J. Gallego et al., LEARNED ACTIVATION OF THORACIC INSPIRATORY MUSCLES IN TETRAPLEGICS, American journal of physical medicine & rehabilitation, 72(5), 1993, pp. 312-317
The aim of this study was to determine whether tetraplegics can learn
to activate accessory inspiratory muscles of the upper rib cage, and h
ow this learning affects respiratory motion. Ten tetraplegics with les
ional levels ranging from C-5 to C-7 were trained to increase the uppe
r rib cage expansion during nine 20-min sessions. They were shown an e
lectromyogram (EMG) feedback of the inspiratory muscles of the upper t
horax and a signal indicating their current breathing phase (inspirati
on or expiration). The subjects were instructed to increase EMG during
inspiration and to decrease it during expiration. Analysis of varianc
e with session and respiratory phase as factors showed that the subjec
ts progressively learned to increase inspiratory EMG. Thoracic motion,
tidal volume and minute ventilation were correlated with inspiratory
EMG and tended to increase as a function of practice. These preliminar
y results lend some support to the clinical use of EMG feedback in bre
athing therapy aimed at increasing thoracic motion and preventing or r
educing paradoxical breathing in tetraplegics.