Abdominal binder use in people with spinal cord injuries: a systematic review and meta-analysis

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 (Medicine, 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 aobdominal binder on outcomes was 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 design. 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 decreased FRC when assuming the sitting or titled position in peole 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 deisgns are required.