Functional electrical stimulation of abdominal muscles to augment tidal volume in spinal cord injury

Stanič, U.; Kandare, F.; Jaeger, Robert J.; Sorli, J

doi:10.1109/86.830946

Cited by 33 publications

(36 citation statements)

References 11 publications

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“…2,[9][10][11][12] All these publications suggested that coughing ability is improved by this method, and some found that it can be as effective as manually assisted coughing. 2,9 Activation of the FES, however, requires turning on a switch, a task that is too difficult for many patients with tetraplegia.…”

Section: Introductionmentioning

confidence: 99%

Electromyographic signal-activated functional electrical stimulation of abdominal muscles: the effect on pulmonary function in patients with tetraplegia

et al. 2007

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Background: Paralysis of abdominal muscles is the main cause of respiratory dysfunctions in patients with lower cervical spinal cord lesion. Activation of the abdominal muscles using functional electrical stimulation (FES) improved respiratory function in these patients. But application of FES frequently requires a caregiver, and it may not be well synchronized with the patient's respiratory activity. Objective: To perform preliminary examination of electromyographic (EMG)-activated FES for caregiver-independent and synchronized cough and expiration induction in tetraplegia. Design: Self-controlled study. Setting: Loewenstein Rehabilitation Center, Raanana, Israel. Subjects: A total of 10 male patients with complete or almost complete tetraplegia. Main outcome measures: Peak expiratory flow (PEF), forced vital capacity (FVC), and maximal voluntary ventilation (MVV). Methods: The outcome measures were examined with the abdominal muscles unassisted or assisted by various methods. These included manual assistance or application of FES, activated by a caregiver, by the patient, or by EMG signals elicited from the patient's muscle. Results: Manual assistance improved the mean PEF value by 36.7% (Po0.01) and the mean FVC value by 15.4% (P ¼ 0.01). FES did not significantly change most measurements, and patient-activated FES even reduced PEF (Po0.05). But following EMG-activated FES PEF and FVC values were higher than those following patient-activated FES (Po0.05 for PEF; Po0.01 for FVC), and their mean values were higher by 15.8 and 18.9%, respectively. Conclusions: Abdominal FES failed to improve respiratory function in this study, but applying FES to abdominal muscles by EMG from the patient's muscle may promote caregiver-free respiration and coughing in persons with cervical SCL.

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Section: Introductionmentioning

confidence: 99%

Electromyographic signal-activated functional electrical stimulation of abdominal muscles: the effect on pulmonary function in patients with tetraplegia

et al. 2007

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“…There have been several studies investigating the use of electrical stimulation over the anterior abdominal wall near the midline to measure the ability to generate expiratory flow or pressure (12,18,21,30,31). The most successful of these studies increased mouth pressure by 33 cmH 2 O during a tetanically stimulated maximal expiratory maneuver in tetraplegic subjects (21).…”

mentioning

confidence: 99%

“…Although functional electrical stimulation (FES) has been widely used to assist paralyzed limb muscles to regain function, there are fewer reports of the use of electrical or other types of stimulation on paralyzed human abdominal muscles, and so far they have had limited success in producing an effective cough (6,10,12,14,16,17,20,21,30,31,33).…”

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confidence: 99%

Optimal electrode placement for noninvasive electrical stimulation of human abdominal muscles

