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(Chest. 2005;128:184-189.)
© 2005 American College of Chest Physicians

Effects of Partial Isothermic Immersion on the Spirometry Parameters of Tetraplegic Patients*

Sérgio Thomaz, PT, MSc; Paulo Beraldo, MD, PhD; Sergio Mateus, PT, MSc; Thomas Horan, MD, FCCP and Josevan Cerqueira Leal, PT

* From the SARAH Network of Hospitals for the Locomotor System (Drs. Beraldo and Horan), Master’s Degree Program in Rehabilitation Sciences (Mr. Thomaz, Mr. Mateus, and Mr. Leal), Brasília, Federal District, Brazil.

Correspondence to: Thomas A. Horan, MD, FCCP, Hospital SARAH, SMHS, Quadra 501, Conjunto "A", Brasília-DF, 70 000-150, Brazil; e-mail: thoran{at}bsb.sarah.br

Study objectives: Our objective was to compare under controlled conditions the effect of immersion on spirometry parameters of patients with tetraplegia vs those of normal individuals.

Design and patients: Twenty-three otherwise well tetraplegic subjects were compared to a control group of 11 similar healthy subjects before and during 5 to 15 min of isothermal immersion in water to shoulder level.

Results: Measured at baseline, tetraplegic subjects exhibited significant pulmonary restriction, characterized by a mean FVC of 54.9 ± 14.6% of the predicted value (range, 23.2 to 80.4%), whereas all controls subjects had > 80% of predicted values. Immersion increased the FVC of tetraplegic patients an average of 18.4 ± 18.7% above basal measurements, while that of the control group worsened ({Delta}FVC, – 8.8 ± 4.4%). Among the tetraplegic patients, the lower the preimmersion vital capacity, the greater the percentage of improvement following immersion (r = 0.79; 95% confidence interval, – 0.91 to – 0.56; p < 0.0001). No relationship was found between the time elapsed since cervical cord injury or its level and the degree of improvement.

Conclusions: Water activities play an important role in the rehabilitation of patients with spinal cord injury. Immersion in isothermal water at shoulder level, under strictly controlled experimental conditions, reduces the vital capacity of normal individuals, while it improves in a group of patients with tetraplegia. The observed phenomenon seems to be mediated by an improvement in breathing mechanics, impaired by cervical cord injury.

Key Words: hydrotherapy • immersion • lung function tests • respiratory mechanics • spinal cord injuries • tetraplegia






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