The individuality of chest wall motion in tetraplegia.

We have studied the motion of the chest wall in eight supine tetraplegic subjects using optical contour mapping. Measurements were obtained during quiet breathing, exaggerated breathing, during the course of a deep inspiration and during static inspiratory efforts. The pattern of motion showed a high degree of individual variability which did not appear to be related to the age of the patient, the duration of injury or the presence of intercostal muscle spasticity. By contrast, it did appear to be related to the presence of bony rib cage stiffness, and possibly the action of the neck accessory muscles. The pattern of rib cage motion in tetraplegia is more complex than conventionally thought.