Ann Rehabil Med.  2018 Jun;42(3):457-464. 10.5535/arm.2018.42.3.457.

Motor and Sensory Function as a Predictor of Respiratory Function Associated With Ventilator Weaning After High Cervical Cord Injury

• Kim TW
• Yang JH
• Huh SC
• Koo BI
• Yoon JA
• Lee JS
• Ko HY
• Shin YB

• KMID: 2417838
• DOI: http://doi.org/10.5535/arm.2018.42.3.457

Abstract

OBJECTIVE
To analyze the respiratory function of high cervical cord injury according to ventilator dependence and to examine the correlations between diaphragm movement found on fluoroscopy and sensory and motor functions.
METHODS
A total of 67 patients with high cervical spinal cord injury (SCI), admitted to our hospital were enrolled in the study. One rehabilitation physician performed sensory and motor examinations on all patients while each patient was in the supine position on the American Spinal Injury Association (ASIA) standard. In addition, fluoroscopic diaphragm movement studies and bedside spirometry were performed.
RESULTS
Bedside spirometry and diaphragm fluoroscopic tests were analyzed according to ventilator dependence. Forced vital capacity and maximal inspiratory pressure were significantly higher in the ventilator weaned group. Natural breathing during the fluoroscopic diaphragm examinations and ventilator weaning showed statistical significance with the movement on the right, while deep breathing showed statistical significance with the movement on both sides. Deep breathing movement has correlation with the C5 key muscle. Diaphragm movement has correlation with right C3 and bilateral C4 sensory functions.
CONCLUSION
The present expansion study showed that, through simple bedside physical examinations, rehabilitation physicians could relatively easily predict diaphragm movement and respiratory function recovery, which showed significance with ventilator weaning in patients with high cervical SCI.

Keyword

Spinal cord injuries; Cervical cord; Respiratory function tests; Physical examination

MeSH Terms

Cervical Cord*
Diaphragm
Fluoroscopy
Humans
Physical Examination
Recovery of Function
Rehabilitation
Respiration
Respiratory Function Tests
Sensation*
Spinal Cord Injuries
Spinal Injuries
Spirometry
Supine Position
Ventilator Weaning*
Ventilators, Mechanical*
Vital Capacity

Figure

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  Fig. 1. Fluoroscopic diaphragm examination.

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