Physiotherapy Secretion Removal Techniques in People with Spinal Cord Injury: a Systematic Review

Overview

Journal J Spinal Cord Med

Date 2010 Nov 11

PMID 21061895

Citations 9

Authors

W Darlene Reid

Jennifer A Brown

Kristin J Konnyu

Jennifer M E Rurak

Brodie M Sakakibara

Affiliations

Soon will be listed here.

Abstract

Objective: To address whether secretion removal techniques increase airway clearance in people with chronic spinal cord injury (SCI).

Data Sources And Study Selection: MEDLINE/PubMed, CINAHL, EMBASE, and PsycINFO were searched from inception to May 2009 for population keywords (spinal cord injury, paraplegia, tetraplegia, quadriplegia) paired with secretion removal-related interventions and outcomes. Inclusion criteria for articles were a research study, irrespective of design, that examined secretion removal in people with chronic SCI published in English.

Review Methods: Two reviewers determined whether articles met the inclusion criteria, abstracted information, and performed a quality assessment using PEDro or Downs and Black criteria. Studies were then given a level of evidence based on a modified Sackett scale.

Results: Of 2416 abstracts and titles retrieved, 24 met the inclusion criteria. Subjects were young (mean, 31 years) and 84% were male. Most evidence was level 4 or 5 and only 2 studies were randomized controlled trials. Three reports described outcomes for secretion removal techniques in addition to cough, whereas most articles examined the immediate effects of various components of cough. Studies examining insufflation combined with manual assisted cough provided the most consistent, high-level evidence. Compelling recent evidence supports the use of respiratory muscle training or electrical stimulation of the expiratory muscles to facilitate airway clearance in people with SCI.

Conclusion: Evidence supporting the use of secretion removal techniques in SCI, while positive, is limited and mostly of low level. Treatments that increase respiratory muscle force show promise as effective airway clearance techniques.

Citing Articles

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Okawara H, Sawada T, Onuki S, Sugai K, Okubo T, Ozaki M Neurol Sci. 2024; .

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Nursing Process Related to the Nursing Focus "Airway Clearance": A Scoping Review.

Gaspar L, Reis N, Sousa P, Silva A, Cardoso A, Brito A Nurs Rep. 2024; 14(3):1871-1896.

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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.

Tsai C, Li H, Yang W, Jhan Y Spinal Cord Ser Cases. 2024; 10(1):27.

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Spinal cord injury and diaphragm neuromotor control.

Fogarty M, Sieck G Expert Rev Respir Med. 2020; 14(5):453-464.

PMID: 32077350 PMC: 7176525. DOI: 10.1080/17476348.2020.1732822.

Community exercise for individuals with spinal cord injury with inspiratory muscle training: A pilot study.

Leathem J, Macht-Sliwinski M, Boak S, Courville A, Dearwater M, Gazi S J Spinal Cord Med. 2019; 44(5):711-719.

PMID: 31525136 PMC: 8477927. DOI: 10.1080/10790268.2019.1655200.

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