Effects of wheelchair use on pulmonary function and muscular respiratory strength in subjects with spinal cord injury: a case series

Résumé

Introduction: People who suffer from spinal cord injuries (SCI) have a high prevalence of respiratory diseases. Their level of respiratory compromise depends on the degree of the injury, whether it is complete or incomplete, and on the age of the individual. Because these patients remain seated for extended periods of time, it is essential to evaluate how a wheelchair affects their lung function. Our objective was to compare pulmonary function and respiratory muscle strength in patients with SCI evaluated while seated in a wheelchair with lumbar concavity (WLC) and while seated in a static chair with lumbar convexity (SLC).

Methods: Forced vital capacity (FVC), forced expiratory volume during the first second (FEV₁), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), and maximal expiratory pressure (MEP) were assessed in subjects with SCI seated in WLC and SLC. For the statistical analysis, STATA 11.1 software was used. We applied t-test to compare the results, and a difference of <0.05 was considered significant.

Results: We recruited seven male subjects, with a mean age of 42.4 ± 15.5 years (range 19 – 61) and level of injury between C7 and T10. The FVC was 4.21 ± 0.91 and 4.39 ± 0.89 L, for WLC and SLC, respectively, showing a significant difference (p = 0.04). FEV₁, PEF, MIP, and MEP did not show any significant difference.

Conclusion: The use of WLC diminished the FVC in subjects with SCI. The PEF, MIP, and MEP did not have a statistically significant difference but showed a marked tendency to the diminution.