Inspiratory Muscle Training Enhances Functional Sitting Balance More Than Usual Care in Individuals With Spinal Cord Injury: A Randomized Controlled Trial.

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.