Effects of abdominal strapping on forced expiration in tetraplegic patients

American Journal of Respiratory and Critical Care Medicine
M EstenneA De Troyer

Abstract

Patients with traumatic transection of the lower segments of the cervical cord contract the clavicular portion of the pectoralis major during forced expiration and cough, and the rise in intrathoracic pressure resulting from this contraction produces dynamic airway compression in many patients. Because the abdominal muscles are paralyzed, however, there is paradoxical expansion of the abdomen, which may reduce the rise in intrathoracic pressure and the degree of airway collapse. To evaluate the magnitude of this effect, we measured expiratory flow rate (Vexp) and esophageal pressure (Pes) during a series of forced expiratory vital capacity maneuvers and constructed isovolume-pressure flow (IVPF) curves before and after abdominal strapping in eight C5-8 tetraplegic subjects. Strapping produced small and inconsistent changes in maximal Vexp and Pes and resulted in the development of small flow plateaus in only four patients. In tetraplegic subjects, abdominal strapping thus has small effects on forced expiration and is unlikely, therefore, to improve the efficiency of cough.

References

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Oct 1, 1994·American Journal of Respiratory and Critical Care Medicine·M EstenneA De Troyer

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Citations

Mar 13, 2012·Translational Stroke Research·Daniela G L Terson de PalevilleAlexander V Ovechkin
Mar 11, 2000·American Journal of Respiratory and Critical Care Medicine·M EstenneA De Troyer
Aug 21, 2002·American Journal of Respiratory and Critical Care Medicine·UNKNOWN American Thoracic Society/European Respiratory Society
Jun 27, 2003·American Journal of Respiratory and Critical Care Medicine·Franco Laghi, Martin J Tobin
Jun 27, 2012·Archives of Physical Medicine and Rehabilitation·Brooke M WadsworthJennifer D Paratz
May 16, 2009·Respiratory Physiology & Neurobiology·Gregory J SchileroMarvin Lesser
Sep 13, 2008·Clinical Physiology and Functional Imaging·Mette Helene ToftLene Simonsen
Jul 9, 2005·Archives of Physical Medicine and Rehabilitation·Nicholas HartFrédéric Lofaso
Dec 22, 2011·Respiratory Physiology & Neurobiology·Christopher R WestLee M Romer
Oct 19, 2010·Neurorehabilitation and Neural Repair·Jane E ButlerSimon C Gandevia
Apr 26, 2003·Spinal Cord·P BodinM Fagevik Olsén
Feb 28, 2014·Topics in Spinal Cord Injury Rehabilitation·Petrea L CornwellBrooke Wadsworth
Jun 27, 2019·Spinal Cord Series and Cases·Michaela de GrootJennifer Hastings
Nov 11, 2010·The Journal of Spinal Cord Medicine·W Darlene ReidBrodie M Sakakibara
Apr 16, 2020·Spinal Cord Series and Cases·Michaela de GrootJennifer Hastings

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