Acute management of patients with spinal cord lesions
NEW
UK Respiratory Guidelines
www.risci.org.uk/

NEW
US Respiratory Guidelines
www.pva.org/site/DocServer/resmgmt.pdf?docID=703


Bauman WA (2000) Metabolic changes in persons after spinal cord injury. Phys Med Rehab Clin N Am, 11, 109-36

Berney S et al (2002) Can early extubation and intensive physiotherapy decrease length of stay of acute quadriplegic patients in intensive care? Physiother Res Internat, 7, 14-22
• early extubation and intensive physio can reduce length of ICU stay

Bracken MB, Shepard MJ, Holford TR (1997) Administration of methylprednisolone for acute spinal cord injury. JAMA, 277, 1597-04
• high-dose steroids within 8 hours of injury improves neurological recovery

Bryce TN (2000) Pain after spinal cord injury. Phys Med Rehab Clin N Am, 11, 157-68

Burns SP (2000) Sleep apnea syndrome in chronic spinal cord injury. Arch Phys Med Rehab, 81, 1334-9

Chung BP, Cheng BKK (2010) Immediate effect of transcutaneous electrical nerve stimulation on spasticity in patients with spinal cord injury. Clin Rehabil, 24, 202-210
• TENS for spasticity causing pain, contractures and impaired mobility

Crane (1994) The effect of exercise training on pulmonary function in persons with quadriplegia. Paraplegia, 32, 435-41.

Crowe J (2000) A multi-centre, randomized controlled trial of positioning on quadriplegic shoulder pain. Physiother Can, 42, 266-72

Curtis KA, Drysdale GA, Lanza RD (1999) Shoulder pain in wheelchair users with tetraplegia and paraplegia. Arch Phys Med Rehab, 80, 453-7

Davies D (2002) Lifestyle risks for three disease outcomes in spinal cord injury. Clin Rehab, 16, 96-108
• cigarette smoking is the most damaging lifestyle behaviour in spinal cord-injured people

Derrickson (1992) A comparison of two breathing exercise programs for patients with quadriplegia. Phys Ther, 72, 763-69

De Troyer (1986) Mechanism of active expiration in tetraplegic subjects. New Eng.J.Med, 314, 740-4

Dimarco AF, Romaniuk JR, Supinski GS (1995) Electrical activation of the expiratory muscles to restore cough. Am J Resp Crit Care Med. 151, 1466-71

Fishburn (1990) Atelectasis and pneumonia in acute spinal cord injury. Arch Phys Med Rehabil, 71, 197-200

Garcia-Morato J (2004) Diaphragmatic pacing in neuromuscular respiratory failure. Clin Pulm Med, 11, 25-32

Goldstein R (2000) Musculoskeletal conditions after spinal cord injury. Phys Med Rehab Clin N Am, 11, 91-108
• a third to a half of patients develop shoulder pain

Gounden (1993) The effect of posture on the role of pectoralis major and latissimus dorsi muscles in expiration in tetraplegia. S Afr J Physiother, 49, 25-27.

Green D et al (2005) Evolving risk for thromboembolism in spinal cord injury. Am.J.Phys Med Rehab, 84, 420-2
www.amjphysmedrehab.com/pt/re/ajpmr/abstract.00002060-200506000-00004.htm;jsessionid=DKQvbFSex77ljgNr0lgv7v2SzdzbHetDKyc74yckVCheXKStUhnM!1556005714!-949856145!9001!-1?index=1&database=ppvovft&results=1&count=10&searchid=1&nav=search

Griffiths K (2000) Acute respiratory management of the spinal cord injured patient (abstract). J ACPRC, 33, 17-18
• overview of assessment, positioning, NIV, weaning, suction

Gupta (1989) Minitracheotomy in the early respiratory management of patients with spinal injuries. Paraplegia, 27, 269-77.

Harris K, Bull J (2004) The role of respiratory clinical specialist physiotherapists in two spinal cord injury units. ACPRC Journal, 36, 37-40

Hartkopp A, Hansen H (1998) Suicide in a spinal cord injured population. Arch Phys Med Rehab, 79, 1356-61
• marginally disabled patients have higher suicide rate than functionally completely disabled

Harvey LA et al (2003) Quantifying the magnitude of torque physiotherapists apply when stretching the hamstrings of people with spinal cord injury. Arch Phys Med Rehab, 84, 1072-5
• wide variety of force applied by different physiotherapists

Jaeger (1993) Cough in spinal cord injured patients: comparison of three methods to produce cough. Arch Phys Med Rehabil, 74, 1358-61.

