Exploration study on respiratory muscle function using mechanomyography during singing in persons with spinal cord injury / Muhammad Imran Ramli

Muhammad Imran , Ramli (2024) Exploration study on respiratory muscle function using mechanomyography during singing in persons with spinal cord injury / Muhammad Imran Ramli. PhD thesis, Universiti Malaya.

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Abstract

Respiratory muscle training (RMT) has been proved to improve pulmonary function and respiratory muscle function in populations with different pathological conditions, including spinal cord injury (SCI). Singing therapy has also been identified as part of RMT that can improve lung functions. Despite the various research on RMT, very few have implemented singing training as part of their methodology. Tamplin et al (2013) was the only study that used singing therapy as an intervention in improving the pulmonary muscle function among people with SCI. Therefore, to fill this gap, this thesis implemented singing in achieving several objectives. First, to compare the sternocleidomastoid (SCM) and rectus abdominis (RA) muscles function during singing. Second, to determine the effect of singing songs with different characteristics on the accessory respiratory muscle performance among people with SCI. Third, to compare the accessory respiratory muscles performance between people with SCI and healthy participants while singing songs with different characteristics. In achieving the first objective, eight people with SCI were recruited and each participant sang a local folk song. Mechanomyography (MMG) detected SCM to be more active during inhalation compared to exhalation throughout the singing session, reflecting the nature of the SCM muscle, which is more prominent during deep and vigorous breathing efforts (P < 0.05). In contrast, RA showed no significant difference between inhalation and exhalation throughout the singing session, aligning with the role of the RA muscle in expiration (P > 0.05). However, this suggests that the RA muscle in the SCI participants may not be entirely paralyzed and could potentially be trained to improve. Both SCM and RA exhibited a decreasing trend of muscle activity throughout the singing session, which may be linked to the experience of shortness of breath among individuals with SCI. Meanwhile, in achieving the second objective, thirteen people with SCI were recruited. Eight music experts helped in categorizing songs into four categories. Each participant sang one song from each category. The performance of the SCM and RA muscles during singing was compared across different song categories using one-way ANOVA, revealing a statistically significant difference among all categories (P < 0.01). Subsequent post-hoc least significant difference (LSD) tests for the SCM and RA muscles unveiled that SCM muscle exhibits increased activity when singing at higher pitches. Meanwhile, the RA muscle demonstrates increased activity when singing songs with a slow tempo and easy rhythmic complexity. In achieving the third objective, twenty-six healthy and thirteen SCI participants were recruited. Each participant sang one song from each category developed in previous methodology. Results indicates that SCI may have higher accessory respiratory muscles activity during singing compared to healthy individuals, especially in slow tempo and high pitch categories. Overall, people with SCI demonstrated varying accessory respiratory muscles performance, especially in songs with different parameters. These outcomes would help in the development of clinical guideline in the future to help clinicians in introducing proper methodology in singing therapy among people with SCI to improve their respiratory conditions.

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