scholarly journals Automatic electrical stimulation of abdominal wall muscles increases tidal volume and cough peak flow in tetraplegia

2008 ◽  
Vol 16 (4) ◽  
pp. 273-281 ◽  
Author(s):  
H. Gollee ◽  
K.J. Hunt ◽  
D.B. Allan ◽  
M.H. Fraser ◽  
A.N. McLean
Keyword(s):  
Electrical Stimulation ◽  
Tidal Volume ◽  
Abdominal Wall ◽  
Peak Flow ◽  
Stimulation Of

scholarly journals Abdominal stimulation for respiratory support in tetraplegia: A tutorial review

2008 ◽  
Vol 18 (2) ◽  
pp. 85-92 ◽  
Author(s):  
H. Gollee ◽  
K.J. Hunt ◽  
M.H. Fraser ◽  
A.N. Mclean
Keyword(s):  
Muscle Contraction ◽  
Tidal Volume ◽  
Abdominal Wall ◽  
Abdominal Muscle ◽  
Respiratory Support ◽  
Muscle Stimulation ◽  
Future Developments ◽  
Expiratory Muscles ◽  
Simple Surface ◽  
Stimulation Of

Neuromuscular stimulation of the abdominal wall muscles can provide respiratory support in tetraplegia, where the main expiratory muscles are affected by paralysis. Stimulation may be applied by simple surface stimulation, resulting in a uniform muscle contraction which can help to improve expiratory function for coughing and breathing. In this review, an overview of methods and approaches available for abdominal muscle stimulation is given. Studies are discussed which show that this technique can lead to improvements in expiratory flow and tidal volume, resulting in enhanced cough and breathing functions. Approaches are introduced which aim to integrate abdominal stimulation with the subject's own voluntary breathing functions. These are illustrated with experimental results from the evaluation of automatic stimulation methods in tetraplegic patients. Clinical significance and applications are discussed and future developments are outlined.

scholarly journals Optimal electrode position for abdominal functional electrical stimulation

2018 ◽  
Vol 125 (4) ◽  
pp. 1062-1068 ◽  
Author(s):  
Euan J. McCaughey ◽  
Claire L. Boswell-Ruys ◽  
Anna L. Hudson ◽  
Simon C. Gandevia ◽  
Jane E. Butler
Keyword(s):  
Electrical Stimulation ◽  
Abdominal Wall ◽  
Functional Electrical Stimulation ◽  
Respiratory Function ◽  
Rectus Abdominis ◽  
Electrode Position ◽  
Clinical Use ◽  
Therapeutic Applications ◽  
External Oblique ◽  
Stimulation Of

Abdominal functional electrical stimulation (abdominal FES) improves respiratory function. Despite this, clinical use remains low, possibly due to lack of agreement on the optimal electrode position. This study aimed to ascertain the optimal electrode position for abdominal FES, assessed by expiratory twitch pressure. Ten able-bodied participants received abdominal FES using electrodes placed: 1) on the posterolateral abdominal wall and at the motor points of 2) the external oblique muscles plus rectus abdominis muscles, and 3) the external obliques alone. Gastric (Pga) and esophageal (Pes) twitch pressures were measured using a gastroesophageal catheter. Single-stimulation pulses were applied at functional residual capacity during step increments in stimulation current to maximal tolerance or until Pgaplateaued. Stimulation applied on the posterolateral abdominal wall led to a 71% and 53% increase in Pgaand Pes, respectively, compared with stimulation of the external oblique and rectus abdominis muscles ( P < 0.001) and a 95% and 56% increase in Pgaand Pes, respectively, compared with stimulation of the external oblique muscles alone ( P < 0.001). Stimulation of both the external oblique and rectus abdominis muscles led to an 18.3% decrease in Pgacompared with stimulation of only the external oblique muscles ( P = 0.040), with inclusion of the rectus abdominis having no effect on Pes( P = 0.809). Abdominal FES applied on the posterolateral abdominal wall generated the highest expiratory twitch pressures. As expiratory pressure is a good indicator of expiratory muscle strength and, thus, cough efficacy, we recommend this electrode position for all therapeutic applications of abdominal FES.NEW & NOTEWORTHY While abdominal functional electrical stimulation (abdominal FES) can improve respiratory function, clinical use remains low. This is at least partly due to lack of agreement on the optimal electrode position. Therefore, this study aimed to ascertain the optimal electrode position for abdominal FES. We show that electrodes placed on the posterolateral abdominal wall generated the highest expiratory twitch pressures. As such, we recommend this electrode position for all therapeutic applications of abdominal FES.

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