Eleven patients with complete cervical and two patients with complete thoracic spinal cord injury were evaluated during both a forced vital capacity and cough. The mean peak flow was 3.74 +/- .171 L/sec during the forced vital capacity and 3.73 +/- 1.5 L/sec during the cough. Both values are low. Using the abdominal push assist during cough there is 13.8% improvement in peak flow which was significant. (p less than 0.01). This was not true with the forced vital capacity even though 9/10 subjects did improve. While peak flow is only one aspect of effective cough the improvement plus the increased intrathoracic pressure suggests this maneuver may be an effective modality in individuals with spinal cord injury.