None listed
Conditions
Brief summary
Patients who experience spinal cord injury loose normal function of respiratory muscles leaving them particularly vulnerable to respiratory complications, loss of optimal speech function and potential development of secondary postural deformities. Gravity, in conjunction with increased abdominal muscle compliance, pulls downward on the diaphragm resulting in flattening of the diaphragm, which reduces its ability to drive respiration. Abdominal binders limit abdominal wall distension when against gravity (sitting in wheelchair) by replacing the non-functioning abdominal muscle (innervated T5-T12) role. The restoration of diaphragm position may assist with improved respiration, speech and blood pressure when a patient is sitting in his/her wheelchair. This study will investigate the effect of an abdominal binder on breathing, speech and blood pressure in newly injured patients admitted to the Spinal Injuries Unit of Princess Alexandra Hospital. Those patients that have suffered an injury resulting in damage to T12 level or above and presenting as a complete injury will be approached. The current practice in the Spinal Injuries Unit is to wean the abdominal binder once the cardiovascular system has adapted and postural hypotension is no longer a concern. However, the abdominal binder has been shown to have an effect on respiratory function. Respiratory, speech and blood pressure measurements will be taken with and without the binder on in sitting at 6weeks post initial mobilizing,12 weeks,24weeks ,and 48 weeks after this point. The results of this study will be analyzed to determine the effect of binder use on outcomes collected. These results will direct further practice and use of the abdominal binder.
Interventions
Subjects will all wear an abdominal binder throughout the study period (there will NOT be two groups with one wearing the AB and one group not). However, testing with and without the abdominal binder will be randomised in order of testing for each time point according to a computer generated randomisation order list of binder on/off. An elastic binder is an elastic garment that wraps around a patients abdomen extending from the bottom of the ribs to just above the hip. It is used when a patient
Subjects will all wear an abdominal binder throughout the study period (there will NOT be two groups with one wearing the AB and one group not). However, testing with and without the abdominal binder will be randomised in order of testing for each time point according to a computer generated randomisation order list of binder on/off. An elastic binder is an elastic garment that wraps around a patients abdomen extending from the bottom of the ribs to just above the hip. It is used when a patient assumes an upright position. Patients are provided with an abdominal binder when they first commence sitting up in a wheelchair after acute injury. Patients are advised to continue the use of an abdominal binder if they have no motor activation of the abdominal muscles. Outcome measures will be collected over 4 points in time during the subjects first 12 months after a spinal cord injury.
Sponsors
Princess Alexandra Hospital
Study design
Allocation
Non-randomised trial
Intervention model
Crossover
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
16 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
Acute spinal cord injury above T12, Amercian Spinal Injuries Association (ASIA) classification system of ASIA classification A or B which indicates complete motor dennervation below level.
Exclusion criteria
Pressure sore of stage 2 or greater, active respiratory disease
Outcome results
None listed