength parameters improved by 14–51% of baseline values and lung function parameters improved by 15–34% after the combined in- and expiratory muscle training.

Conclusion
Respiratory resistance training improved respiratory function of individuals with acute spinal cord injury. Even if the combined respiratory muscle training was performed with more repetitions per training and nearly twice as long, relative improvements of respiratory function parameters were comparable with isolated inspiratory muscle training.