Respiratory Management (Rehab Phase)

Other Surgery

There is 1 study (Level 4 evidence: Yang et al. 2014) that used rib suspension surgery (the trapezius muscle strength can be surgically transferred to the rib cage through the scapula to recover the lost thoracic breathing) and found that people reported improved breathing, cough & expectoration 1 day post-surgery, and increased range of diaphragmatic activity 2-3 weeks post-surgery, and significantly increased VC post-surgery.

Author Year; Country
Score
Research Design
Total Sample Size		 Methods Outcome
Yang et al. 2014; China
Pre-Post
N=6		 Population: N=6 SCI individuals (4M 2F); Mean age (SD): 41.7(16.2); Mean DOI* (SD): 84(26.7) days; All with limited diagraphragmatic function, dyspnea, and good trapezius muscle strength; All cervical SCI, AIS-A. *At time of surgery.
Treatment: Rib suspension surgery.
Outcome Measures: Vital capacity (VC), tidal volume (TV), cough & expectoration assessment, ventilator & oxygen dependence, diaphragmatic activity (fluoroscopy), phonation ability, electromyography, arterial blood gas analysis and development of complications.
  1. Patients reported improved breathing, cough & expectoration 1 day post-surgery.
  2. Increased range of diaphragmatic activity 2-3 weeks post-surgery.
  3. Extubation completed in all patients within 4 weeks post-surgery.
  4. Significantly increased VC post-surgery.
  5. No significant change in TV.
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