Abdominal functional electrical stimulation to enhance mechanical insufflation-exsufflation

The Journal of Spinal Cord Medicine, 2016 · DOI: 10.1080/10790268.2015.1114226 · Published: January 1, 2016

Spinal Cord Injury Pulmonology Rehabilitation

Simple Explanation

The study explores a method to help people with tetraplegia (paralysis of all four limbs) clear lung secretions, a common and dangerous problem. It combines two techniques: Abdominal Functional Electrical Stimulation (AFES), which uses electrical pulses to make abdominal muscles contract, and Mechanical Insufflation-Exsufflation (MI-E), a device that simulates a cough. The study found it feasible to combine these techniques, with some evidence suggesting the combination may be more effective than MI-E alone in improving breathing function.

Study Duration

14 weeks

Participants

One sub-acute participant with tetraplegia

Evidence Level

Level 4: Case Report

Key Findings

1
AFES was successfully combined with MI-E at eight assessment sessions with a participant with tetraplegia.
2
AFES was correctly applied in synchrony with MI-E with an accuracy of 96.7%.
3
Acute increases in exhaled volume and peak flow were observed during AFES assisted MI-E, compared to MI-E alone, at six of eight assessment sessions.

Research Summary

This case study evaluated the feasibility of combining abdominal functional electrical stimulation (AFES) with mechanical insufflation-exsufflation (MI-E) in a participant with tetraplegia. The study demonstrated the successful integration of AFES with MI-E, with AFES being accurately synchronized with MI-E using a pressure sensor. Results suggest that combining AFES with MI-E may enhance respiratory function and potentially improve secretion clearance compared to MI-E alone, warranting further investigation.

Practical Implications

Improved Secretion Clearance

Combining AFES with MI-E may lead to more effective secretion clearance, reducing the risk of respiratory complications in tetraplegic patients.

Broader Application

The technique could potentially benefit other patient groups with reduced respiratory function, such as those with COPD or neurodegenerative disorders.

Future Research

Further clinical trials are warranted to fully evaluate the effectiveness of AFES combined with MI-E and compare it with other secretion clearance techniques.

Study Limitations

1
The MI-E pressures used were lower than commonly recommended for clinical practice.
2
Respiratory function during manually assisted coughing combined with MI-E was not compared.
3
Results are reported from only one participant.

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