Kanishka Gambhir, Shambhovi Mitra, Anne E Palermo
Objective: To evaluate the effect of inspiratory muscle training (IMT) on functional sitting balance (FSB) in individuals with spinal cord injury (SCI).
Design: Rater-masked, parallel, 2-group randomized clinical trial.
Setting: Tertiary care SCI rehabilitation hospital.
Participants: Forty-four participants (N=44) (aged 18-60) with C4-T6 injuries (American Spinal Injury Association Impairment Scale A-C) (cervical-SCI=25, thoracic-SCI=19, American Spinal Injury Association Impairment Scale A=33, B=11, C=0) in their first SCI-specific inpatient rehabilitation were randomly assigned into experimental and control groups.
Interventions: Both groups received standard respiratory care and physiotherapy. The experimental group received additional flow-resistive IMT sessions over 6 weeks.
Main outcome measures: FSB was measured using the Function in Sitting Test-SCI, and respiratory function was assessed via maximal inspiratory pressure, sustained maximal inspiratory pressure, and Fatigue Index Test score at baseline, 4 weeks and 6 weeks. Data were analyzed using repeated measures general linear model framework in IBM SPSS version 21.
Results: Analysis showed significant improvements in FSB for both groups (P<.001). Sustained maximal inspiratory pressure, maximal inspiratory pressure, and Fatigue Index Test scores improved only for the experimental group (P<.05). Post-hoc analyses of interaction effects showed significantly greater improvements in all variables in the experimental group.
Conclusions: This study is the first to show that FSB improves more with addition of IMT to standard care in individuals with SCI.