Ventilator-Assisted Living©

Spring 2001, Vol. 15, No. 1

(continued)

Respiratory Study with SCI Ventilator Users

Millennium Man Bill Miller, Florida (MaxNWM@aol.com; www.lookmomnohands.net)

In early January I received a phone call from Dr. Danny Martin at the University of Florida. He told me about a small research grant he had received to test his theory that inspiratory muscle training can improve air intake and management for spinal cord injured ventilator users. The primary goals would be to increase ventilator-free breathing time and to improve speech ability. Participation would require three trips to the University of Florida in Gainesville. The first two trips would be for evaluation and testing of my initial abilities, and then a physical therapist would come to my home five days a week for six weeks to train my breathing muscles. They would come to me for free? Unbelievable! I agreed immediately.

Our first trip to UF filled a Friday afternoon with preliminary paperwork, testing, and a physical assessment. My parents and I met with all the people involved in the respiratory research (several students, therapists, and about six doctors with various specialties). The sharing of thoughts and conjectures was very candid, and I found it most enlightening and enjoyable. The doctors have the formal knowledge while my parents and I have the experiential, and we seemed to validate each other's ideas.

Our second trip was for the breathing endurance test. To pass the time and to make the breathing environment as “normal” as possible, Dr. Martin suggested I bring a movie to watch. On the way out the door, we grabbed two movies. The thought of needing two movies to watch never crossed my mind; we were taking both to decide on one later.

For the endurance test, I was hooked up to several monitors (EKG, oxygen and carbon dioxide levels, heart rate, and tidal volume) and asked to breathe on my own without the ventilator for as long as I could. This consisted of me breathing in and out through my open trach tube as the physicians monitored the numbers. Every 15 minutes Dr. Martin asked me to rate my comfort level from 0 to 10 – 0 representing easy breathing and 10 being a struggle for air.

After the first 15 minutes, I rated my comfort level at 1. After the second 15 minutes, I indicated 2. I had absolutely no idea how long I would last during the endurance test. My record of ventilator-free breathing time was three hours, and I had only done that once – well over a year before. But watching the movie helped me to relax, the time rolled by, and every 15 minutes I indicated a comfort level of 2. The movie ended, and I was still going strong, so we starting watching the second movie.

This breathing test was designed to last a maximum of three hours, but I went for three hours and 15 minutes. (Dr. Martin said that they let me continue for another 15 minutes so I could set a new personal record.) My numbers held up well, and my comfort level remained at 2. Now I get to “work out” my breathing muscles five days a week for the next six weeks. Then I must return to Gainesville and top this performance so that the research is deemed a success and a larger grant can be used to study more people. Next time we will bring three movies – I hope we will need them.

More about the project from Danny Martin, PhD, PT
University of Florida (Dmartin@hp.ufl.edu; www.hp.ufl.edu/pt/ADM.html)

The pilot project “The effect of inspiratory muscle strength training on mechanical ventilator-dependent spinal cord injury (SCI) patients” began in January 2001 and was funded by the State of Florida's Brain and Spinal Cord Injury Rehabilitation Trust Fund through the Brain Institute at the University of Florida. It is intended to provide enough data to evaluate feasibility, and, if the results are promising, to help secure funding for a larger project.

Our hypothesis is that people with SCI, levels C1-C6, who are ventilator users with some spontaneous breathing will increase inspiratory muscle strength through inspiratory muscle strength training, increase their spontaneous breathing periods, and enhance sound production.

Bill Miller is our first subject, and we hope to study six to eight subjects before moving to the next level. At this time, we are only studying subjects within a 75-minute drive of our Gainesville campus because the researchers are going to the subjects' homes, five times per week for six weeks. I expect to have preliminary data by July 2001.

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