Objective
It is known that Mechanical in-exsufflator (MI-E) can reduce pulmonary complications such as pneumonia, atelectasis in tetraplegia by increasing inspiratory and expiratory capacity. The aim of this study is to clarify the effectiveness of MI-E on pulmonary function and coughing capacity in tetraplegia.

Method
Thirty tetraplegic patients who had neither history nor radiologic finding of pulmonary disease were divided into two groups; control (n=15) and experimental (n=15) groups. Control group received conventional pulmonary rehabilitation, while experimental group received additional MI-E therapy for one month. The pulmonary function was evaluated by measuring percentage of predicted value of vital capacity (% VC), maximal insufflation capacity (MIC), unassisted peak cough flow (UPCF), volume assisted peak cough flow (VPCF), manual assisted peak cough flow (MPCF), manual and volume assisted peak cough flow (MVPCF). These data of pulmonary function before and after treatment were compared between two groups.

Results
1) There are significant improvement of pulmonary function in both groups (p＜0.05) except UPCF in control group before and after treatment. 2) The experimental group showed more improvement in MIC, VPCF, MPCF and MVPCF than control group (p＜0.05).

Conclusion
MI-E therapy can be used as an effective therapeutic modality for the improvement of pulmonary function in combination with conventional pulmonary rehabilitation. (J Korean Acad Rehab Med 2002; 26: 403-408)