Improved pulmonary function in chronic quadriplegics after pulmonary therapy and arm ergometry.

Quadriplegics suffer from restrictive lung disease due to neural damage, spasticity, and prolonged immobilisation. These studies were undertaken to see whether respiratory therapy can improve expiratory capacity in quadriplegics. Fifteen patients with chronic quadriplegia participated in a programme of pulmonary therapy and resistance exercise for 7 to 12 weeks. Pulmonary therapy consisted of incentive spirometry for 15 minutes a day 3 to 5 days per week. Resistance exercise consisted of pedalling an arm ergometer up to 30 minutes three times a week. Forced vital capacity was measured with the subject in a wheelchair wearing a nose clip. The volume of expired air (max Ve) was as determined with a paramagnetic analyser during arm ergometry. The volume of expired air was divided by the number of breaths, giving the volume of expired air per breath (Ve). The results indicated that a combination of incentive spirometry and arm ergometry improves vital capacity and increased the maximum volume of expired air during exercise. These methods are non-invasive, and such modalities should constitute part of the rehabilitation of patients with neuromuscular disease.