© Walter Eggenberger

The importance of respiratory training

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Breathing complications are still the leading cause of death in complete spinal cord injury (SCI) patients. A high spinal cord injury has also a paralyzing effect on the important respiratory muscles: it alters cough capacity, secretion clearance and often leads to complications such as lung infections. Respiratory complications are also linked with a worse neurological recovery. That is why patients should receive the best respiratory training possible.

One goal – several means
There are two types of respiratory muscle strength training:
1.)  Resistive training comprises breathing through a small diameter hole, which limits the airflow.
2.)  Threshold training includes breathing with sufficient force in order to overcome a spring-loaded valve. 

Therefore, respiratory training can differ between a volume (resistive training) and intensity (threshold training) type.The current practice was mainly based on clinical experience.

A group of scientists led by Gabi Müller from the Swiss Paraplegic Centre in Nottwil, Switzerland, embarked on a study to find which of the training regimes had the best results. Therefore, they gathered data on 67 individuals with a lesion level C4-T12 over a 5-year periodretrospectively.

Gabi Müller and Anja Raab  (Walter Eggenberger )
Gabi Müller and Anja Raab   © Walter Eggenberger

What did the study show?
All data indicate that training intensity was far more important in increasing respiratory muscle strength. Indeed, volume training had almost no impact on the breathing capacity of patients with spinal cord injuries. 

First author of the publication, Anja Raab, recommends: “Training intensity should be chosen as high as possible”. The findings are really important for current clinical practice and should lead to an optimized management of respiratory training for SCI patients.

This study was supported by Wings for Life and was published in the journal Spinal Cord.


Source:“Respiratory muscle training in individuals with spinal cord injury: effect of training intensity and -volume on improvements in respiratory muscle strength” by Raab AM, Krebs J, Pfister M, Perret C, Hopman M, Mueller G. Published in July 2019 in the journal Spinal Cord.