Lim

Gorman²,

Saboisky³

et al. 2007

Journal of Applied Physiology

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Abdominal muscles are the most important expiratory muscles for coughing. Spinal cord-injured patients have respiratory complications because of abdominal muscle weakness and paralysis and impaired ability to cough. We aimed to determine the optimal positioning of stimulating electrodes on the trunk for the noninvasive electrical activation of the abdominal muscles. In six healthy subjects, we compared twitch pressures produced by a single electrical pulse through surface electrodes placed either posterolaterally or anteriorly on the trunk with twitch pressures produced by magnetic stimulation of nerve roots at the T 10 level. A gastroesophageal catheter measured gastric pressure (Pga) and esophageal pressure (Pes). Twitches were recorded at increasing stimulus intensities at functional residual capacity (FRC) in the seated posture. The maximal intensity used was also delivered at total lung capacity (TLC). At FRC, twitch pressures were greatest with electrical stimulation posterolaterally and magnetic stimulation at T 10 and smallest at the anterior site (Pga, 30 Ϯ 3 and 33 Ϯ 6 cmH 2O vs. 12 Ϯ 3 cmH2O; Pes 8 Ϯ 2 and 11 Ϯ 3 cmH2O vs. 5 Ϯ 1 cmH 2O; means Ϯ SE). At TLC, twitch pressures were larger. The values for posterolateral electrical stimulation were comparable to those evoked by thoracic magnetic stimulation. The posterolateral stimulation site is the optimal site for generating gastric and esophageal twitch pressures with electrical stimulation. cough; functional electrical stimulation; abdomen PEOPLE WITH HIGH-LEVEL SPINAL cord injury (SCI) are up to 150 times more likely to die from pneumonia, at any time after their injury, compared with the general population. Respiratory complications are the major cause of death in acute SCI patients (22). Reduced ability to cough and the subsequent buildup of pulmonary secretions result in respiratory complications, including atelectasis, sputum retention, pneumonia, and pleural effusion.The abdominal muscles are the major group of muscles that develop expiratory force, required to cough. Although functional electrical stimulation (FES) has been widely used to assist paralyzed limb muscles to regain function, there are fewer reports of the use of electrical or other types of stimulation on paralyzed human abdominal muscles, and so far they have had limited success in producing an effective cough (6,10,12,14,16,17,20,21,30,31,33).There have been several studies investigating the use of electrical stimulation over the anterior abdominal wall near the midline to measure the ability to generate expiratory flow or pressure (12,18,21,30,31). The most successful of these studies increased mouth pressure by 33 cmH 2 O during a tetanically stimulated maximal expiratory maneuver in tetraplegic subjects (21).As an alternative to electrical stimulation on the anterior wall of the abdomen, other groups have used magnetic stimulation over the T 10 spinous process to activate the spinal nerve roots around this level (T 8 -T 12 ). The benefit of magnetic stimulation is that it is r...

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“…Ten studies investigated the acute effect of 6 Abdominal FES, [2][3][4][5][6][7][8][31][32][33] while four studies investigated the chronic effect of Abdominal FES training. 9,10,14,15 …”

Section: Resultsmentioning

confidence: 99%

“…For patients with impaired ventilatory respiration, for example due to paralysis affecting the major 2 respiratory muscles, Abdominal FES can be used to activate paralysed abdominal muscles, which may achieve an acute (immediate and temporary) improvement in respiratory function. [2][3][4][5][6][7][8][9] The repeated application of Abdominal FES, termed Abdominal FES training, has been hypothesised to increase abdominal muscle mass and tone, placing the diaphragm in a more efficient position for respiration. 10 Abdominal FES training may improve the unassisted respiratory function in patients with impaired respiration.…”

Section: Introductionmentioning

confidence: 99%

Abdominal functional electrical stimulation to improve respiratory function after spinal cord injury: a systematic review and meta-analysis

et al. 2016

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Background: Abdominal Functional Electrical Stimulation (Abdominal FES) is the application of a train of electrical pulses to the abdominal muscles, causing them to contract. Abdominal FES has been used as a neuroprosthesis to acutely augment respiratory function and as a rehabilitation tool to achieve a chronic increase in respiratory function after Abdominal FES training, primarily focusing on patients with Spinal Cord Injury (SCI).

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Functional electrical stimulation of abdominal muscles to augment tidal volume in spinal cord injury

Cited by 33 publications

References 11 publications

Electromyographic signal-activated functional electrical stimulation of abdominal muscles: the effect on pulmonary function in patients with tetraplegia

Electromyographic signal-activated functional electrical stimulation of abdominal muscles: the effect on pulmonary function in patients with tetraplegia

Optimal electrode placement for noninvasive electrical stimulation of human abdominal muscles

Abdominal functional electrical stimulation to improve respiratory function after spinal cord injury: a systematic review and meta-analysis

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