Abdominal Functional Electrical Stimulation to Augment Respiratory Function in Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2019 · DOI: 10.1310/sci2502–105 · Published: January 1, 2019

Spinal Cord Injury Pulmonology Rehabilitation

Simple Explanation

Functional electrical stimulation (FES) involves applying electrical pulses to a nerve to cause a muscle contraction. When applied to abdominal muscles, this is termed abdominal FES. Abdominal FES helps the abdominal muscles contract, even if they are paralyzed due to spinal cord injury. This is important because these muscles are key for breathing, especially for those with tetraplegia. By improving cough and respiratory function through abdominal FES, the health of individuals with spinal cord injuries can be improved, reducing complications and improving their quality of life.

Study Duration

Not specified

Participants

People with tetraplegia

Evidence Level

Narrative Review

Key Findings

1
Abdominal FES can provide an immediate and effective cough for individuals with tetraplegia.
2
Repeated use of abdominal FES over six weeks can improve respiratory function without assistance.
3
Abdominal FES can lead to reduced time on a ventilator and shorter tracheostomy cannulation duration.

Research Summary

Abdominal FES is a noninvasive technique that enhances cough and respiratory function in people with spinal cord injuries, especially those with tetraplegia. Practical benefits of using abdominal FES include shorter durations of ventilation, easier removal of tracheostomy tubes, and fewer respiratory complications. The positive effects of abdominal FES can lead to less illness and death, better quality of life, and lower healthcare costs.

Practical Implications

Improved Cough Effectiveness

Abdominal FES can be used in conjunction with existing physiotherapy techniques to improve cough efficacy.

Enhanced Respiratory Training

Repeated abdominal FES training can improve overall unassisted respiratory function, potentially reducing respiratory complications.

Reduced Ventilation Dependence

Abdominal FES may reduce the duration of mechanical ventilation and tracheostomy cannulation times, improving patient outcomes and reducing healthcare costs.

Study Limitations

1
Abdominal FES requires intact lower motor neurons to be effective, making it unsuitable for patients with lower motor neuron damage.
2
There is a risk of autonomic dysreflexia in individuals with spinal cord injuries at T6 and above, although this has not been reported in the literature to date.
3
Stimulation intensity may need to be adjusted for individuals with incomplete spinal cord injuries who can feel the stimulation.

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