Abstract
Objective
To examine the relationship between inspiratory muscle performance (IMP) and functional
sitting balance (FSB) in persons with chronic spinal cord injury (SCI). We hypothesized
that a moderate correlation would be found between IMP and FSB and that individuals
with better balance would have better IMP.
Design
The SCI-specific modification of the Function in Sitting Test (FIST-SCI) measured
FSB. The IMP measures included (1) maximal inspiratory pressure (MIP), (2) sustained
MIP (SMIP), and (3) inspiratory duration. Upper extremity motor score (UEMS) and level
of injury (LOI) were taken from International Standards for Neurological Classification
of Spinal Cord Injury examinations. Spearman correlational analyses assessed relationships
among these factors in the sample (N=37). Mann-Whitney U tests explored differences between 2 comparison group pairs (tetraplegia group [TG]
vs paraplegia group [PG]; independent transfer group [ITG] vs assisted transfer group
[ATG]). Regression analysis examined variables predictive of FSB in the TG.
Setting
Research facility.
Participants
Volunteers with tetraplegia (n=21, American Spinal Injury Association Impairment Scale
(AIS) A=8, B=7, C=6) and paraplegia (n=16, AIS A=9, B=4, C=3) (N=37).
Intervention
Not applicable.
Main Outcome Measures
IMP, LOI, UEMS, FIST-SCI.
Results
UEMS, MIP, SMIP, and LOI had moderate to high correlations with FIST-SCI scores (ρ=0.720
(P<.001), 0.480 (P=.003), 0.467 (P=.004), 0.527 (P=.001), respectively). UEMS, MIP, and FIST-SCI scores were higher in the PG and ITG
than the TG and ATG, respectively (PG vs. TG P values=<.001, .008, .002, respectively, and ITG vs. ATG P values=<.001, .032, <.001, respectively). Further, SMIP and UEMS predicted FIST-SCI
balance scores in the TG, accounting for 55% of total variance (P<.001) (FIST-SCI=11.88+0.03 [SMIP]+0.425 [UEMS]).
Conclusions
The relationship between IMP and balance appears preserved after SCI. FSB was predicted,
in part, via UEMS and SMIP in the TG. Future research should focus on the effect of
SCI-based breathing interventions on FSB.
List of abbreviations:
AIS (American Spinal Injury Association Impairment Scale), ATG (assisted transfer group), COPD (chronic obstructive pulmonary disease), FIST-SCI (Function in Sitting Test for individuals with spinal cord injury), FSB (functional sitting balance), IMP (inspiratory muscle performance), ITP (independent transfer group), LOI (level of injury), MIP (maximal inspiratory pressure), PG (paraplegia group), SCI (spinal cord injury), SMIP (sustained maximal inspiratory pressure), TG (tetraplegia group), UEMS (upper extremity motor score)Keywords
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Article info
Publication history
Published online: December 16, 2021
Accepted:
November 16,
2021
Received in revised form:
November 14,
2021
Received:
August 27,
2021
Footnotes
Current affiliation for Anne E. Palermo: Neuroscience Research Australia, Randwick, New South Wales, Australia.
Presented in poster form to the American Physical Therapy Association, January 23–26, 2019, Washington, DC; American Spinal Injury Association, April 2–5, 2019, Waikiki, HI; and Paralyzed Veterans of America, August 15–17, 2019, Orlando, FL
This article has been edited from a chapter in Dr Palermo's Dissertation Defense on October 1, 2020. These findings are also part of the written Defense, which is published in the University of Miami Archives at this link: (https://scholarship.miami.edu/discovery/fulldisplay?docid=alma991031524579402976&context=L&vid=01UOML_INST:ResearchRepository&lang=en&search_scope=Research&adaptor=Local%20Search%20Engine&tab=Research&query=any,contains,Palermo&offset=0).
Supported by the Foundation for Physical Therapy Research: Promotion of Doctoral Studies I Patricia Leahy Award Scholarship/Grant and the Craig H. Neilsen Foundation: Allied Health Professional Research Award of ASIA
Disclosures: This research was funded by the Foundation for Physical Therapy Research and the Craig H. Neilsen Foundation via the Allied Health Professional Research Award of ASIA.
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© 2021 by the American Congress of Rehabilitation Medicine.
