J Korean Acad Rehabil Med.  2002 Dec;26(6):704-708.

The Relationships of Coughing to the Respiratory Muscle Strength and Pulmonary Compliance in Tetraplegic Patients

• Kang SW
• Ryu HH
• Shin JC
• Kim YR
• Kim JE

Abstract

OBJECTIVE
To analyze the factors influencing the capacity of cough, the relationships between maximal respiratory pressure, lung compliance, capacity of cough, and assisted cough techniques were evaluated in tetraplegics. METHOD: The vital capacity (VC) in seated and supine position, maximum insufflation capacity (MIC), maximum inspiratory (MIP) and expiratory (MEP) pressure in seated position were measured. Unassisted and assisted peak cough flow (PCF) at two different conditions (a volume assisted method by the mechanical insufflation [PCFmic] and the manual assistance by abdominal compression [MPCF]) were evaluated in 44 tetraplegic patients.
RESULTS
The mean value of VC in supine was greater than that of seated position (p<0.01). The MICs of the subjects were significantly higher than VCs in a same position (<0.01). Both volume and manual assisted method showed significantly higher PCF than unassisted PCF (p<0.01). MIP (r=0.53) correlated with UPCF as well as MEP (r=0.68), although MEP was better correlated with UPCF.
CONCLUSION
Generally the therapists apply manual pressure only to increase capacity of cough, which assist the expulsive phase. The results of this study showed that both inspiratory and expulsive phases should be assisted to enhance the effectiveness of cough.

Keyword

Tetraplegics; Maximal respiratory pressure; Compliance; Peak cough flow; Assisted cough

MeSH Terms

Compliance*
Cough*
Humans
Insufflation
Lung Compliance
Respiratory Muscles*
Supine Position
Vital Capacity