A Study on the Effect of Time Lapse After Position Change and Abdominal Band on Pulmonary Function in the Cervical Cord Injuries

척수손상 환자의 자세 변화 후 시간경과와 복대사용이 폐기능에 미치는 영향

The objective of this study was to identify pulmonary functional variations in relation to postural changes, lapse after changing position, and the use of abdominal band in the cervical cord injured. The subjects of this study were 19 quadriplegic patients who had been admitted to the department of the Rehabilitation Hospital, College of Medicine, Yousei University, from April, 1997 through May 3, 1997. A spiroanalyzer was used to measure pulmonary function in supine, standing, time after changing position, and recording to the position, application method, and tightness of the abdominal band. The data were analyzed by the repeated measure one-way ANOVA, and Wilcoxon signed rank test. The findings were as follows: 1. All phase of the patients' pulmonary function improved significantly in supine posture in contrast to standing (vital capacity by $0.46{\ell}$ and expiratory reserve volume by $0.09{\ell}$). 2. The longer the time lapsed from supine posture to standing, the patient's expiratory reserve volume, maximum ventilation volume, vital capacity, and forced expiratory volume increased. 3. When the patient lay in supine position, the maximum ventilation volume, vital capacity, and the forced vital capacity increased then the center line of the abdominal band was placed along iliac crest; on the other hand, when the patient was standing, placing the bottom line of the abdominal band along iliac crest increased the maximum ventilation volume, vital capacity, and forced expiratory volume. 4. In placing the abdominal band in the patients, leaving space between the top and bottom lines of the band helped increased in maximum ventilation volume, vital capacity, and forced vital capacity for patient in supine as well as in standing. 5. When placing the abdominal band to patients in supine posture, reducing the length of the band by 2.5% along the patient's waist line increased the patients' vital capacity, while reducing the length by 10% to patients in standing increased the maximum ventilation volume. The abdominal band should be placed in such a way that the bottom part of the band should be more tightly fastened while leaving enough room for a hand to be placed in between the body and the band for the top part of the hand. It should also be noted that in a supine position, the bottom line of the band should be placed along the iliac crest, while in standing, the center line should be placed along the iliac crest. The length of the band should also be reduced by 2.5% of the waist line in supine position, and in standing, the length should be reduced by 10%. It should also be noted that the pulmonary function of the patients should be measured at least 10 minutes after one position change.