<qa>  What is the main reason patients with high spinal cord injury have paralysed intercostal musclesPatients with high spinal cord injury SCI usually have paralysed intercostal muscles and rely on diaphragm function alone for respiration. They have low tidal volumes and inadequate cough. These patients are vulnerable to respiratory complications in the immediate post-injury phase and remain at life-long risk of chest problems. Usual treatments include intensive physiotherapy and intermittent positive pressure ventilation to augment the patients tidal volume and to help clear excess secretions. 