Breathing Exercise in High Cervical Cord Injury : Report of two Cases

Spinal cord injury patients, particularly high cervical cord injury patients, have breathing disturbance due to diaphragm paresis. They are maintained on a ventilator, which has a tremandous restriction on the activities of daily living (ADL). We used breathing care to wean two patients from the ventilator. They were both males, one aged 26 years and the other 17. Both patients had complete quadriplegic paralysis and diaphragm paresis due to C3 dislocation. The breathing care consisted of exercises for phlegm drainage, muscle strengthening, and prevention of muscle shortening and joint stiffness. In one patient, weaning from artificial ventilation was successful, spontaneous breathing was achieved, and it was possible to remove the tracheal canula by Day 492. The other patient improved to take off the ventilator for 5 hours at atime except during meal and sleep by Day 99. For both patients there were significant effects not only on the ADL and mentality, but also on nursing care given to them.

High cervical cord injury

Breathing disturbance

Breathing exercise

Weaning

Physical therapy