Abstract
Study design
Quasi experimental.
Objective
To evaluate the effect of glossopharyngeal insufflation on pulmonary function in cervical cord injury.
Setting
Indian Spinal Injuries Centre, Vasant Kunj, Delhi, India.
Methods
Thirty-one cervical cord injured (ISNCSCI A and B) subjects received respiratory rehabilitation for 4 weeks, with the experimental group performing glossopharyngeal insufflation along with respiratory rehabilitation. The groups were assessed at baseline and after 4 weeks for pulmonary function test, chest expansion, dyspnea, and chest tightness.
Results
Significant differences were observed in IVC, IC, FVC, FEV1, MEF 75%, PEF, tidal volume, chest expansion, dyspnea, and chest tightness (pā<ā0.05).
Conclusion
Glossopharyngeal insufflation is a technique that can be used to improve the respiratory function after cervical cord injury.
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Data availability
The datasets generated and analyzed during this study are not publicly available to maintain confidentiality. These are available from the corresponding author on a reasonable request.
References
Berlowitz DJ, Wadsworth B, Ross J. Respiratory problems and management in people with spinal cord injury. Breathe. 2016;12:328ā40.
Chen S, Lin C-M, Lee C-N, Huang C-Y, Chiang L-L. The experience in respiratory care of a patient with cervical spinal cord injury. FJPT. 2008;33:294ā301.
Berlowitz D, Tamplin J. Respiratory muscle training for cervical spinal cord injury. Cochrane Database Syst Rev. 2013;2013. https://doi.org/10.1002/14651858.CD008507.pub2.
Ledsome JR, Sharp JM. Pulmonary function in acute cervical cord injury. Am Rev Respir Dis. 1981;124:41ā4.
Haas F, Axen K, Pineda H, Gandino D, Haas A. Temporal pulmonary function changes in cervical cord injury. Arch Phys Med Rehabil. 1985;66:139ā44.
Bruschi C, Cerveri I, Zoia MC, Fanfulla F, Fiorentini M, Casali L. et al. Reference values of maximal respiratory mouth pressures: a population-based study. Am Rev Respir Dis. 1992;146:790ā3.
Fishburn M, Marino R, Ditunno JF. Atelectasis and pneumonia in acute spinal cord injury. Arch Phys Med Rehabil. 1990;71:197ā200.
Bhaskar KR, Brown R, OāSullivan DD, Melia S, Duggan M, Reid L. Bronchial mucus hypersecretion in acute quadriplegia: macromolecular yields and glycoconjugate composition. Am Rev Respir Dis. 1991;143:640ā8.
Nygren-Bonnier M, Wahman K, Lindholm P, Markstrƶm A, Westgren N, Klefbeck B. Glossopharyngeal pistoning for lung insufflation in patients with cervical spinal cord injury. Spinal Cord. 2009;47:418ā22.
Bach JR, Mehta AD. Respiratory muscle aids to avert respiratory failure and tracheostomy: a new patient management paradigm. J Neurorestroratology. 2014;2:25ā35.
Nygren-Bonnier M, Markstrƶm A, Lindholm P, Mattsson E, Klefbeck B. Glossopharyngeal pistoning for lung insufflation in children with spinal muscular atrophy type II. Acta Paediatr. 2009;98:1324ā8.
Nygren Bonnier M, Gullstrand L, Klefbeck B, Lindholm P. Effects of glossopharyngeal pistoning for lung insufflation in elite swimmers. Med Sci Sports Exerc. 2007;39:836ā41.
Nygren-Bonnier M, Lindholm P, Markstrom A, Skedinger M, Mattsson E, Klefbeck B. Effects of glossopharyngeal pistoning for lung insufflation on vital capacity in healthy women. Am J Phys Med Rehabil. 2007;86:290ā4.
Loring SH, OāDonnell CR, Butler JP, Lindholm P, Jacobson F, Ferrigno M. Transpulmonary pressures and lung mechanics with glossopharyngeal insufflation and exsufflation beyond normal lung volumes in competitive breath-hold divers. J Appl Physiol. 2007;102:841ā6.
Huldtgren AC, Fugl-Meyer AR, Jonasson E, Bake B. Ventilatory dysfunction and respiratory rehabilitation in post-traumatic quadriplegia. Eur J Respir Dis. 1980;61:347ā56.
Nygren-bonnier M. Glossopharyngeal breathing. Karolinska Institutet. 2008.
Metcalf VA. Vital capacity and glossopharyngeal breathing in traumatic quadriplegia. J Am Phys Ther Assoc. 1966;46:835ā8.
Kang S-W. Pulmonary rehabilitation in patients with neuromuscular disease. Yonsei Med J. 2006;47:307ā14.
Kellehar H, Parida RK. Glossopharyngeal breathing: its value in respiratory muscle paralysis of poliomyelitis. BMJ. 1957;740ā3.
Bianchi C, Carrara R, Khirani S, Tuccio MC. Independent cough flow augmentation by glossopharyngeal breathing plus table thrust in muscular dystrophy. Am J Phys Med Rehabil. 2014;93:43ā48.
De Troyer A, Estenne M. The expiratory muscles in tetraplegia. Paraplegia. 1991;29:359ā63.
Bach JR, Bianchi C, Vidigal-Lopes M, Turi S, Felisari G. Lung inflation by glossopharyngeal breathing and air stacking in duchenne muscular dystrophy. Am J Phys Med Rehabil. 2007;86:295ā300.
Johansson KM, Nygren-Bonnier M, Klefbeck B, Schalling E. Effects of glossopharyngeal breathing on voice in cervical spinal cord injuries. Int J Ther Rehabil. 2011;18:501ā10.
Loeser WD. Glossopharyngeal breathing as an aid to recovery from paralytic poliomyelitis. Am J Med Sci. 1956;231:487ā93.
Acknowledgements
We thank all the individuals who provided their insight and expertise that greatly assisted the research.
Funding
Indian Spinal Injuries Centre, Delhi, India, has funded this study by providing necessary instrumentation (pulmonary function test) at no cost to the participants.
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Sharma, A., Mitra, S., Dutta, V. et al. Effects of glossopharyngeal insufflation on pulmonary function in cervical cord injury patients. Spinal Cord Ser Cases 7, 15 (2021). https://doi.org/10.1038/s41394-021-00390-w
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DOI: https://doi.org/10.1038/s41394-021-00390-w


