A comparison study of two breathing exercise techniques in tetraplegics

Abstract

Objective: To compare the effectiveness of ab-dominal weights and incentive spirometry for improving the strength of diaphragm in tetra-plegics. Setting: Department of Physical Medicine and Rehabilitation, Christian Medical College, Vel-lore, Tamil Nadu, India. Study Design: Two group comparison study Methods: Seventeen patients who fulfilled the inclusion criteria were assigned into an ABW or INS treatment groups using judgment sampling after obtaining an informed consent. Evaluation of the chest, respiratory status, vital signs and strength of diaphragm were done during initial assessment. ABW group underwent diaphrag-matic strengthening using Abdominal weights (ABW) and INT group with Incentive Spirometer (INS) for 15 minutes daily, 6 days a week, for a period of 6 weeks. The pre and post training values of peak amplitude in electro myogram (EMG) of the diaphragm, intercostals and ster-nocleidomastoid muscles were measured. Statistical analysis: The analysis was done using SPSS 11. The pre and post-training values of peak EMG amplitudes of the diaphragm, inter- costals and sternocleidomastoid were com- pared within the groups using Wilicoxon’s sign test and between the two groups using Mann- Whitney’s test. Results: The peak EMG of diaphragm of ABW group raised from 1.1289 to 1.3036 milli-volts with a significance of p<0.001, whereas it fell from 1.7001 to 1.0441 milli-volts among INS group subjects with a significance of p<0.001. Comparison between the 2 groups showed sta-tistically significant improvement in diaphrag-matic strength among the ABW group. Conclusion: The results of this study sug-gests that, in the pulmonary rehabilitation of motor complete tetraplegic subjects abdominal weighted training of the diaphragm has better results in improving the strength of the muscle.Sponsorship: Fluid research grant of Christian Medical College, Vellore.