Mild Resistive Expiratory Breathing Technique On Spinal Cord Injury
Condition: Spinal Cord Injuries
MeSH terms: Spinal Cord Injuries; Wounds and Injuries
Study type: Interventional

Summary: 
      Studies have been conducted on the effectiveness of inspiratory muscle training on
      tetraplegics, and less has been reported on expiratory muscle training on paraplegics;
      especially in Pakistan there was no such study done up-to my knowledge. Paraplegic
      individuals develop pulmonary complications due to prolonged general immobilization of body
      and ineffective cough due to respiratory muscle weakness. This study will identify the
      effects of expiratory muscle training using "Expiratory Muscle Strength Trainer- 150" in
      paraplegic individuals in Peshawar, Pakistan
    

Detailed description: 
      A study on the effects of accessory expiratory muscle training and showed that there was a
      significant improvement in vital capacity of experimental group. The investigator recruited
      40 patients and randomly allocated them to control and experimental groups. Experimental
      group received expiratory muscle training for half hour a day, six days a week for eight
      weeks, which included training using PFLEX muscle trainer. Control group received
      conventional breathing exercises and assistance in coughing. Experimental group showed
      improvement in mean vital capacity from 1.48 to 1.98 liters and in mean expiratory muscle
      strength from 43.76 cmH2O to 68 cmH2O. Control group yielded no changes.

      A respiratory muscle training and electrical stimulation of abdominal muscles on thirteen
      quadriplegic individuals to assess their respiratory function. The study consisted of
      training the patients for three months. Each subject was given one-month inspiratory
      training, followed by second month of expiratory muscle training, and then last month without
      training. Vital capacity showed 19% increase in the experimental group while control group
      showed no improvement .

      A randomized controlled trial to assess the effect of expiratory muscle training on pulmonary
      function of 29 spinal cord injury patients in an acute inpatient rehabilitation hospital.
      Patients were randomized into two groups. Experimental group consisting of 16 patients
      received expiratory muscle training using EMST for 10 repetitions twice a day, 5 days a week,
      for 6 weeks. Control group consisted of 13 individuals and they received sham training. There
      was no significant difference reported between both groups
    

Intervention name(s): Mild Resistive Expiratory Technique; Conventional Training
Intervention type(s): Other; Other
Intervention description(s): Mild Resistive Expiratory Technique (EMST150- five-week training protocol):
The EMST requires the participant to forcibly blow into the device for 5 seconds with sufficient pressure to open the one-way valve. Each "blow" is one repetition. The device will be set at a resistance of 30 cmH2O. Participants will be instructed to complete five sets of five repetitions (total of 25 times and approximately 20 minutes per day), any five days per week, for five weeks. Whole exercise will be done in sitting position. Rest between repetitions will be given according to comfort level of patient.; Breathing exercise: Deep breathing 10-15 repetitions twice a day. Assistive Coughing: 5-6 repetitions twice a day. ROM Exercises: Both active and passive limb ROM exercises 10-15 repetitions twice a day.
Sustained stretching: Both upper and lower limbs, 10 repetitions, held for 5 seconds, twice a day.
Splinting: According to patient's injury level Bracing: According to patient's injury level Functional Mobility: Mobilizing patient according to injury level Tilt table standing: 10-15 minutes once a day
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Pulmonary Function Test; Spinal Cord; Breathing Exercise; Expiratory