Longitudinal association between respiratory muscle strength and cough capacity in persons with spinal cord injury: An explorative analysis of data from a randomized controlled trial
Karin Postma, Lonneke Y Vlemmix, Janneke A. Haisma, Sonja de Groot, Tebbe A. R. Sluis, Henk J. Stam, Johannes B. J. Bussmann
Rijndam Rehabilitation Center, PO Box 23181, NL-3000 KD Rotterdam, The Netherlands. E-mail: firstname.lastname@example.org
Objective: To assess the longitudinal association between respiratory muscle strength and cough capacity in persons with recent spinal cord injury.
Design: Longitudinal analyses.
Subjects: Forty persons with recent spinal cord injury and impaired pulmonary function.
Methods: Measurements were performed 4 weeks after the start of rehabilitation, 9 and 17 weeks after the first measurement, and one year after discharge from inpatient rehabilitation. Peak cough flow was measured with a spirometer. Maximum inspiratory and expiratory pressures (MIP and MEP), expressed in cmH2O, were measured at the mouth.
Results: Both MIP and MEP were significantly positively associated with peak cough flow. After correction for confounders and time 10 cmH2O higher MIP was associated with a 0.32 l/s higher peak cough flow, and a 10 cmH2O higher MEP was associated with a 0.15 l/s higher peak cough flow. The association between MIP and peak cough flow was mainly based on within-subject variance. The association between MIP and peak cough flow was stronger than between MEP and peak cough flow.
Conclusion: Improvement in respiratory muscle strength is associated with improvement in cough capacity in persons with recent spinal cord injury who have impaired pulmonary function.
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