Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 8 , Pages 1499-1506 , August 2008

Determinants of Lung Volumes in Chronic Spinal Cord Injury

Presented as a poster to the American Thoracic Society, May 18–23, 2007, San Francisco, CA.

  • Evan L. Stepp, MD

      Affiliations

    • Research and Development Service, Department of Veterans Affairs, VA Boston Healthcare System, West Roxbury, MA
    • Pulmonary and Critical Care Medicine Section, Medical Service, VA Boston Health Care System, West Roxbury, MA
    • Department of Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA
    • Harvard Medical School, Boston, MA
    • ,
  • Robert Brown, MD

      Affiliations

    • Department of Medicine, Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital, Boston, MA
    • Harvard Medical School, Boston, MA
    • ,
  • Carlos G. Tun, MD

      Affiliations

    • Research and Development Service, Department of Veterans Affairs, VA Boston Healthcare System, West Roxbury, MA
    • Rehabilitation Medicine Service, VA Boston Health Care System, West Roxbury, MA
    • Harvard Medical School, Boston, MA
    • ,
  • David R. Gagnon, MD, MPH, PhD

      Affiliations

    • Research and Development Service, Department of Veterans Affairs, VA Boston Healthcare System, West Roxbury, MA
    • VA Cooperative Studies Program, VA Boston Health Care System, West Roxbury, MA
    • Department of Biostatistics, Boston University School of Public Health, Boston, MA
    • ,
  • Nitin B. Jain, MD

      Affiliations

    • Research and Development Service, Department of Veterans Affairs, VA Boston Healthcare System, West Roxbury, MA
    • Programs in Research at VA, VA Boston Health Care System, West Roxbury, MA
    • Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Boston, MA
    • Harvard Medical School, Boston, MA
    • Harvard Medical School, Boston, MA
    • ,
  • Eric Garshick, MD, MOH

      Affiliations

    • Research and Development Service, Department of Veterans Affairs, VA Boston Healthcare System, West Roxbury, MA
    • Pulmonary and Critical Care Medicine Section, Medical Service, VA Boston Health Care System, West Roxbury, MA
    • Department of Medicine, Channing Laboratory, Brigham and Women's Hospital, Boston, MA
    • Harvard Medical School, Boston, MA
    • Corresponding Author InformationReprint requests to Eric Garshick, MD, MOH, Pulmonary and Critical Care Medicine Section, VA Boston Healthcare System, 1400 VFW Pkwy, West Roxbury, MA 02132

