Ventilatory dysfunction and respiratory rehabilitation in post-traumatic quadriplegia.

Lung volumes and maximum static respiratory pressures were examined in 35 patients rendered quadriplegic by traumatic transection of the cervical spinal cord at levels between C:IV and C:VIII. Twelve of these patients were treated 15 min a day for about 6 weeks by insufflation of air using a manually operated pump and by performing forced voluntary expirations and inspirations against a resistance. The markedly reduced total lung capacity, vital capacity, expiratory reserve volume and maximum static respiratory pressures all improved significantly upon treatment. The lung volumes remained improved in the 11 patients who were restudied after about 1 year and in the five patients who were restudied after about 5 years. However, maximum static respiratory pressures appeared to have decreased at the last follow-up study compared with those immediately after treatment.