Changes in Pulmonary Function During the Early Years After Inpatient Rehabilitation in Persons With Spinal Cord Injury: A Prospective Cohort Study |
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Authors: | Karin Postma Janneke A. Haisma Sonja de Groot Maria T. Hopman Michael P. Bergen Henk J. Stam Johannes B. Bussmann |
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Affiliation: | 1. Department of Rehabilitation Medicine and Physical Therapy, Erasmus MC, Rotterdam, The Netherlands;2. Rijndam Rehabilitation Center, Rotterdam, The Netherlands;3. Reade, Centre for Rehabilitation and Rheumatology, Amsterdam, The Netherlands;4. Center for Human Movement Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;5. Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. Current affiliation for Haisma: Department of Rehabilitation Medicine, Kennemer Gasthuis, Haarlem, The Netherlands |
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Abstract: | ObjectiveTo describe changes in pulmonary function (PF) during the 5 years after inpatient rehabilitation in persons with spinal cord injury (SCI) and to study potential determinants of change.DesignProspective cohort study.SettingEight rehabilitation centers with specialized SCI units.ParticipantsPersons with SCI (N=180).InterventionsNot applicable.Main Outcome MeasuresPF was determined by forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1) as a percentage of the predicted value, at the start of rehabilitation, at discharge, and 1 and 5 years after discharge from inpatient rehabilitation. The population was divided into 3 subgroups on the basis of whether their PF declined, stabilized, or improved.ResultsFVC improved on average 5.1% over the whole period between discharge of inpatient rehabilitation and 5 years thereafter, but changes differed largely between persons. FVC declined in 14.9% of the population during the first year after discharge. During this year, body mass index, inspiratory muscle strength, change in peak power output, and change in peak oxygen uptake differed significantly between subgroups. FVC declined in 28.3% of the population during the following 4 years, but no differences were found between the subgroups for this period. Subgroups based on changes in FEV1 differed only with respect to change in peak oxygen uptake the first year after discharge.ConclusionsIn our study, many persons with SCI showed a decline in PF, larger than the normal age-related decline, during the 5 years after inpatient rehabilitation. Results suggest that a decline in PF during the first year after inpatient rehabilitation is associated with higher body mass index, lower inspiratory muscle strength, and declined physical fitness. |
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Keywords: | Longitudinal studies Pulmonary function test Rehabilitation Spinal cord injuries Vital capacity |
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