References 

  1. DeVivo MJ, Stover SL. Long term survival and causes of death. In:  Stover SL,  DeLisa JA,  Whiteneck GG editor. Spinal cord injury clinical outcomes from the model systems. Gaithersburg: Aspen; 1995;p. 289–316
  2. DeVivo MJ, Black KJ, Stover SL. Causes of death during the first 12 years after spinal cord injury. Arch Phys Med Rehabil. 1993;74:248–254
  3. Garshick E, Kelley A, Cohen SA, et al. A prospective assessment of mortality in chronic spinal cord injury. Spinal Cord. 2005;43:408–416
  4. Grandas NF, Jain NB, Denckla JB, et al. Dyspnea during daily activities in chronic spinal cord injury. Arch Phys Med Rehabil. 2005;86:1631–1635
  5. Jain NB, Brown R, Tun CG, Gagnon D, Garshick E. Determinants of forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC in chronic spinal cord injury. Arch Phys Med Rehabil. 2006;87:1327–1333
  6. Bergofsky EH. Mechanism for respiratory insufficiency after cervical cord injury. Ann Intern Med. 1964;61:435–447
  7. Huldtgren AC, Fugl-Meyer AR, Jonasson E, Bake B. Ventilatory dysfunction and respiratory rehabilitation in post-traumatic quadriplegia. Eur J Respir Dis. 1980;61:347–356
  8. De Troyer A, Heilporn A. Respiratory mechanics in quadriplegia: the respiratory function of the intercostal muscles. Am Rev Respir Dis. 1980;122:591–600
  9. Estenne M, Heilporn A, Delhez L, Yernault JC, De Troyer A. Chest wall stiffness in patients with chronic respiratory muscle weakness. Am Rev Respir Dis. 1983;128:1002–1007
  10. Haas F, Axen K, Pineda H, Gandino D, Haas A. Temporal pulmonary function changes in cervical cord injury. Arch Phys Med Rehabil. 1985;66:139–144
  11. De Troyer A, Estenne M, Heilporn A. Mechanism of active expiration in tetraplegic subjects. N Engl J Med. 1986;314:740–744
  12. Estenne M, De Troyer A. The effects of tetraplegia on chest wall statics. Am Rev Respir Dis. 1986;134:121–124
  13. Estenne M, De Troyer A. Mechanism of the postural dependence of vital capacity in tetraplegic subjects. Am Rev Respir Dis. 1987;135:367–371
  14. Estenne M, De Troyer A. Cough in tetraplegic subjects: an active process. Ann Intern Med. 1990;112:22–28
  15. Almenoff PL, Spungen AM, Lesser M, Bauman WA. Pulmonary function survey in spinal cord injury: influences of smoking and level and completeness of injury. Lung. 1995;173:297–306
  16. Linn WS, Adkins RH, Gong H, Waters RL. Pulmonary function in chronic spinal cord injury: a cross-sectional survey of 222 southern California adult outpatients. Arch Phys Med Rehabil. 2000;81:757–763
  17. Spungen AM, Grimm DR, Lesser M, Bauman WA, Almenoff PL. Self-reported prevalence of pulmonary symptoms in subjects with spinal cord injury. Spinal Cord. 1997;35:652–657
  18. Baydur A, Adkins RH, Milic-Emili J. Lung mechanics in individuals with spinal cord injury: effects of injury level and posture. J Appl Physiol. 2001;90:405–411
  19. Spungen AM, Grimm DR, Schilero G, et al. Relationship of respiratory symptoms with smoking status and pulmonary function in chronic spinal cord injury. J Spinal Cord Med. 2002;25:23–27
  20. Jones R, Nzekwu MU. The effects of body mass index on lung volumes. Chest. 2006;130:827–833
  21. Boren HG, Kory RC, Snyer JC. The Veterans Administration-Army cooperative study of pulmonary function II: the lung volume and its subdivisions in normal men. Am J Med. 1966;41:96–114
  22. Biring MS, Lewis MI, Liu JT, Mohsenifar Z. Pulmonary physiologic changes of morbid obesity. Am J Med Sci. 1999;318:293–297
  23. Hakala K, Stenius-Aarniala B, Sovijarvi A. Effects of weight loss on peak flow variability, airways obstruction, and lung volumes in obese patients with asthma. Chest. 2000;118:1315–1321
  24. Cotes JE, Chinn DJ, Reed JW. Body mass, fat percentage, and fat free mass as reference variables for lung function: effects on terms for age and sex. Thorax. 2001;56:839–844
  25. Ray CS, Sue DY, Bray G, Hansen JE, Wasserman K. Effects of obesity of respiratory function. Am Rev Respir Dis. 1983;128:501–506
