Comparison of respiratory muscle training methods in individuals with motor and sensory complete tetraplegia: a randomized controlled trial

J Rehabil Med. 2013 Mar;45(3):248-53. doi: 10.2340/16501977-1097.


Objective: To compare the effects of inspiratory resistance training and isocapnic hyperpnoea vs incentive spirometry (placebo) on respiratory function, voice, thorax mobility and quality of life in individuals with tetraplegia.

Design: Randomized controlled trial.

Patients/methods: A total of 24 individuals with traumatic, complete tetraplegia (C5-C8, American Spinal Injury Association (ASIA) Impairment Scale; AIS A) were randomly assigned to 1 of 3 groups. They completed 32 supervised training sessions over a period of 8 weeks. Before and after the training period, the following tests were performed: body plethysmography, inspiratory and expiratory muscle strength, subjective breathing parameters using a visual analogue scale, voice measurements, thorax mobility and quality of life. Cohen's effect sizes and Kruskal-Wallis tests for differences between pre- and post-training values were calculated.

Results: Compared with placebo training, inspiratory resistance training showed high effect sizes for inspiratory muscle strength (d = 1.13), the subjective ability "to blow one's nose" (d = 0.97) and the physical component of quality of life (d = 0.82). Isocapnic hyperpnoea compared with placebo showed a high effect size for breathlessness during exercise (d = 0.81). We found a significant effect of inspiratory resistance training vs placebo (p = 0.016) and vs isocapnic hyperpnoea (p = 0.012) for inspiratory muscle strength.

Conclusion: In individuals with motor and sensory complete tetraplegia during the first year post-injury, inspiratory resistance training is more advantageous than isocapnic hyperpnoea, performed 4 times a week for 10 min.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Breathing Exercises*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quadriplegia / physiopathology
  • Quadriplegia / rehabilitation*
  • Quality of Life
  • Resistance Training
  • Respiratory Muscles / physiopathology
  • Spirometry
  • Voice Quality
  • Young Adult