A Secondary Analysis of Short- and Long-Term Variability of Inspiratory Muscle Performance in People Living With SCI

Abstract

Objectives To explore the expected variability in repeated short-term (ST) and long-term (LT) inspiratory muscle performance (IMP) in individuals with chronic spinal cord injury (SCI). Methods Maximal inspiratory pressure (MIP), sustained MIP (SMIP), and inspiratory duration (ID) were collected from 22 individuals with chronic SCI (C1-T9, American Spinal Injury Association Impairment Scale [AIS] A–C) over 18 months. ST data were collected four times within 2 weeks (n = 19). LT data were collected at two time points at least 7 months apart (n = 20). Results SMIP was the most reliable IMP assessment with an intraclass correlation coefficient (ICC) of 0.959, followed by MIP (ICC 0.874) and ID (ICC 0.689). The ID was the only ST measure to have a significant difference [MIP: F(3, 54) = 2.5, p = .07; SMIP: F(3, 54) = 1.3, p = .29; ID: F(1.4, 25.6) = 4.8, p = .03]. Post hoc analysis showed the mean day 1 ST ID measure was significantly different from both days 3 and 4. The percent change of ID from day 3 to day 6 was 11.6%. No LT measures differed significantly [mean change (SD) [95% CI] for MIP: 5.2 cm H2O (18.8) [−3.6, 13.9], p = .235; SMIP: 60.9 pressure time unit (166.1) [−16.9, 138.6], p = .118; ID: 0.1 s (2.5) [−1.1, 1.3], p = .855]. Conclusion These data provide a foundation for understanding normal variance in ST and LT IMP in the SCI population. Change in MIP function outside 10% is likely a true and meaningful change and may help clinicians recognize individuals with SCI at risk for respiratory compromise. Future studies should explore changes in MIP and SMIP that are associated with meaningful functional changes.