  26. McDonnell WF, Seal E. Relationships between lung function and physical characteristics in young adult black and white males and females. Eur Respir J. 1991;4:279–289
  27. Pelosi P, Croci M, Ravagnan I, Vicardi P, Gattinoni L. Total respiratory system, lung, and chest wall mechanics in sedated-paralyzed postoperative morbidly obese patients. Chest. 1996;109:144–151
  28. Pelosi P, Croci M, Ravagnan I, et al. The effects of body mass on lung volumes, respiratory mechanics, and gas exchange during general anesthesia. Anesth Analg. 1998;87:654–660
  29. King GG, Brown NJ, Diba C, et al. The effects of body weight on airway caliber. Eur Respir J. 2005;25:896–901
  30. Sahebjami H, Doers JT, Render ML. Anthropometric and pulmonary function test profiles of outpatients with stable chronic obstructive pulmonary disease. Am J Med. 1993;94:469–474
  31. Collins LC, Hoberty PD, Walker JF, Fletcher EC, Peiris AN. The effect of body fat distribution on pulmonary function tests. Chest. 1995;107:1298–1302
  32. Marino RJ, Barros T, Biering-Sorensen F, et al. International standards for neurological classification of spinal cord injury. J Spinal Cord Injury Med. 2003;26:550–556
  33. Garshick E, Ashba J, Tun CG, Lieberman SL, Brown R. Assessment of stature in spinal cord injury. J Spinal Cord Med. 1997;20:36–42
  34. Ferris BG. Epidemiology Standardization Project (American Thoracic Society). Am Rev Respir Dis. 1978;118:1–120
  35. American Thoracic Society (Standardization of spirometry, 1994 Update). Am J Respir Crit Care Med. 1995;152:1107–1136
  36. Kelley A, Garshick E, Gross ER, Lieberman SL, Tun CG, Brown R. Spirometry testing standards in spinal cord injury. Chest. 2003;123:725–730
  37. Ashba J, Garshick E, Tun CG, et al. Spirometry—acceptability and reproducibility in spinal cord injured subjects. J Am Paraplegia Soc. 1993;16:197–203
  38. Brown R, Leith DE, Enright PL. Multiple breath helium dilution measurement of lung volumes in adults. Eur Respir J. 1998;11:246–255
  39. Crapo RO, Morris AH, Clayton PD, Nixon CR. Lung volumes in healthy nonsmoking adults. Bull Eur Physiopathol Respir. 1982;18:419–425
  40. Fugl-Meyer AR, Grimby G. Ventilatory function in tetraplegic patients. Scand J Rehabil Med. 1971;3:151–160
  41. Anke A, Aksnes AK, Stanghelle JK, Hjeltnes N. Lung volumes in tetraplegic patients according to cervical spinal cord injury level. Scand J Rehabil Med. 1993;25:73–77
  42. Schilero G, Grimm DR, Bauman WA, Lenner R, Lesser M. Assessment of airway caliber and bronchodilator responsiveness in subjects with spinal cord injury. Chest. 2005;127:149–155
  43. Scanlon PD, Loring SH, Pichurko BM, et al. Respiratory mechanics in acute quadriplegia (Lung and chest wall compliance and dimensional changes during respiratory maneuvers). Am Rev Respir Dis. 1989;139:615–620
  44. Mannino DM, Ford ES, Redd SC. Obstructive and restrictive lung disease and functional limitation: data from the Third National Health and Nutrition Examination. J Intern Med. 2003;254:540–547
  45. Sin DD, Man SF. Impaired lung function and serum leptin in men and women with normal body weight: a population based study. Thorax. 2003;58:695–698
  46. Sin DD, Lacy P, York E, Man SF. Effects of fluticasone on systemic markers of inflammation in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2004;170:760–765
  47. Broekhuizen R, Wouters EF, Creutzberg EC, Schols AM. Raised CRP levels mark metabolic and functional impairment in advanced COPD. Thorax. 2006;61:17–22
  48. Broekhuizen R, Vernooy JH, Schols AM, Dentener MA, Wouters EF. Leptin as local inflammatory marker in COPD. Respir Med. 2005;99:70–74
  49. Bruno A, Chanez P, Chiappara G, et al. Does leptin play a cytokine-like role within the airways of COPD patients?. Eur Respir J. 2005;26:398–405
  50. Aronson D, Roterman I, Yigla M, et al. Inverse association between pulmonary function and C-reactive protein in apparently healthy subjects. Am J Respir Crit Care Med. 2006;174:626–632
