The effect of elastic abdominal binder use on respiratory function on persons with high spinal cord injury at orthostatic position.
Costa, Viviane de Souza Pinho; Costa, Bianca Teixeira; Silva Jr, Rubens Alexandre da; Costa Filho, Ruy Moreira da; Cardoso, Jefferson Rosa
Abstract
Introduction: Spinal cord injury causes respiratory muscles paralysis, especially in high thoracic paraplegia and tetraplegia with injury above or right on the sixth thoracic segment, and also biomechanics, volumes, capacities and respiratory pressures changes in affected people. The elastic abdominal binder provides a mechanical support for respiratory function treatment, assisting with abdominal restraint and abdominal compliance reduction while at orthostatic position. Objective: To verify the elastic abdominal binder effect on the respiratory function of people with spinal cord injuries during standing position with the help of orthostatic table, from vertical angle position of 60° and 90°. Method: The study included 56 people suffering from spinal cord injury with motor level above or right on the sixth thoracic segment. They were randomly divided into four distinct groups regarding the use or not of the binder and different inclinations of the orthostatic table during the evaluation procedure. The measured outcomes were vital capacity, tidal volume, inspiratory and expiratory pressure and oxygen saturation. The descriptive analysis presented according to average and standard deviation or median and interquartile. For the outcomes analysis of the five evaluations, the Analysis of Variance (ANOVA) of two factors with repeated measures was used. Statistical significance was set at 5%. Results: The values obtained from respiratory parameters showed no statistical significance regarding the elastic abdominal binder intervention nor on the angle of the standing position. Conclusion: There was no contrasting effect regarding the use of the binder among the evaluated people, therefore it should not be nominated as a standard procedure in the treatment of spinal cord injury at orthostatic position. However, this procedure should not be absolute contraindicated, thus its effect has not demonstrated any harm to participants.
Keywords
References
1. Winslow C, Rozovsky J. Effect of spinal cord injury on the respiratory system. Am J Phys Med Rehabil. 2003;82:803-814.
2. Schneider FJ. Lesão Medular Traumática. In: Umphred DA (Editor). Fisioterapia Neurológica. 2ed. São Paulo: Manole; 1994. p 421-481.
3. Maynard FM Jr, Bracken MB, Creasey G, Ditunno JF Jr, Donavan WH, Ducker TB, et al. Internacional standarts for neurological and functional classification of spinal cord injury. Spinal Cord. 1997;35:266-274.
4. Andrada L, Vito EL. Evaluacion funcional respiratoria en pacientes con lesion medular traumatica alta. Medicina. 2001;61:529-534.
5. Chen CF, Lien IN, Wu MC. Respiratory function in patients with spinal cord injuries: effects of posture. Paraplegia. 1990;28:81-86.
6. Roth EJ, Nuussbaum SB, Berkowitz M, Primack S, Oken J, Powley S, et al. Pulmonary function testing in spinal cord injury: correlation with vital capacity. Paraplegia. 1995;33:454-457.
7. Roth EJ, Lu A, Primack S, Oken J, Nuusbaum S, Berkowitz M, et al. Ventilatory function in cervical and high thoracic spinal cord injury: relationship to level of injury and tone. Am J Phys Med Rehabil. 1997;76:262-267.
8. Wadsworth BM, Haines TP, Cornwell PL, Paratz JD. Abdominal binder use in people with spinal cord injuries: a systematic review and meta-analysis. Spinal Cord. 2009;47:274–285.
9. Wadsworth BM, Haines TP, Cornwell PL, Rodwell LT, Paratz JD. Abdominal binder improves lung volumes and voice in people with tetraplegic spinal cord injury. Arch Phys Med Rehabil. 2012;93:2189-2197.
10. Cornwell PL, Ward EC, Lim Y, Wadsworth, B. Impact of an Abdominal Binder on Speech Outcomes in People With Tetraplegic Spinal Cord Injury: Perceptual and Acoustic Measures. Top Spinal Cord Inj Rehabil. 2014;20:48–57.
11. Wang AY, Jaeger RJ, Yarkony GM, Turba RM. Cough in spinal cord injuried patients: the relationship between motor level and peak expiratory flow. Spinal Cord. 1997;35:299-302.
12. Boaventura CM, Gastaldi AC, Silveira JM, Santos PR, Guimarães RC, Lima LC. Effect of abdominal binder on the efficacy of respiratory muscle in seated and supine tetraplegic patients. Physiotherapy. 2003;89:290-295.
13. Gounden P. Static respiratory in patients with post-traumatic tetraplegia. Spinal Cord. 1997;35:43-47.
14. Estenne M, De Troyer A. Mechanism of the postural dependence of vital capacity in tetraplegics subjects. Am Rev Respir Dis. 1987;135:367-371.
15. Ali J, Qi W. Pulmonary function and posture in traumatic quadriplegia. J Trauma. 1995;39:334-337.
16. Goldman JM, Rose LS, Williams SJ, Silver JR, Denison DM. Effect of abdominal binders on breathing in tetraplegic patients. Thorax. 1986;41:940-945.
17. Kunkel CF, Scremin AM, Eisenberg B, Garcia JF, Roberts S, Martinez S. Effect of “Standing” on Spasticity, Contracture, and Osteoporosis in Paralyzed Males. Arch Phys Med Rehabil. 1993;74:73-78.
18. Medronho RA. Epidemiologia. São Paulo: Atheneu; 2003.
19. Defino HLA. Trauma raquimedular. Medicina. 1999; 32: 388-400.
20. Pacheco AM, Amim RST. Desmame da ventilação mecânica. Fisioterapia Brasil. 2003;4:295-299.
21. Rosner B. Fundamentals of Biostatistics. 5 ed. Pacific Grove: Duxbury-Thomson Learning; 2000.
22. Atrice MB, Morrison SA, McDowell SL, Shandalov B. Lesão Medular Traumática. In: Umphred DA (Editor). Reabilitação Neurológica. 4 ed. São Paulo: Manole; 2004. p.506-560.
23. Bodin P, Fagevik Olsén M, Kreuter M. Effects of abdominal binding on breathing patterns during breathing exercises in person with tetraplegia. Spinal Cord. 2005;43:117-122.
24. Eng JJ, Levins SM, Townson AF, Mah-Jones D, Bremner J, Huston G. Use of Prolonged Standing for With Spinal Cord Injuries. Phys Ther. 2001;81:1392-1399.
25. Fujiwara T, Hara Y, Chino N. Expiratory function in complete tetraplegics: study of spirometry, maximal expiratory pressure, and muscle activity of pectoralis major and latissimus dorsi muscles. Am J Phys Med Rehabil. 1999;78:464-469.
26. Pryor JA, Webber BA. Fisioterapia para Problemas Respiratórios e Cardíacos. 2 ed. Rio de Janeiro: Guanabara Koogan; 2002.
27. Mccool FD, Pichurko BM, Slustsky AS, Sarkarati M, Rossier A, Brown R. Changes in the volume and rib cage configuration with abdominal binding in quadriplegia. J Appl Physiol. 1986;60:1198-1202.
28. Estenne M, Van Muylem A, Gorini M, Kinnear W, Heilporn A, De Troyer A. Effects of abdominal strapping on forced expiration in tetraplegic patients. Am J Respir Crit Care Med. 1998;157:95-98.
Facebook
Google+
Twitter
LinkedIn
Mendeley
StumbleUpon
CiteULike
Reddit
Email