Introduction
pneumonia, Tetraplegic, cord injury, atelectasis, abdominal muscle weakness, C-SCI, cough
RESPIRATORY FAILURE, PNEUMONIA, ATELECTASIS, NEUROMUSCULAR DISEASES
Respiratory and abdominal muscle weakness due to cervical spinal cord injury (C-SCI) results in a high mortality burden due to respiratory failure, including atelectasis, pneumonia, and ventilator failureAs one such airway clearance technique, mechanical insufflation–exsufflation (MI-E) is a noninvasive cough aid that augments in/exsufflation volume and flow by inducing a series of positive and negative pressures followed by a short pause. Gradual application of positive pressures to ensure sufficient inhaled volume to mobilize secretion and induce rapid shifts to negative pressures to produce a high expiratory flow can move secretions toward the mouth, allowing them to be easily removed. Tetraplegic individuals with a reduced peak cough flow (PCF) of less than 4.5–6 L/s (270 L/min)However, body position affects pulmonary function in people with C-SCI differently from that in healthy people or those with other neuromuscular diseases (NMD)MI-E-assisted cough can generate a sufficient insufflation volume more easily than voluntary or manually assisted cough. This is achieved through the application of external positive pressure to compensate for a deficient FVC. Once the maximal insufflation volume is achieved, the individual’s expiratory effort and strength would contribute less to the production of sufficient PCFThis pilot study aimed to investigate how body position influences PCF during MI-E treatment in individuals with C-SCI. Knowledge regarding the differences in PCF depending on body position could suggest proper positioning for MI-E use in individuals with C-SCI in clinical practice.