PREDICTION OF PULMONARY-FUNCTION IN WHEELCHAIR USERS

As a result of the improved medical treatment of infectious diseases, these formerly leading causes of mortality in the United States have b een supplanted in rank by chronic events as the major causes of death. The major causes include coronary artery disease, respiratory disease , and cancer. Static and dynamic pulmonary functions in the apparently healthy wheelchair user population were measured and then modelled us ing stepwise regression. One hundred and nine wheelchair users (97 mal es, 12 females) with paraplegia (n = 77) or quadriplegia (n = 32) gave informed consent and participated in this study. Subjects ranged from being Olympic caliber wheelchair marathon racers to those who live se dentary life styles. Subjects performed three slow vital capacity (SVC ) tests, three forced vital capacity (FVC) tests, and three maximal vo luntary ventilation (MVV) tests while seated in their standard wheelch air. The order of the pulmonary function tests was randomized. Subject s also completed two functional residual capacity (FRC) measurements. Analysis of variance revealed significant differences in several pulmo nary functions based on gender (FEVC, p = 0.0001, FEV1, p = 0.0001, FE VC 25-75%, p = 0.005, PEF, p = 0.002, FIVC, p = 0.002, RV, p = 0.0001, MVV, p = 0.0001, SVC, p = 0.001). The women's unforced prediction equ ations using age, height, weight did yield some significant correlatio ns with predictions based upon ambulatory subjects. The men's unforced adapted prediction equations did reveal significant correlations with the validation group for FEVC (r = 0.66, p = 0.007), FEV1 (r = 0.62, p = 0.015), PIF (r = 0.95, p = 0.015), MVV (r = 0.57, p = 0.067), SVC (r = 0.69, p = 0.019), and RV (r = 0.67, p = 0.009). Pulmonary functio n in male wheelchair users should be predicted using equations which i ncorporate years with disability and level of impairment. Additional s tudy is required to make any recommendations regarding women wheelchai r users. However, study of pulmonary function in women should be made a priority. Pulmonary function is affected by the extent of physical i mpairment, and tends to decline as years with disability increase.