Jones ML, Mathewson CS, Adkins VK et al (2003) Use of behavioral contingencies to promote prevention of recurrent pressure ulcers. Arch Phys Med Rehabil, 84, 796-9
• money rewards help patients prevent pressure sores

Karlet MC (2001) Acute management of the patient with spinal cord injury. Int J Trauma Nurs, 7, 43-8
• early intervention to prevent secondary pain

Laffont I, Durand M-C, Rech C et al (2003) Breathlessness associated with abdominal spastic contraction in a patient with C6 tetraplegia. Arch Phys Med Rehab, 84, 906-8
• spastic abdominal muscles impose significant load on diaphragm, relieved by baclofen

Lin KH (1999) Abdominal weight and inspiratory resistance. Arch Phys Med Rehab, 80, 741-5

Lin VWH, Singh H, Chitkara RK (1998) Functional magnetic stimulation for restoring cough in patients with tetraplegia. Arch Phys Med Rehab, 79, 517-22

Linsenmeyer TA (2000) Sexual function and infertility following spinal cord injury. Phys Med Rehab Clin N Am, 11, 141-63
• ability to enjoy sex and have children

Lohne V (2008) The battle between hoping and suffering: a conceptual model of hope within a context of spinal cord injury. Adv Nurs Science, 31(3): 237-248.
• hope of improvement was the main focus in early rehabilitation, whereas hope as being just fine was the main focus after 3 to 4 years’ rehabilitation

March A (2005) A review of respiratory management in spinal cord injury. J Orthopaed Nurs, 9, 19
www.sciencedirect.com/science?_ob=ArticleURL&_aset=V-WA-A-W-A-MsSAYZW-UUW-U-AAVYBVAYUU-AAVCEWWZUU-YAYBUVBZA-A-U&_rdoc=1&_fmt=summary&_udi=B6WKG-4F320NW-2&_coverDate=02%2F01%2F2005&_cdi=6906&_orig=search&_st=13&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=4c2751872d92d7461424ae82ba2d894f
• positioning, chest physiotherapy and assisted coughing techniques

Mautes AEM (2000) Vascular events after spinal cord injury. Phys Ther, 80, 673—88
• secondary damage that defines the extent of functional recovery

Ramakrishnan (1991) Bronchial mucus hypersecretion in acute quadriplegia. Am Rev Respir Dis, 143, 640-48.

Rose (1987) The effect of lung volume expansion in tetraplegia. Phys Practice, 3, 163-67

Rutchik A (1998) Resistive inspiratory muscle training in subjects with chronic cervical spinal cord injury. Arch Phys Med Rehab, 79, 293-7
• inspiratory muscle training can reduce breathlessness

Schweitzer JA (1994) Specific breathing exercises for the patient with quadriplegia. Phys Ther Practice, 3, 109-22.

Soundy A, Smith B, Cressy F, Webb L (2009) The experience of spinal cord injury. Physiotherapy, 96, 1, 52-58
www.sciencedirect.com/science?_ob=ArticleURL&_udi=B7CVK-4WWFN7B-1&_user=10&_coverDate=03%2F31%2F2010&_rdoc=8&_fmt=high&_orig=browse&_srch=doc-info%28%23toc%2318081%232010%23999039998%231628125%23FLA%23display%23Volume%29&_cdi=18081&_sort=d&_docanchor=&_ct=41&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=c2a4542a03f91dddab2e3187c3d3eb18

Stambolis V (2003) Dysphagia after anterior cervical spinal surgery. Arch.Phys.Med.Rehab, 84, E37 (www.archives-pmr.org)
• dysphagia present in 67.4% of patients, leading to aspiration

Stolp-Smith KA (1999) Antidepressant exacerbation of spasticity. Arch Phys Med Rehab, 80, 339-42
• anti-depressants have been known to increase spasticity

Sumida M (2001) Early rehabilitation effect for traumatic spinal cord injury. Arch Phys Med Rehab, 82, 391-5

van Koppenhagen CF (2009) Recovery of life satisfaction in persons with spinal cord injury during inpatient rehabilitation. Am J Phys Med Rehab, 88, 11, 887-895

van Velzen JM (2009) Return to work after spinal cord injury: is it related to wheelchair capacity at discharge from clinical rehabilitation? Am J Phys Med Rehab, 88, 1, 47-56
www.amjphysmedrehab.com/pt/re/ajpmr/abstract.00002060-200901000-00007.htm;jsessionid=JTMLMh9MK5C9NmsrGfYNyFXvS2pJkX1bnkG6xMJ91QqQBDt7Q5hZ!-1035908147!181195628!8091!-1
• ability to return to work is related to ability to use wheelchair

Vergès S, Flore P, Nantermoz G (2009) Respiratory muscle training in athletes with spinal cord injury. Internat J Sports Med, 30, 526-32.
www.thieme-connect.com/ejournals/abstract/sportsmed/doi/10.1055/s-0029-1202336
• respiratory muscle training can reduce breathlessness

Warren VC (2002) Glossopharyngeal and and neck accessory muscle breathing in a young adult with C2 tetraplegia resulting in ventilator dependency. Phys Ther, 82, 590-610
www.ptjournal.org/PTJournal/Jun2002/v82n6p590.cfm

Warren VC (2002) Glossopharyngeal and neck accessory muscle breathing in a young adult with C2 complete tetraplegia resulting in ventilator dependency. Phys Ther, 82, 6, 590-600
• glossopharyngeal breathing can provide 30 minutes’ ventilator-free time, a functional cough and a 35-fold increase in FVC

Widerström-Noga EG (2002) Assessment of the impact of pain and impairments associated with spinal cord injuries. Arch Phys Med Rehab, 83, 395-404

Winslow C et al (2003) Effect of spinal cord injury on the respiratory system. Am J Phys Med Rehab, 82, 803-14
• well-written, comprehensive, clear description of respiratory mechanics and complications


ACPRC = Association of Chartered Physiotherapists in Respiratory Care
JAMA = Journal of American Medical Association


updated 26/12/10