  51. Man SF, Connett JE, Anthonisen NR, Wise RA, Tashkin DP, Sin DD. C-reactive protein and mortality in mild to moderate chronic obstructive pulmonary disease. Thorax. 2006;61:849–853
  52. de Torres JP, Cordoba-Lanus E, Lopez-Aguilar C, et al. C-reactive protein levels and clinically important predictive outcomes in stable COPD patients. Eur Respir J. 2006;27:902–907
  53. Dahl M, Vestbo J, Lange P, Bojesen SE, Tybjaerg-Hansen A, Nordestgaard BG. C-reactive protein as a predictor of prognosis in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2007;175:250–255
  54. Kony S, Zureik M, Driss F, Neukirch C, Leynaert B, Neukirch F. Association of bronchial hyperresponsiveness and lung function with C-reactive protein (CRP): a population based study. Thorax. 2004;59:892–896
  55. Pinto-Plata VM, Müllerova H, Toso JF, et al. C-reactive protein in patients with COPD, control smokers and non-smokers. Thorax. 2006;61:23–28
  56. Huang TS, Wang YH, Chen SY. The relation of serum leptin to body mass index and to serum cortisol in men with spinal cord injury. Arch Phys Med Rehabil. 2000;81:1582–1586
  57. Maimoun L, Puech A, Manetta J, et al. Circulating leptin concentrations can be used as a surrogate marker of fat mass in acute spinal cord injury patients. Metabolism. 2004;53:989–994
  58. Frost F, Roach MJ, Kushner I, Schreiber P. Inflammatory C-reactive protein and cytokine levels in asymptomatic people with chronic spinal cord injury. Arch Phys Med Rehabil. 2005;86:312–317
  59. Manns PJ, McCubbin JA, Williams DP. Fitness, inflammation, and the metabolic syndrome in men with paraplegia. Arch Phys Med Rehabil. 2005;86:1176–1181
  60. Wang YH, Huang TS, Liang HW, Su TC, Chen SY, Wang TD. Fasting serum levels of adiponectin, ghrelin, and leptin in men with spinal cord injury. Arch Phys Med Rehabil. 2005;86:1964–1968
  61. Goldman JM, Williams SJ, Denison DM. The rib cage and abdominal components of respiratory system compliance in tetraplegic patients. Eur Respir J. 1988;1:242–247
  62. Wang T, Wang Y, Tang F, Lin K, Lien I. Resistive inspiratory muscle training in sleep-disordered breathing of traumatic tetraplegia. Arch Phys Med Rehabil. 2002;83:491–496
  63. Rutchik A, Weissman AR, Almenoff PL, Spungen AM, Bauman WA, Grimm DR. Resistive inspiratory muscle training in subjects with chronic cervical spinal cord injury. Arch Phys Med Rehabil. 1998;79:293–297
  64. Gross D, Ladd HW, Riley EJ, Macklem PT, Grassino A. The effect of training on strength and endurance of the diaphragm in quadriplegia. Am J Med. 1980;68:27–35
  65. Corbin R, Loveland M, Martin RR, Macklem PT. A four-year follow-up study of lung mechanics in smokers. Am Rev Respir Dis. 1979;120:293–304
  66. Paoletti P, Viegi G, Carrozzi L, et al. Residual volume in a general population: effects of body size, age, cigarette smoking, and respiratory symptoms. Chest. 1992;102:1209–1215
  67. Kilburn KH, Warshaw RH, Thornton K, Miller A. Predictive equations for total lung capacity and residual volume calculated from radiographs in a random sample of the Michigan population. Thorax. 1992;47:519–523
  68. Villanueva EV. The validity of self-reported weight in US adults: a population based cross-sectional study. BMC Public Health. 2001;1:11

 Supported by the National Institute of Child Health and Human Development, National Institutes of Health (grant no. RO1 HD42141), Health Services Research and Development, and the Cooperative Studies Program, Department of Veterans Affairs, Massachusetts Veterans Epidemiology Research and Information Center.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 authors or upon any organization with which the authors are associated.

PII: S0003-9993(08)00319-5

doi: 10.1016/j.apmr.2008.02.018

Archives of Physical Medicine and Rehabilitation
Volume 89, Issue 8 , Pages 1499-1506 , August 2008

Article Tools

* Image Usage & Resolution