Individuals with SCI should also have an ongoing, life-long plan to help prevent respiratory complications. Maintain proper posture and mobility and sit up in your wheelchair everyday and turn regularly in bed to prevent buildup of congestion. Coughing regularly is a useful technique in avoiding respiratory complications; individuals can use machines to help them cough, have someone perform manual assist coughs, or perform self-assist coughs. Individuals should wear an abdominal binder to help assist the intercostal and abdominal muscles.

Individuals with SCI should attempt to follow a healthy diet and manage their weight. Weight management is important because respiratory problems are more likely to occur if an individual is too underweight or too overweight. Drinking plenty of water is important because doing so helps the body in many ways, and water helps to keep congestion from becoming thick and difficult to cough up.

Do not smoke under any circumstances! Smoking not only causes cancer, but other harmful effects include a decrease of oxygen in the blood, an increase in congestion in the chest and windpipe, a reduction in the ability to clear secretions from your lungs, a destruction of lung tissue, and an increase in the risk for respiratory infections such as pneumonia and bronchitis.

Live sensibly by avoiding close contact with people who may have a cold or flu and avoid areas with dust, smog and other air pollutants. See a doctor at least once per year. The doctor may recommend that the individual receive a chest x-ray or a flu shot.

Exercise is another critical element to avoiding respiratory complications. Every individual with SCI can benefit from some type of exercise. However, it is important to first talk to your doctor to find the right exercise program. Participation in athletics and other cardiovascular activities can improve strength and endurance while helping to keep the pulmonary system strong. If an individual suffers from a high level of injury or does not like strenuous exercise, it may be helpful to do breathing exercises.

Here are five breathing exercises that you can do at least two times a day to help your pulmonary system.

  1. Take a deep breath and hold it for a few seconds before slowly breathing out.
  2. Take a deep breath bringing in as much air as you can and as fast as you can before pushing the air out as fast as you can.
  3. Take a deep breath and hold it, take another breath and hold it, and take one more before slowly breathing out.
  4. Take a deep breath in then breathe out counting as long and as fast as you can.
  5. If you have a spirometer, use it to both exercise and keep a measurement of your progress.


With a spinal cord injury, being immobile for long periods of time slows blood circulation and can cause clots to form. Blood-thinning medications, leg pumps, and special stockings, can help improve circulation and prevent fluid build up.

An individual living with a spinal-cord injury may experience muscles spasms which cause their limbs to twitch or “jump”; this is relatively rare and unfortunately it is not an indication that the person is regaining sensation or movement in those areas. These involuntary movements occur because some nerves have become more sensitive, yet the damaged spinal cord will not allow the brain to interpret and regulate these nerves’ signals.


Between 40 and 45 percent of individuals with spinal cord injuries (SCI) need personal assistance with some daily activities. It is understandable that the majority of persons needing assistance have higher levels of injury. They may need personal care assistance with getting in or out of bed, managing bowel and bladder issues, bathing and dressing. Some individuals may need someone to drive, shop and clean for them too. However, there is also a growing percentage of persons with lower levels of injury needing assistance as they get older. They may need assistance with household activities as they grow older and experience increased pain or fatigue.

Most Personal Care Attendants (PCAs) need education and training on general issues associated with SCI.  Even if you find a PCA with a lot of experience, you yourself have unique needs. Although all issues are important, your bowel, bladder, skin, and respiratory care must be understood by your PCA. Communicate your bowel and bladder needs clearly. Make sure you stress the importance of daily skin care, and your PCA should know how to conduct daily skin checks and spot problems.

PCAs need to know about respiratory sickness too. Flu and pneumonia can be life-threatening for most people with SCI. This fact makes it important to have PCAs understand these dangers and work to prevent spreading these conditions. Washing hands should always be done often to help prevent the spread of germs. PCAs who are sick with a cold or flu should avoid contact when possible. If contact is unavoidable, PCAs should wear a mask and wash hands more often. For individuals on a ventilator, PCA training on all the mechanical works of a ventilator can mean life or death. There should also be an emergency plan for ventilator problems and failures.