© Walter Eggenberger
Gabi M├╝ller, Clinical Trial Unit, Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland

Inspiratory muscle strength and respiratory complications after spinal cord injury

Funded in: 2016, 2017, 2018

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Problem: High spinal cord injuries also impair respiratory muscles possibly leading to pneumonia

Target: Using inspiratory muscle strength as predictor to identifying patients at risk

Goal: Improve prevention of respiratory complications and hopefully decrease mortality due to pneumonia


After a spinal cord injury (SCI) also respiratory muscles are affected by the lesion. Especially individuals with tetraplegia often have no more active expiratory muscles. Therefore coughing, e.g. for secretion clearance is a major problem. This may lead to pneumonia which is still one of the main complications after SCI. Unfortunately, predictors of pneumonia in this population are widely unknown. Nevertheless, respiratory muscles can be trained by respiratory muscle training and we have first evidence, that inspiratory muscle strength may be a modifiable predictor of pneumonia in the SCI population.

Hypothesis: Inspiratory muscle strength is an excellent predictor of pneumonia in individuals with SCI.

Methods: We will perform an international, longitudinal multi-center cohort study to get a large amount of data on the relationship of inspiratory muscle strength and pneumonia as well as other important parameters with potential predictive value concerning the risk of pneumonia. This study will include patients at the start of their active rehabilitation after a SCI and perform measurements at 4 standardized time-points during inpatient rehabilitation. In total, 9 SCI rehabilitation centers from Switzerland (4), Austria (2), Australia (1) and The Netherlands (2) will participate in this project. We will be able to recruit about 550 patients for this study during a 2.5-year recruitment period. All these patients will regularly perform lung function and respiratory muscle strength measurements as well as complete various questionnaires about quality of life, personal and respiratory issues as well as individual exercise and treatment.

Expected results: This study will help to improve prevention of respiratory complications and hopefully decrease mortality due to pneumonia.

Potential clinical application: If we will be able to identify patients at increased risk for pneumonia at an early stage, preventative strategies as e.g. inspiratory muscle strength training may be prescribed.

 (Walter Eggenberger)
© Walter Eggenberger