Zhang Xinyu, Zhang Xiaobo, Yang Dong, Liu Li, Huo Xiulin, Deng Zhuojun
Emergency Department (Xiangjiang Campus), Hebei Medical University Third Hospital, Shijiazhuang, 050000, Hebei, China.
Department of Anesthesiology, Hebei Medical University Third Hospital, Shijiazhuang, 050000, Hebei, China.
Eur J Med Res. 2025 Aug 11;30(1):733. doi: 10.1186/s40001-025-03023-2.
Traumatic spinal cord injury (TSCI) often leads to respiratory dysfunction, in which the impaired diaphragm function is one of the main causes. Respiratory muscle rehabilitation training can be used to improve respiratory function, but its effect on diaphragm function has not been deeply investigated. This study employed ultrasound monitoring to assess how respiratory muscle rehabilitation training affects diaphragmatic function in TSCI patients.
In this prospective randomized controlled trial (RCT) study, 56 patients with spinal cord injury were randomly divided into experimental group and control group, 28 cases in each group. The experimental group received respiratory muscle rehabilitation training twice a day for 15 min each time; and the control group received only the usual care. The diaphragm thickness, diaphragm movement and diaphragm contraction speed of the two groups were measured by ultrasound before and after training.
Compared to the control group, the experimental group had significant improvements. Diaphragm thickness increased from 2.05 ± 0.25 mm to 2.38 ± 0.30 mm in the experimental group (P < 0.001), while the control group changed minimally from 2.02 ± 0.22 mm to 2.05 ± 0.23 mm (P = 0.338). Diaphragm movement increased from 1.52 ± 0.20 mm to 1.85 ± 0.25 mm in the experimental group (P < 0.001), versus a small change from 1.50 ± 0.18 mm to 1.53 ± 0.20 mm in the control group (P = 0.315). Diaphragm contraction speed accelerated from 1.20 ± 0.15 cm/s to 1.45 ± 0.20 cm/s in the experimental group (P < 0.001), while the control group changed slightly from 1.18 ± 0.13 cm/s to 1.20 ± 0.15 cm/s (P = 0.380). Respiratory frequency decreased from 20.3 ± 3.4 times/min to 16.0 ± 2.5 times/min in the experimental group (P < 0.001), and the control group changed less from 19.5 ± 2.1 times/min to 18.2 ± 2.3 times/min (P = 0.070). Ventilator removal time was significantly reduced in the experimental group (14.1 ± 1.5 days) compared to the control group (20.2 ± 2.0 days, P = 0.002).
Respiratory muscle rehabilitation significantly enhances diaphragm function and respiratory parameters in spinal cord injury patients. Ultrasound monitoring effectively evaluates these improvements, providing a valuable, novel clinical approach for TSCI rehabilitation. While this preliminary RCT demonstrates positive outcomes, the sample size limitation (n = 56) and absence of long-term follow-up should be acknowledged. These aspects will be addressed through larger sample sizes and extended observation periods in subsequent research.
创伤性脊髓损伤（TSCI）常导致呼吸功能障碍，其中膈肌功能受损是主要原因之一。呼吸肌康复训练可用于改善呼吸功能，但其对膈肌功能的影响尚未得到深入研究。本研究采用超声监测来评估呼吸肌康复训练对TSCI患者膈肌功能的影响。
在这项前瞻性随机对照试验（RCT）研究中，56例脊髓损伤患者被随机分为实验组和对照组，每组28例。实验组每天接受两次呼吸肌康复训练，每次15分钟；对照组仅接受常规护理。训练前后通过超声测量两组的膈肌厚度、膈肌移动度和膈肌收缩速度。
与对照组相比，实验组有显著改善。实验组膈肌厚度从2.05±0.25毫米增加到2.38±0.30毫米（P<0.001），而对照组从2.02±0.22毫米到2.05±0.23毫米变化极小（P=0.338）。实验组膈肌移动度从1.52±0.20毫米增加到1.85±0.25毫米（P<0.001），而对照组从1.50±0.18毫米到1.53±0.20毫米变化较小（P=0.315）。实验组膈肌收缩速度从1.20±0.15厘米/秒加快到1.45±0.20厘米/秒（P<0.001），而对照组从1.18±0.13厘米/秒到1.20±0.15厘米/秒变化轻微（P=0.380）。实验组呼吸频率从20.3±3.4次/分钟降至16.0±2.5次/分钟（P<0.001），对照组从19.5±2.1次/分钟到18.2±2.3次/分钟变化较小（P=0.070）。与对照组（20.2±2.0天，P=0.002）相比，实验组脱机时间显著缩短（14.1±1.5天）。
呼吸肌康复显著增强脊髓损伤患者的膈肌功能和呼吸参数。超声监测有效地评估了这些改善情况，为TSCI康复提供了一种有价值的新型临床方法。虽然这项初步的RCT显示了积极的结果，但应承认样本量有限（n=56）且缺乏长期随访。在后续研究中将通过更大的样本量和更长的观察期来解决这些问题。
