Content » Vol 45, Issue 3

Original report

Comparison of respiratory muscle training methods in individuals with motor and sensory complete tetraplegia: A randomized controlled trial

Gabi Mueller, Maria T.E. Hopman, Claudio Perret
Clinical Trial Unit, Swiss Paraplegic Center, CH-6207 Nottwil, Switzerland. E-mail:
DOI: 10.2340/16501977-1097


Objective: To compare the effects of inspiratory resistance training and isocapnic hyperpnoea vs incentive spirometry (placebo) on respiratory function, voice, thorax mobility and quality of life in individuals with tetraplegia.
Design: Randomized controlled trial.
Patients/methods: A total of 24 individuals with traumatic, complete tetraplegia (C5–C8, American Spinal Injury Association (ASIA) Impairment Scale; AIS A) were randomly assigned to 1 of 3 groups. They completed 32 supervised training sessions over a period of 8 weeks. Before and after the training period, the following tests were performed: body plethysmography, inspiratory and expiratory muscle strength, subjective breathing parameters using a visual analogue scale, voice measurements, thorax mobility and quality of life. Cohen’s effect sizes and Kruskal-Wallis tests for differences between pre- and post-training values were calculated.
Results: Compared with placebo training, inspiratory resistance training showed high effect sizes for inspiratory muscle strength (d = 1. 13), the subjective ability “to blow one’s nose” (d = 0. 97) and the physical component of quality of life (d = 0. 82). Isocapnic hyperpnoea compared with placebo showed a high effect size for breathlessness during exercise (d = 0. 81). We found a significant effect of inspiratory resistance training vs placebo (p = 0. 016) and vs isocapnic hyperpnoea (p = 0. 012) for inspiratory muscle strength.
Conclusion: In individuals with motor and sensory complete tetraplegia during the first year post-injury, inspiratory resistance training is more advantageous than isocapnic hyperpnoea, performed 4 times a week for 10 min.

Lay Abstract


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