Effects of abdominal binding on breathing patterns during breathing exercises in persons with tetraplegia

Abstract

Study design: Cross-sectional, experimental. Objectives: To investigate and compare static lung volumes and breathing patterns in persons with a cervical spinal cord lesion during breathing at rest, ordinary deep breathing, positive expiratory pressure (PEP) and inspiratory resistance-positive expiratory pressure (IR-PEP) with and without an abdominal binder (AB). Setting: The outpatient clinic at the Spinal Unit at Sahlgrenska University Hospital, Go¨teborg, Sweden. Method: The study group consisted of 20 persons with complete cervical cord lesion at C5-C8 level. Breathing patterns and static lung volumes with and without an AB were measured using a body plethysmograph. Results: With an AB, static lung volumes decreased, vital capacity increased, breathing patterns changed only marginally and functional residual capacity remained unchanged during PEP and IR-PEP. Conclusion: Evidence supporting the general use of an AB to prevent respiratory complications by means of respiratory training is questionable. However, the interindividual variation in our results indicates that we cannot rule out that some patients may benefit from the treatment.

Benefit of triple-strap abdominal binder on voluntary cough in patients with spinal cord injury

“…As in other studies, [9][10][11]13 there were no reports of discomfort and no side-effects were observed, indicating that the use of abdominal binders is safe, simple, inexpensive and well tolerated by patients.…”

“…It also pushes the abdominal contents inward, moving the diaphragm upward and increasing its length during coughing, allowing the diaphragm to contract more effectively 21 and the subject to generate higher intrathoracic pressure during forced expiration. 13 In addition, the increased pressure over the abdomen would increase the fulcrum effect of the abdominal contents on the diaphragm and increase its efficiency. This would lead to an increase in inspiratory volume before coughing, thereby increasing the PEFR.…”

“…[4][5][6] A few studies that focus on improving cough ability among persons with SCI have been conducted. These include studies on therapeutic manoeuvres, 7 use of abdominal binders, [8][9][10][11][12][13] the use of electrical stimulator 14,15 and functional magnetic stimulator. 16,17 Studies by Jaeger et al 7 and Linder 15 found that cough efficacy produced by electrical stimulation was as effective as manually assisted cough in subjects with tetraplegia.…”

“…13 Variables such as demographics of subjects, type of abdominal binders and respiratory outcome parameters in previous studies on the use of the abdominal binder were not well controlled, thus making the use of abdominal binders in SCI unclear. [9][10][11]13 As there is evidence that abdominal binders may be useful for SCI patients, [10][11]13 we chose to explore the effectiveness of different types of elastic abdominal binders (single-strap versus triple-strap abdominal binder) and their methods of application.…”

Abdominal binder use in people with spinal cord injuries: a systematic review and meta-analysis

“…2 Abdominal binders (ABs) have been used to aid respiratory function in people who have suffered SCI. [3][4][5][6][7][8][9][10][11][12][13] Several studies have reported that vital capacity (VC) in tetraplegic SCI is decreased to 50-80% of predicted values. 14,15 The mechanism of action of ABs is thought to be related to improving respiratory mechanics.…”