Airflow Obstruction and Reversibility in Spinal Cord Injury: Evidence for Functional Sympathetic Innervation

Miroslav Radulovic, Gregory J. Schilero, Jill M. Wecht, Joseph P. Weir, Ann M. Spungen, William A. Bauman, Marvin Lesser

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20 Scopus citations


Radulovic M, Schilero GJ, Wecht JM, Weir JP, Spungen AM, Bauman WA, Lesser M. Airflow obstruction and reversibility in spinal cord injury: evidence for functional sympathetic innervation. Objectives: The first objective was to assess group differences for specific airway conductance (sGaw) among subjects with tetraplegia, high paraplegia (HP: T2-T6), and low paraplegia (LP: T10-L4). The second objective was to determine the significance of responsiveness to ipratropium bromide (IB) by the assessment of the inherent variability of baseline measurements for impulse oscillation (IOS), body plethysmography, and spirometry. Design: Prospective cross-sectional intervention study. Setting: James J. Peters Veterans Administration Medical Center. Participants: Subjects (N=43): 12 with tetraplegia (C4-8), 11 with HP, 11 with LP, and 9 controls. Interventions: Not applicable. Main Outcome Measures: Measurement of IOS, body plethysmography, and spirometry parameters at baseline and 30 minutes after IB. Results: Baseline sGaw was significantly lower in tetraplegia (0.14±0.03) compared with HP (0.19±0.05) and LP (0.19±0.04) patients. By use of minimal difference to evaluate IB responsiveness in tetraplegia, 4 of 12 and 12 of 12 subjects had significant increases in forced expiratory volume in 1 second and sGaw, respectively, whereas 11 of 12 and 10 of 12 subjects had significant decreases in respiratory resistances measured at 5 and 20Hz (R5 and R20), respectively. Conclusions: The finding of group differences for baseline sGaw supports the hypothesis that human lung contains functional sympathetic innervation. Body plethysmography and IOS were comparable in detecting IB-induced bronchodilation in tetraplegia and significantly more sensitive than spirometry.

Original languageEnglish
Pages (from-to)2349-2353
Number of pages5
JournalArchives of Physical Medicine and Rehabilitation
Issue number12
StatePublished - Dec 2008


  • Anticholinergic agents
  • Plethysmography
  • Pulmonary function tests
  • Rehabilitation
  • Spinal cord injuries
  • Spirometry
  • whole body


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