Respiratory treatment of the adult patient with spinal cord injury.

The respiratory program of the Spinal Injury Service at Rancho Los Amigos Hospital has demonstrated effective respiratory treatment to be a prerequisite for comprehensive rehabilitation. To facilitate program planning, patients are classified according to functional neurosegmental levels and residual respiratory muscles. Breathing mechanics are the basis of evaluation and treatment. Evaluative elements are strength of residual respiratory muscles, respiratory rate, vital capacity, breathing pattern, chest expansion, and cough. Respiratory functions of patients with spinal injury are compared with respiratory functions of healthy subjects. Treatment objectives are prepared according to the individual patient's functional classification and evaluation. Specific methods are discussed, including strengthening, chest wall mobilization, external support devices, and bronchial hygiene.