The purpose of this clinical trial is to understand whether threshold pressure load respiratory muscle training combined with iTBS can effectively improve the respiratory function of SCI patients. The main questions it aims to answer are: * The impact of threshold pressure load respiratory muscle training on the respiratory function of SCI patients. * The impact of iTBS treatment at the cortical projection point of the diaphragm on the respiratory function of SCI patients. * Whether the combination of the above two treatment techniques is superior to single treatment.
Researchers will combine threshold pressure load respiratory muscle training and transcranial iTBS and compare them with single treatments to see if the combined treatment is superior to single treatment. Participants will: * Undergo threshold pressure load respiratory muscle training or transcranial iTBS treatment or a combination of both daily for 4 weeks. * Visit the hospital for check-ups and tests every 2 weeks. * Record their symptoms and respiratory function.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
Participants received group-specific interventions 5 days/week for 4 weeks.
Rehabilitation Center of Shengjing Hospital, China Medical University
Shenyang, Liaoning, China
RECRUITINGMaximal Inspiratory Pressure
the maximum negative pressure generated in the respiratory system during a maximal inhalation against a closed airway, measured in cmH₂O to assess inspiratory muscle strength.
Time frame: Week 0 , Week 2 , Week 4
Maximal Expiratory Pressure
the maximum positive pressure generated in the respiratory system during a maximal exhalation against a closed airway, measured in cmH₂O to assess expiratory muscle strength.
Time frame: Week 0 , Week 2 , Week 4
Peak Expiratory Flow
the maximum speed of air flow during a forced exhalation, measured in liters per minute (L/min) to assess airway patency and respiratory function.
Time frame: Week 0 , Week 2 , Week 4
Peak Inspiratory Flow
the maximum speed of air flow during a forced inhalation, measured in liters per minute (L/min) to evaluate inspiratory muscle function and airway resistance during inhalation.
Time frame: Week 0 , Week 2 , Week 4
Forced Expiratory Volume in 1 second
the volume of air exhaled forcefully within the first second of a maximal expiratory effort, measured in liters to assess airway obstruction and lung function.
Time frame: Week 0 , Week 2 , Week 4
Forced Vital Capacity
the total volume of air exhaled forcefully and completely after a maximal inhalation, measured in liters to evaluate lung function and airway patency.
Time frame: Week 0 , Week 2 , Week 4
Diaphragmatic Thickness
Position patient supine with arms up. Place convex probe at mid-axillary line (7th-9th intercostal space), parasagittal plane. Identify diaphragmatic muscle between pleural and peritoneal interfaces, 2-3 cm from central tendon. Measure thickness at end-expiration and end-inspiration (3 trials each). Calculate DTF to assess diaphragmatic function.
Time frame: Week 0 , Week 2 , Week 4
Diaphragmatic Displacement
Position patient supine/semi-recumbent, expose lower chest. Place convex probe at mid-axillary line (8th-10th intercostal space), sagittal plane. Visualize diaphragmatic-liver interface (right hemidiaphragm preferred). Use M-mode to record diaphragmatic movement over respiratory cycles. Measure vertical distance between end-expiration and end-inspiration positions (normal \>1.5 cm for weaning).
Time frame: Week 0 , Week 2 , Week 4
Diaphragmatic Thickening Fraction
Measure Thickness at End-Expiration: Using ultrasound, measure the diaphragm thickness at the end of a quiet exhalation (when the diaphragm is relaxed). Measure Thickness at End-Inspiration: Measure the thickness at the end of a maximal inhalation (when the diaphragm is fully contracted). Calculate the Difference: Subtract the end-expiration thickness from the end-inspiration thickness. Normalize by End-Expiration Thickness: Divide the difference by the end-expiration thickness, then multiply by 100 to get a percentage.
Time frame: Week 0 , Week 2 , Week 4
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.