Chest motion analysis of patients with spinal cord injury and the effect of insufflation and exsufflation

2018 Fiscal Year Final Research Report

• Project/Area Number: 15K01403
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Rehabilitation science/Welfare engineering
• Research Institution: Kawasaki Medical School
• Principal Investigator: Hanayama Kozo 川崎医科大学, 医学部, 教授 (80189589)
• Co-Investigator(Kenkyū-buntansha): 平岡 崇 川崎医科大学, 医学部, 准教授 (20351926) ; 関 聰介 川崎医科大学, 医学部, 講師 (10341124) ; 目谷 浩通 川崎医科大学, 医学部, 准教授 (30330583)
• Research Collaborator: SUGIYAMA Takefumi ; HYODO Masaki ; FURUSAWA Kazunari
• Project Period (FY): 2015-04-01 – 2019-03-31
• Keywords: 脊髄損傷 / 呼吸リハビリテーション / 四肢麻痺 / 排痰補助装置 / 拘束性換気障害

Outline of Final Research Achievements

We analyzed chest wall motion of patients with cervical spinal cord injury and the effect of mechanical insufflation and exsufflation using a three-dimensional motion analysis system. As a result, in patients with cervical spinal cord injury, paradoxical movement was observed in which the upper thorax volume decreases during inhalation of quiet breathing, and the change in chest wall volume is reduced at head-up position compared with supine position which was mainly caused by the difference of abdominal volume change. Regarding mechanical insufflation, we found that increase in　rib cage volume according to insufflation plateaued at certain insufflation pressure or higher.

Free Research Field

リハビリテーション医学

Academic Significance and Societal Importance of the Research Achievements

頸髄損傷者で急性期に特徴的とされる奇異性呼吸は慢性期にも残存していること、頸髄損傷者においては仰臥位の方が頭部挙上位の方が換気量が多いことなど興味深い知見が得られた。高齢社会において、高齢の頸髄損傷者も増加しているが、その呼吸障害の一端が明らかになったことにより、呼吸器合併症の予防などに今回の研究成果や今後得られる知見が生かされることが期待される。