Review
Spinal Cord (2009) 47, 274–285; doi:10.1038/sc.2008.126; published online 21 October 2008
Abdominal binder use in people with spinal cord injuries: a systematic review and meta-analysis
B M Wadsworth1,2, T P Haines3, P L Cornwell2,4 and J D Paratz5
- 1Department of Physiotherapy, Princess Alexandra Hospital, Brisbane, Australia
- 2School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
- 3Department of Physiotherapy and Southern Health, School of Primary Health Care, Monash University, Melbourne, Australia
- 4Department of Speech Pathology, Princess Alexandra Hospital, Brisbane, Australia
- 5Burns, Trauma and Critical Care Research Centre, School of Medicine, The University of Queensland, Brisbane, Australia
Correspondence: BM Wadsworth, Department of Physiotherapy, Princess Alexandra Hospital, Ipswich road, Woolloongabba 4102, Queensland, Australia. E-mail: painsolutions@bigpond.com
Received 14 July 2008; Revised 18 September 2008; Accepted 18 September 2008; Published online 21 October 2008.
Abstract
Study design:
Systematic review and meta-analysis.
Objectives:
To review the evidence for the use of an abdominal binder on breathing, speech and cardiovascular function in people who have suffered a spinal cord injury (SCI).
Setting:
Brisbane, Australia.
Methods:
A search of multiple databases (Medline, Cinahl, Cochrane, Embase, PEDro) was undertaken accompanied by the reference list evaluation of each relevant publication identified. Methodological quality of studies identified was assessed using the PEDro scale. The size of effect of an abdominal binder on outcomes was also calculated where sufficient data were reported. Further descriptive analysis was performed.
Results:
Eleven studies met the review inclusion criteria and employed either crossover or within subject designs. Comparison of studies involving elastic and non-elastic binders was performed. A PEDro mean score of 4.3 out of 8 (range: 3–6) was found. Meta-analysis indicated that the use of abdominal binders improved vital capacity (VC) by (weighted mean difference (95% confidence interval (CI)) 0.32 (0.09, 0.55) litres, decreased functional residual capacity (FRC) by 0.41 (0.14, 0.67) litres, but did not significantly influence total lung capacity (TLC).
Conclusions:
This review found some evidence that the use of an abdominal binder improves VC, but decreases FRC when assuming the sitting or tilted position in people who have suffered SCI. Overall, the quality of the studies was poor. Available evidence is not yet sufficient to either support or discourage the use of an abdominal binder in this patient population. Further studies utilizing more methodologically rigorous designs are required.
Keywords:
spinal cord injury, abdominal binder, pulmonary function, review
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