OBJECTIVE: To investigate the effect of an elasticated abdominal binder on respiratory, voice, and blood pressure outcomes for people with a motor complete acute tetraplegia during the first year after injury. DESIGN: Randomized crossover study. SETTING:Large university-affiliated referral hospital. PARTICIPANTS: Consenting participants (N=14, 13 men and 1 woman) with recent, motor complete, C3-T1 spinal cord injury. INTERVENTIONS:Abdominal binder on/off with participant seated in upright wheelchair, with 3 repeated measures at 6 weeks, 3 months, and 6 months after commencing daily use of an upright wheelchair. MAIN OUTCOME MEASURES: Forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow, maximal inspiratory pressure, and maximal expiratory pressure were measured. Mean arterial pressure, maximum sustained vowel time, and sound pressure level were also measured. RESULTS: Overall, an abdominal binder resulted in a statistically significant improvement in forced vital capacity (weighted mean difference .34 L [95% confidence interval (CI) .10-.58], P=.005), forced expiratory volume in 1 second (.25 L [95% CI -.01 to .51], P=.05), peak expiratory flow (.81 L/s [95% CI .13-1.48], P=.02), maximal inspiratory pressure (7.40 cm H(2)O [95% CI 1.64-13.14], P=.01), and maximum sustained vowel time (3.75 s [95% CI .90-6.60], P=.01). There was no statistically significant improvement in maximal expiratory pressure (5.37 cm H(2)O [95% CI -1.15 to 11.90], P=.11), mean arterial pressure (4.41 mmHg [95% CI -6.15 to 14.97], P=.41), or sound pressure level (1.14 dB [95% CI -1.31 to 3.58], P=.36). CONCLUSIONS: An individually fitted abdominal binder significantly improved forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow, maximal inspiratory pressure, and maximum sustained vowel time in people with newly acquired tetraplegia. Further study is needed into the effect of the long-term use of the abdominal binder on breathing mechanics, functional residual capacity, total lung capacity, and respiratory health.
RCT Entities:
OBJECTIVE: To investigate the effect of an elasticated abdominal binder on respiratory, voice, and blood pressure outcomes for people with a motor complete acute tetraplegia during the first year after injury. DESIGN: Randomized crossover study. SETTING: Large university-affiliated referral hospital. PARTICIPANTS: Consenting participants (N=14, 13 men and 1 woman) with recent, motor complete, C3-T1 spinal cord injury. INTERVENTIONS: Abdominal binder on/off with participant seated in upright wheelchair, with 3 repeated measures at 6 weeks, 3 months, and 6 months after commencing daily use of an upright wheelchair. MAIN OUTCOME MEASURES: Forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow, maximal inspiratory pressure, and maximal expiratory pressure were measured. Mean arterial pressure, maximum sustained vowel time, and sound pressure level were also measured. RESULTS: Overall, an abdominal binder resulted in a statistically significant improvement in forced vital capacity (weighted mean difference .34 L [95% confidence interval (CI) .10-.58], P=.005), forced expiratory volume in 1 second (.25 L [95% CI -.01 to .51], P=.05), peak expiratory flow (.81 L/s [95% CI .13-1.48], P=.02), maximal inspiratory pressure (7.40 cm H(2)O [95% CI 1.64-13.14], P=.01), and maximum sustained vowel time (3.75 s [95% CI .90-6.60], P=.01). There was no statistically significant improvement in maximal expiratory pressure (5.37 cm H(2)O [95% CI -1.15 to 11.90], P=.11), mean arterial pressure (4.41 mmHg [95% CI -6.15 to 14.97], P=.41), or sound pressure level (1.14 dB [95% CI -1.31 to 3.58], P=.36). CONCLUSIONS: An individually fitted abdominal binder significantly improved forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow, maximal inspiratory pressure, and maximum sustained vowel time in people with newly acquired tetraplegia. Further study is needed into the effect of the long-term use of the abdominal binder on breathing mechanics, functional residual capacity, total lung capacity, and respiratory health.