AbstractThe Effects of Injury Level on Pulmonary Function in the Patients with Chronic Spinal Cord Injury Objective: Reduction in pulmonary functions in the patients with spinal cord injury is a significant cause of morbidity and mortality. Impaired or ceased diaphragm functionality results in inadequate functioning of intercostal and abdominal muscles, leading to decrease in inspiratory and expiratory volumes. In our study, it was aimed to compare some pulmonary functions of chronic stage patients with a high level spinal cord injury [high tetraplegic patients (C3-5)] having lesions in the segments of the innervated diaphragm to those of low level spinal cord injury [tetraplegic (C6-8)-high paraplegic (T1-6)] patients. Method: A total of 20 high tetraplegic and 22 low tetraplegic-high paraplegic patients registered at our hospital with at least 1 year old injuries were enrolled in the study. Pulmonary function tests were employed in pulmonary laboratory taking the ATS/ERS criteria into consideration. The data obtained were then calculated as percentages of the reference values given in the software of the PFT device and were evaluated statistically by using Mann-Whitney U Test Result: The results revealed that in both groups forced vital capacity (FVC), forced expiratory volume at the first second (FEV1), peak expiratory flow rate (PEFR) and vital capacity (VC) decreased as predicted for both groups. Measured pulmonary function test parameters were (FVC, FEV1, PEFR and VC) showed statistically low values in high tetraplegic patients in comparison to low tetraplegic-high paraplegic patients. Conclusion: The data obtained in this study revealed that lesion level in spinal cord injury affects the pulmonary function in spinal cord injury. The reduction in pulmonary functions in the chronic stage was much more significant for high tetraplegic patients in comparison to low tetraplegic- high paraplegic patients. This factor should be taken into consideration while planing and implicating a rehabilitation program in order to correct and improve quality of life functions in the patients with spinal cord injuries.
Türkçe Özet:Amaç: Spinal kord yaralanması olan hastalarda pulmoner fonksiyonlardaki azalma önemli mortalite ve morbidite nedenidir. Diyafragma işlevinin bozulması, interkostal ve abdominal kasların yeterli işlev görememesi, inspiratuar, ekspiratuar hacimlerde azalmayla sonuçlanır. Çalışmamızda, diafragmanın innerve olduğu segmentlerin hasarlandığı kronik dönem yüksek seviye spinal kord yaralanmalı hastalarla [yüksek tetraplejik (C3-5)] daha alt seviye spinal kord yaralanması olan hastaların [alçak tetraplejik (C6-8) ve yüksek paraplejik (T1-6)] bazı pulmoner fonksiyonlarının karşılaştırılması amaçlandı. Yöntem: Çalışmaya rehabilitasyon ve bakım merkezine başvuran, yaralanmanın üzerinden en az 1 yıl geçmiş; 20 yüksek tetraplejik ve 22 alçak tetraplejik-yüksek paraplejik hasta alındı. Solunum fonksiyon testleri solunum laboratuarında ATS/ERS kriterleri göz önüne alınarak yapıldı. Ölçümler sonucu elde edilen veriler PFT cihazının paket programında verilen referans değerlerin yüzdesi şeklinde alınarak hesaplamalar yapıldı ve Mann-Whitney U testi ile istatistiksel olarak değerlendirildi. Bulgular: Bulgular, her iki yaralanma seviyesindeki grupta da zorlu vital kapasitenin (FVC), birinci saniyedeki zorlu ekspirasyon hacminin (FEV1), tepe ekspirasyon akım hızının (PEFR) ve vital kapasitenin (VC) beklenen değerlere göre azaldığını gösteriyordu. Ölçülen solunum fonksiyon testi değişkenleri (FVC, FEV1, PEFR, VC) yüksek tetraplejik hastalarda alçak tetraplejik-yüksek paraplejik hastalara göre istatistiksel olarak anlamlı şekilde düşüktü (p<0.05). Sonuç: Bulgular, spinal kord yaralanmasının seviyesinin pulmoner fonksiyonları etkilediğini göstermektedir. Kronik dönemde yüksek tetraplejik hastaların pulmoner fonksiyonlarındaki azalma alçak tetraplejik-yüksek paraplejik hastalarla kıyaslandığında daha belirgindir. Spinal kord yaranması olan hastaların yaşamsal fonksiyonlarını düzeltmek ve hayat kalitelerini arttırmak için rehabilitasyon programı yapılırken bu durumun göz önüne alınması önemli olabilir.
Primary Language | Turkish |
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Journal Section | Articles |
Authors | |
Publication Date | June 1, 2009 |
Submission Date | June 13, 2014 |
Published in Issue | Year 2009 Volume: 2 Issue: 2 |
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