Original articleDeterminants of Forced Expiratory Volume in 1 Second (FEV1), Forced Vital Capacity (FVC), and FEV1/FVC in Chronic Spinal Cord Injury
Section snippets
Patient Population
Between October 1994 and June 2003, 484 participants free from acute illness were recruited from the SCI Service of the Veterans Affairs (VA) hospital in West Roxbury, MA, and by advertisement from the community. A recruitment criterion of being 1 or more years post-SCI was selected to ensure that we tested subjects who had survived acute injury and related complications. Participants requiring mechanical ventilation or having a tracheostomy were not tested. The recruitment was from a pool of
Results
Baseline characteristics are presented with the cohort divided into 3 motor injury level and completeness groups (table 1) because some of the 9 injury level and severity groups had few subjects. The mean age of study participants was 50.7±14.9 years (range, 21.8−87.0y), and they were tested at an average of 17.4±12.8 years postinjury (range, 0.9−54.7y). Of the 120 people with a chest injury or operation, 64 (53%) reported broken ribs and 36 (30%) reported a history of a “punctured” or
Discussion
Although previous investigations on pulmonary function in SCI have assessed factors in addition to SCI level and completeness in large cross-sectional cohorts, to our knowledge the contribution of respiratory muscle strength and coexisting medical conditions has not been considered previously.4, 5, 6, 7, 8, 9, 10, 11, 12, 13 The results for cigarette smoking have also varied. Some previous studies4, 5, 6, 7, 8, 13 included relatively few participants, resulting in inadequate power to assess
Conclusions
Our study shows that in SCI, in addition to level and severity of injury, pulmonary function is influenced by previous chest injury or operation, age, time since injury, lifetime smoking, obesity, wheeze, and MIP. The effects of age and lifetime smoking were less apparent in participants with greater degrees of neurologic impairment and muscle weakness. Hence, decrements in FEV1, FVC, and FEV1/FVC in tetraplegia, and by extension in others with respiratory muscle weakness, may not reliably
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Inspiratory Muscle Performance and Anthropometric Measures—Novel Assessments Related to Pulmonary Function in People with Spinal Cord Injury: A Pilot Study
2022, Archives of Physical Medicine and RehabilitationCitation Excerpt :Visceral obesity is common after SCI, which increases pulmonary resistance in the seated position, further limiting the contraction of respiratory muscles.16 Higher BMI post-SCI, especially >30, has been associated with lower forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) ratio and further PF decline.18,19 As such, PF assessment in people with SCI should be coupled with anthropometric assessment.
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Supported by National Institute of Child Health and Human Development, National Institutes of Health (grant no. RO1 HD42141), the Massachusetts Veterans Epidemiology Research and Information Center, Cooperative Studies Program, and Health Services Research and Development, Department of Veterans Affairs.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.