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The effect of craniocervical flexion and neck endurance exercises plus pulmonary rehabilitation on pulmonary function in spinal cord injury: a pilot single-blinded randomised controlled trial

Spinal Cord Series and Cases volume 10, Article number: 27 (2024) Cite this article

Subjects

Abstract

Study design

Randomised controlled trial with computerised allocation, assessor blinding and intention-to-treat analysis.

Objective

This study wanted to prove that cervicocranial flexion exercise (CCFE) and superficial neck flexor endurance training combined with common pulmonary rehabilitation is feasible for improving spinal cord injury people’s pulmonary function.

Setting

Taoyuan General Hospital, Ministry of Health and Welfare: Department of Physiotherapy, Taiwan.

Method

Thirteen individuals who had sustained spinal cord injury for less than a year were recruited and randomised assigned into two groups. The experimental group was assigned CCFEs and neck flexor endurance training plus normal cardiopulmonary rehabilitation. The control group was assigned general neck stretching exercises plus cardiopulmonary rehabilitation. Lung function parameters such as forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow rate (PEFR), inspiratory capacity (IC), dyspnoea, pain, and neck stiffness were recorded once a week as short-term outcome measure.

Result

The experimental group showed significant time effects for FVC (pre-therapy: 80.4 ± 21.4, post-therapy: 86.9 ± 16.9, p = 0.021, 95% CI: 0.00–0.26) and PEFR (pre-therapy: 67.0 ± 33.4; post-therapy: 78.4 ± 26.9, p = 0.042, 95% CI: 0.00–0.22) after the therapy course. Furthermore, the experimental group showed significant time effects for BDI (experimental group: 6.3 ± 3.0; control group: 10.8 ± 1.6, p = 0.012, 95% CI: 0.00–0.21).

Conclusion

The exercise regime for the experimental group could efficiently increase lung function due to the following three reasons: first, respiratory accessory muscle endurance increases through training. Second, posture becomes less kyphosis resulting increasing lung volume. Third, the ratio between superficial and deep neck flexor is more synchronised.

IRB trial registration

TYGH108045.

Clinical trial registration

NCT04500223.

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Fig. 1: CONSORT flow diagram.

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Data availability

The datasets generated and/or analysed during the current study are not publicly available due the hospital’s policy but are available from the corresponding author upon reasonable request.

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Authors and Affiliations

  1. Department of Physiotherapy, TaoYuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan

    Cheng Shin Tsai, Hsin-Tzu Li, Wan-Li Yang & Yi-Ting Jhan

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  1. Cheng Shin Tsai
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Contributions

CS was involved in study design; collected the data; performed the data analysis; wrote and revised the article. HT help data collection; wrote and revised the article. WL and YT were involved in experiment preparation; wrote and revised the article. All authors approved and read the final version of the article.

Corresponding author

Correspondence to Cheng Shin Tsai.

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Competing interests

The authors declare no competing interests.

Ethics

All the research process was supervised and approved by the institutional board of Taoyuan General Hospital (Trial number: TYGH108045). We followed all the institutional and government regulation about ethic of human volunteers during the process of the experiment.

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Tsai, C.S., Li, HT., Yang, WL. et al. The effect of craniocervical flexion and neck endurance exercises plus pulmonary rehabilitation on pulmonary function in spinal cord injury: a pilot single-blinded randomised controlled trial. Spinal Cord Ser Cases 10, 27 (2024). https://doi.org/10.1038/s41394-024-00637-2

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