Functional Magnetic Stimulation of Inspiratory and Expiratory Muscles in Subjects With Tetraplegia

Zhang, Xiaoming; Plow, Ela B.; Ranganthan, Vinoth; Huang, Honglian; Schmitt, Melissa S.; Nemunaitis, Gregory; Kelly, Clay M.; Frost, Frederick; Lin, Vernon W.

doi:10.1016/j.pmrj.2016.01.016

Cited by 8 publications

(9 citation statements)

References 46 publications

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“…In addition, characteristics of diaphragm movement during cough may differ substantially for patients with spinal cord injuries. 25 Our results and ultrasonography data may not be generalizable to such patients. Future studies should investigate the relationship between cough strength and ultrasonography data in patients with various medical conditions, especially those on mechanical ventilation.…”

Section: Discussionmentioning

confidence: 59%

Ultrasonographic Assessment of Passive Cephalic Excursion of Diaphragm During Cough Expiration Predicts Cough Peak Flow in Healthy Adults

Norisue¹,

Santanda²,

Homma³

et al. 2019

Respir Care

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BACKGROUND: Evaluation of cough strength is clinically important, especially for patients with neuromuscular disorders and before extubation of mechanically ventilated patients. The pressure gradient between the airway and thoracoabdominal cavities during the cough expiratory phase generates cough flow and passive cephalic movement of the diaphragm. We hypothesized that passive diaphragmatic cephalic excursion, peak velocity, or both during cough expiration might predict cough peak flow (CPF). This physiologic study investigated associations of CPF with simultaneously measured ultrasonographic indices in healthy adults during the cough expiratory phase. METHODS: 56 healthy adults participated in this study. Right hemidiaphragm excursion and peak velocity were measured with ultrasonography during voluntary cough expiration with maximum effort. CPF was simultaneously measured for all coughs along with the ultrasonographic measurements. A linear regression model was used to determine whether ultrasonographic indices predicted CPF. RESULTS: Simple regression analysis showed significant associations between excursion and CPF in men and women (P < .001, beta coefficient 37.8, 95% CI 10.9-64.7, adjusted R 2 ‫؍‬ 0.195 for men; P < .001, beta coefficient 46.1, 95% CI 22.3-69.9, adjusted R 2 ‫؍‬ 0.386 for women). A multiple regression model adjusted for age, height, and sex showed a significant association between CPF and excursion (P < .001, adjusted beta coefficient 38.32, 95% CI 21.20-55.44, adjusted R 2 ‫؍‬ 0.643). Simple regression analysis showed a significant association between diaphragmatic peak velocity and CPF only in women (P ‫؍‬ .004, beta coefficient 5.07, 95% CI 1.81-8.33, adjusted R 2 ‫؍‬ 0.280 for women). CONCLUSIONS: Passive cephalic excursion of the diaphragm during the cough expiratory phase significantly predicted CPF with maximum cough effort in healthy adults. Future studies should investigate the relationship between CPF and excursion in persons with respiratory and neuromuscular disorders.

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Section: Discussionmentioning

confidence: 59%

Ultrasonographic Assessment of Passive Cephalic Excursion of Diaphragm During Cough Expiration Predicts Cough Peak Flow in Healthy Adults

Norisue¹,

Santanda²,

Homma³

et al. 2019

Respir Care

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“…Studies in patients with SCI for upper thorax stimulation and inspiratory effects includes electrodes implanted on the spinal cord and external magnetic stimulation over the back. 9,10,12,14,16 This promising work continues in technology transfer programs. To our knowledge, this is the first report of successful stimulation of upper thoracic external intercostal muscles using surface electrodes in an animal model.…”

Section: Upper Thoracic Muscle Stimulationmentioning

confidence: 98%

“…Abdominal stimulation in paralyzed patients has been conducted with three different methods: abdominal surface electrodes, [19][20][21][22][23] lower thoracic spinal cord electrodes, 12,[15][16][17][18] and magnetic stimulation over the lower thoracic spinal cord. 14 Among these methods, the use of surface electrodes is promising because they are noninvasive and easily applied. Surface stimulation was currently optimized in adult (8 month old) canines that were anesthetized and respiratory apneic.…”

Section: Abdominal Muscle Stimulationmentioning

confidence: 99%

“…[5][6][7] Methods to expand the upper chest with FES are under intense investigation and include electrodes applied to the upper thoracic spinal cord, electrodes in the upper thoracic intercostal muscles, and external magnetic coils for stimulation of the upper thoracic spinal cord. [8][9][10][11][12][13][14]27,28 None of these methods, however, have been commercialized. Stimulation with surface electrodes placed over the upper thorax are promising because they can be easily and safely applied.…”

Section: Introductionmentioning

confidence: 99%

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Stimulation of abdominal and upper thoracic muscles with surface electrodes for respiration and cough: Acute studies in adult canines

Walter

Posluszny

Dieter

et al. 2017

The Journal of Spinal Cord Medicine

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“…Transcutaneous magnetic stimulation appears to be painless and is typically well-tolerated, including in persons with allodynia and cutaneous hypersensitivity [42]. Magnetic SCS has seen minimal use in persons and animal models of SCI; however, magnetic SCS has demonstrated effectiveness in the restoration of respiratory function [43,44], gastric function [45], and antinociception [46].…”

Section: Transcutaneous Stimulationmentioning

confidence: 99%

Spinal cord stimulation for the restoration of bladder function after spinal cord injury

Steadman

Grill

2020

Healthcare Technology Letters

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Spinal cord injury (SCI) results in the inability to empty the bladder voluntarily, and neurogenic detrusor overactivity (NDO) and detrusor sphincter dyssynergia (DSD) negatively impact both the health and quality of life of persons with SCI. Current approaches to treat bladder dysfunction in persons with SCI, including self-catheterisation and anticholinergic medications, are inadequate, and novel approaches are required to restore continence with increased bladder capacity, as well as to provide predictable and efficient on-demand voiding. Improvements in bladder function following SCI have been documented using a number of different modalities of spinal cord stimulation (SCS) in both persons with SCI and animal models, including SCS alone or SCS with concomitant activity-based training. Improvements include increased volitional voiding, voided volumes, bladder capacity, and quality of life, as well as decreases in NDO and DSD. Further, SCS is a well-developed therapy for chronic pain, and existing Food And Drug Administration (FDA)-approved devices provide a clear pathway to sustainable commercial availability and impact. However, the effective stimulation parameters and the appropriate timing and location of stimulation for SCS-mediated restoration of bladder function require further study, and studies are needed to determine underlying mechanisms of action.

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Functional Magnetic Stimulation of Inspiratory and Expiratory Muscles in Subjects With Tetraplegia

Abstract: FMS conditioning of the inspiratory and expiratory muscles improved voluntary inspiratory and expiratory functions. FMS may be a noninvasive technology for respiratory muscle training in persons with tetraplegia.

Cited by 8 publications

References 46 publications

Ultrasonographic Assessment of Passive Cephalic Excursion of Diaphragm During Cough Expiration Predicts Cough Peak Flow in Healthy Adults

Ultrasonographic Assessment of Passive Cephalic Excursion of Diaphragm During Cough Expiration Predicts Cough Peak Flow in Healthy Adults

Stimulation of abdominal and upper thoracic muscles with surface electrodes for respiration and cough: Acute studies in adult canines

Spinal cord stimulation for the restoration of bladder function after spinal cord injury

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