How are respiratory problems managed and prevented long term?

Author: Sharon Jang | Reviewer: Tova Plashkes | Published: 24 September 2020 | Updated: 7 December 2021

Illustration accompanying How are respiratory problems managed and prevented long term?

Getting vaccinated is one of the ways to prevent secondary complications such as pneumonia.9

Prevention is important to avoid getting respiratory illnesses when you have an SCI. Some things you can do to stay as healthy as possible include:

  • Avoiding smoking any substances and taking in second hand smoke. The lungs of people with SCI are easily irritated, and those who smoke are more susceptible to lung infections.
  • Staying hydrated – drink plenty of water. This helps to keep mucus in the lungs from being too thick.
  • Ensuring proper nutrition to help maintain a healthy weight and ensure the body has enough vitamins, minerals and protein to heal well when sick.
  • Exercising, as it can help by:
    • Helping you maintain a healthy weight, as lung complications become more prevalent in people who are overweight or obese,
    • Strengthening your breathing muscles.
  • Getting vaccinated for influenza (the flu) and pneumonia. This can help decrease your odds of getting these illnesses.
  • Coughing on a regular basis. Coughing is important for keeping your airways clear of secretions. If you have difficulties coughing by yourself, have someone help you perform manual assist coughs, or use a cough assist machine.
  • Maintaining mobility and proper posture. In order to prevent build up in the lungs, try to sit up everyday and turn when laying in bed.

Secretion removal techniques

Illustration accompanying How are respiratory problems managed and prevented long term?

Equipment used for lung volume recruitment.10

Upon returning to the community, common secretion removal techniques include glossopharyngeal breathing and the use of lung volume recruitment (LVR) bags with an assisted cough. Glossopharyngeal breathing (or frog breathing) is a technique that is used to get a deeper breath. This is done by rapidly taking “gulps” of breaths one after the other, followed by exhaling. This can help create a cough, or facilitate assisted coughing.

LVR, or “breath stacking” is done with an LVR kit which consists of a resuscitation bag connected with a flexible tube to a mouth piece with a one-way valve. The individual will inhale the most they can, and once this point is reached, a clinician (or second person) will squeeze the bag to “stack” breaths to fully inflate the lungs. This allows the individual to breathe more air than they are able to themselves, and to exhale more air more quickly to produce an improved cough. This also can help with maintaining chest mobility and flexibility.

Exercise Training

Illustration accompanying How are respiratory problems managed and prevented long term?

Exercise training involving arm and leg movements can improve muscle strength and cardiovascular endurance. Breathing muscles are also challenged with exercise and may become stronger with exercise. This increase in strength can help decrease the effort of breathing at rest and with functional activity, like transfers. An example of a method of exercise training for individuals with higher levels of injuries include the use of a

Functional Electrical Stimulation

(FES) bike. Other exercises like arm cycling or strengthening exercises are commonly prescribed by a physiotherapist or health care professional. While exercise can help strengthen respiratory muscles, low-moderate evidence studies debate whether lung volumes are impacted. This is to say, exercising may help make breathing feel easier, but it is unknown whether the amount of air you can take into your lungs is affected. High intensity exercise three times per week for six weeks has shown to significantly improve respiratory function. However, standard guidelines for high intensity exercise have not yet been established.

Illustration accompanying How are respiratory problems managed and prevented long term?

An abdominal binder wrapped around the abdomen to correct the positioning of the diaphragm.12

Refer to our article on Functional Electrical Stimulation for more information!

Girdle/Abdominal Binder

Girdles or abdominal binders are garments that apply pressure around the abdominal area to help keep the diaphragm in an optimal position. Abdominal binders are also used for managing orthostatic hypotension and blood pooling. Although there may be short-term improvements when using a girdle or binder, more research is needed in determining their long-term utility.

Refer to our article on Abdominal binders for more information!