Abdominal binders in sitting may be provided to improve lung volume in people with SCI who have abdominal muscle weakness or paralysis.
Abdominal binders in sitting (v no intervention) on lung volumes in people with SCI who have abdominal muscle weakness or paralysis | |||||||
---|---|---|---|---|---|---|---|
P | People with SCI who have abdominal muscle weakness or paralysis | Evidence recommendation Weak for (100%) | Weak evidence recommendation FOR Abdominal binders in sitting may be provided to improve lung volume in people with SCI who have abdominal muscle weakness or paralysis. Clinical note: Abdominal binders (to improve lung volumes) are provided in people with respiratory compromise and abdominal muscle paralysis (full or partial). Abdominal binders may not be suitable for people with significant abdominal distension, central adiposity, or large abdomens. Abdominal binders may also be provided for purposes other than improving lung volume. |
||||
I | Abdominal binders | ||||||
C | No abdominal binder | Consensus-based opinion statement No opinion statements |
|||||
O | Lung volume | ||||||
SUMMARY | 5 RCTs (see references) | Mean difference (95% CI): Lung volume in litres 0.3 (0.1 to 0.5) Favours abdominal binders |
|||||
GRADE Very low certainty ⨁◯◯◯ | Risk of bias Very serious | Inconsistency Not serious | Imprecision Not serious | Indirectness Serious | Publication bias Serious |
||
ABDOMINAL BINDERS FOR LUNG VOLUME: GRADE Evidence to Decision | ||||||
---|---|---|---|---|---|---|
PROBLEM | No | Probably no | Probably yes | Yes | Don't know | |
DESIRABLE EFFECTS | Trivial | Small | Moderate | Large | Don't know | |
UNDESIRABLE EFFECTS | Large | Moderate | Small | Trivial | Don't know | |
CERTAINTY OF EVIDENCE | Very low | Low | Moderate | High | No included studies | |
HOW MUCH PEOPLE VALUE THE MAIN OUTCOME | Important uncertainty or variability | Possibly important uncertainty or variability | Probably no important uncertainty or variability | No important uncertainty or variability | ||
BALANCE OF EFFECTS | Favours the Control | Probably favours the Control | Does not favour either the intervention (I) or the comparison (C) | Probably favours the I | Favours the I | Don't know |
RESOURCES REQUIRED | Large costs | Moderate costs | Negligible costs and savings | Moderate savings | Large savings | Don't know |
CERTAINTY OF EVIDENCE OF REQUIRED RESOURCES | Very low | Low | Moderate | High | No included studies | |
COST EFFECTIVENESS | Favours the comparison | Probably favours the comparison | Does not favour either the intervention or the comparison | Probably favours the intervention | Favours the intervention | No included studies |
EQUITY | Reduced | Probably reduced | Probably no impact | Probably increased | Increased | Don't know |
ACCEPTABILITY | No | Probably no | Probably yes | Yes | Don't know | |
FEASIBILITY | No | Probably no | Probably yes | Yes | Don't know |
ABDOMINAL BINDERS FOR LUNG VOLUME: Randomised Controlled Trial Details | ||||||
---|---|---|---|---|---|---|
STUDY | COMPARISON | DOSAGE/DETAILS | PARTICIPANTS | N (Rx/C) | OUTCOME | ROB 2 PEDRo |
GOLDMAN 1996 | Sitting with abdominal binder V Sitting without abdominal binder | Elastic binder | C5-C7 Complete SCI >3 months post injury | 7/7 | Lung volume Vital Capacity (VC) | High Risk of Bias PEDro = 5/10 |
BOAVENTURA 2003 | Sitting with abdominal binder V Sitting without abdominal binder | Elastic binder | C4-C7 Complete SCI 1 year post injury | 10/10 | Lung volume Forced Vital Capacity (FVC) | Some Concerns of Risk of bias PEDro = 6/10 |
BODIN 2005 | Sitting with abdominal binder V Sitting without abdominal binder | Elastic binder | C5-C8 SCI At least 1 year post injury | 20/20 | Lung volume (VC) | High Risk of Bias PEDro = 4/10 |
HART 2005 | Sitting with abdominal binder V Sitting without abdominal binder | Combination elastic and non-elastic binder | C5-T6 AIS A SCI | 10/10 | Lung volume (FVC) | High Risk of Bias PEDro = 4/10 |
WADSWORTH 2012 | Sitting with abdominal binder V Sitting without abdominal binder | Elastic binder | C3-T5 AIS A or AIS B SCI Acute | 14/14 | Lung volume (FVC) | High Risk of Bias PEDro = 4/10 |
The Australian and NZ SCI Physiotherapy guideline committee recommends abdominal binders in sitting may be provided to improve lung volume in people with SCI who have abdominal muscle weakness or paralysis. This is an evidence recommendation supported by the results of five randomised controlled trials. The guideline states:
Abdominal binders in sitting may be provided to improve lung volume in people with SCI who have abdominal muscle weakness or paralysis.
This recommendation was formed by considering the results of five randomised controlled trials alongside other factors. The combined trial results indicate that abdominal binders in sitting are better than no abdominal binders for improving lung volume. The other factors that were considered were benefits and harms, values and preferences, resource use, equity, accessibility, and feasibility.
This is an evidence-based recommendation. Evidence-based recommendations are more robust than consensus-based opinion statements. They can be strong or weak. This is a weak evidence-based recommendation which means the guideline panel is confident that they can probably recommend abdominal binders in sitting may be provided to improve lung volume in people with SCI who have abdominal muscle weakness or paralysis based on the evidence.
To learn more about this recommendation go to the research summary.
-
Boaventura, C. D.Gastaldi, A. C.Silveira, J. M.Santos, P R.Guimaraes, R. C.De, L. L. C. Effect of an abdominal binder on the efficacy of respiratory muscles in seated and supine tetraplegic patients. Physiotherapy 2003 May;89(5):290-295.
-
Wadsworth, B. M. Haines, T. P. Cornwell, P. L. Rodwell, L. T. Paratz, J. D. An abdominal binder improves lung volumes and voice in people with tetraplegic spinal cord injury. Archives of Physical Medicine and Rehabilitation 2012 Dec;93(12):2189-2197.
-
Hart, N. Laffont, I.de la Sota, A. P.Lejaille, M.Macadou, G.Polkey, M. I.Denys, P.Lofaso, F. Respiratory effects of combined truncal and abdominal support in patients with spinal cord injury. Archives of Physical Medicine and Rehabilitation 2005 Jul;86(7):1447-1451
-
Bodin P, Fagevik Olsen M, Bake B, Kreuter M. Effects of abdominal binding on breathing patterns during breathing exercises in persons with tetraplegia. Spinal Cord 2005; 43: 117–122.
-
Goldman JM, Rose LS, Williams SJ, Silver JR, Denison DM. Effect of abdominal binders on breathing in tetraplegic patients. Thorax 1986; 41: 940–945.