Yoshida Ryo, Tomita Kazuhide, Kawamura Kenta, Setaka Yukako, Ishii Nobuhisa, Monma Masahiko, Mutsuzaki Hirotaka, Mizukami Masafumi, Ohse Hirotaka, Imura Shigeyuki
Graduate School of Health Science, Ibaraki Prefectural University of Health Sciences: 4669-2 Ami, Ibaraki 300-0394, Japan.
Department of Physical Therapy, Ibaraki Prefectural University of Health Sciences, Japan.
J Phys Ther Sci. 2021 Feb;33(2):153-157. doi: 10.1589/jpts.33.153. Epub 2021 Feb 13.
[Purpose] The respiratory function in patients with cervical spinal cord injury is influenced by inspiratory intercostal muscle function. However, inspiratory intercostal muscle activity has not been conclusively evaluated. We evaluated the inspiratory intercostal muscle activity in patients with cervical spinal cord injury by using inspiratory intercostal electromyography, respiratory inductance plethysmography, and ultrasonography. [Participants and Methods] Three patients with cervical spinal cord injury were assessed. The change in mean amplitude (rest vs. maximum inspiration) was calculated by using intercostal muscle electromyography. Changes in intercostal muscle thickness (resting expiration and maximum inspiration) were also evaluated on ultrasonography. The waveform was converted to spirometry ventilation with respiratory inductance plethysmography, and the waveform at the xiphoid was considered to determine the rib cage volume. Each index was compared with the inspiratory capacities in each case. [Results] Intercostal muscle electromyography failed to measure the notable myoelectric potential in all the patients. The rib cage volume was higher at higher inspiratory capacities. The changes in muscle thickness were not significantly different between the patients. [Conclusion] The rib cage volume (measured with inductance plethysmography) was greater in the patients with cervical spinal cord injury when inspiratory intercostal muscle activity was high. Respiratory inductance plethysmography can capture inspiratory intercostal muscle function in patients with cervical spinal cord injury.
[目的] 颈脊髓损伤患者的呼吸功能受吸气性肋间肌功能影响。然而，吸气性肋间肌活动尚未得到最终评估。我们通过吸气性肋间肌肌电图、呼吸感应体积描记法和超声检查来评估颈脊髓损伤患者的吸气性肋间肌活动。[参与者与方法] 对3例颈脊髓损伤患者进行评估。使用肋间肌肌电图计算平均振幅（静息状态与最大吸气时）的变化。还通过超声检查评估肋间肌厚度（静息呼气和最大吸气时）的变化。利用呼吸感应体积描记法将波形转换为肺量计通气量，并以剑突处的波形来确定胸廓容积。将每个指标与各病例的吸气能力进行比较。[结果] 肋间肌肌电图未能在所有患者中测量到明显的肌电电位。吸气能力越高，胸廓容积越大。患者之间肌肉厚度的变化无显著差异。[结论] 当吸气性肋间肌活动较高时，颈脊髓损伤患者的胸廓容积（用感应体积描记法测量）更大。呼吸感应体积描记法可捕捉颈脊髓损伤患者的吸气性肋间肌功能。
