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吸气肌功能与人体测量指标——脊髓损伤患者肺功能相关的新评估:一项初步研究。

Inspiratory Muscle Performance and Anthropometric Measures-Novel Assessments Related to Pulmonary Function in People with Spinal Cord Injury: A Pilot Study.

作者信息

Palermo Anne E, Janyszek Emily, Young Abigail, Villane Allison, Kirk-Sanchez Neva J, Cahalin Lawrence P, Nash Mark S

机构信息

Department of Physical Therapy, University of Miami Miller School of Medicine, Miami.

Department of Physical Therapy, University of Miami Miller School of Medicine, Miami.

出版信息

Arch Phys Med Rehabil. 2022 Mar;103(3):441-450. doi: 10.1016/j.apmr.2021.09.008. Epub 2021 Oct 14.

Abstract

OBJECTIVE

To investigate the feasibility and validity of using the novel axillary:umbilical (A:U) ratio and sustained maximal inspiratory pressure (SMIP) as supplementary measures in the assessment of respiratory function in people with spinal cord injury.

DESIGN

Pilot study with a single day of data collection. All measurements were taken with participants in their personal wheelchairs to best represent normal functioning and positioning for each individual.

SETTING

Research institution.

PARTICIPANTS

A convenience sample of 30 community dwelling volunteers with chronic spinal cord injury (C2-T12, American Spinal Injury Association Impairment Scale A-D) participated.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Participants underwent anthropometric measurements (trunk height, abdominal circumference, axillary circumference) and assessment of inspiratory muscle performance, incluidng maximal inspiratory pressure, SMIP, and inspiratory duration, as well as standard pulmonary function tests.

RESULTS

The A:U ratio and SMIP were recorded for all participants. The SMIP was significantly related to more respiratory performance measures than the maximal inspiratory pressure (P<.05) and the A:U ratio was significantly related to more respiratory performance measures than any other anthropometric measure (P<.05). Additionally, an A:U ratio cutoff point detected individuals with a peak expiratory flow ≥ 80% of their predicted value with a sensitivity and specificity of 85.7% and 91.3%, respectively (area under the curve: 0.92).

CONCLUSIONS

It is feasible to capture the A:U Ratio and SMIP in individuals with spinal cord injury. Further, the strong significant relationships of SMIP and the A:U ratio to respiratory performance measures suggests their clinical importance in the pulmonary assessment and risk stratification of people with chronic spinal cord injury.

摘要

目的

探讨使用新型腋部:脐部(A:U)比值和持续最大吸气压力(SMIP)作为补充指标评估脊髓损伤患者呼吸功能的可行性和有效性。

设计

单日数据收集的试点研究。所有测量均在参与者的个人轮椅上进行,以最好地代表每个人的正常功能和姿势。

地点

研究机构。

参与者

30名社区居住的慢性脊髓损伤志愿者(C2-T12,美国脊髓损伤协会损伤分级A-D级)的便利样本。

干预措施

不适用。

主要观察指标

参与者接受人体测量(躯干高度、腹围、腋围)以及吸气肌功能评估,包括最大吸气压力、SMIP和吸气持续时间,以及标准肺功能测试。

结果

记录了所有参与者的A:U比值和SMIP。与最大吸气压力相比,SMIP与更多呼吸功能指标显著相关(P<0.05);与其他人体测量指标相比,A:U比值与更多呼吸功能指标显著相关(P<0.05)。此外,A:U比值的截断点能够检测出呼气峰值流量≥预测值80%的个体,其敏感性和特异性分别为85.7%和91.3%(曲线下面积:0.92)。

结论

在脊髓损伤患者中获取A:U比值和SMIP是可行的。此外,SMIP和A:U比值与呼吸功能指标之间的强显著相关性表明它们在慢性脊髓损伤患者的肺部评估和风险分层中具有临床重要性。

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