Surface Functional Electrical Stimulation of the Abdominal Muscles to Enhance Cough and Assist Tracheostomy Decannulation After High-Level Spinal Cord Injury

J Spinal Cord Med, 2008 · DOI: · Published: January 1, 2008

Spinal Cord Injury Pulmonology Rehabilitation

Simple Explanation

This study explores using electrical stimulation on the abdominal muscles to improve coughing in a man with a spinal cord injury. The man had trouble coughing and needed a tracheostomy. The researchers used electrical stimulation to train him to cough more effectively. After the training, the man was able to get his tracheostomy removed and had better secretion control.

Study Duration

4 weeks training, 1 year follow up

Participants

A 65-year-old man with C4 ASIA C tetraplegia

Evidence Level

Single case study

Key Findings

1
Anterior SES increased maximal expiratory pressure (80%), maximal expiratory cough pressure (67%), and peak expiratory flow rate (11%).
2
Three weeks after training began, the patient was decannulated following a program of SES and assisted and voluntary coughing.
3
SES with posterolaterally placed electrodes also produced an enhancement of voluntary cough attempts.

Research Summary

This case study evaluates noninvasive stimulation modalities to augment cough and assist tracheostomy decannulation in high-level tetraplegia. Anterior surface electrical stimulation (SES) of the abdominal musculature was conducted to train an effective cough and enable decannulation. Noninvasive SES can potentially assist decannulation of tracheostomies.

Practical Implications

Improved Respiratory Hygiene

Surface functional electrical stimulation can augment cough and thus improve respiratory hygiene.

Tracheostomy Decannulation

SES can assist in tracheostomy decannulation.

Posterolateral SES Technique

The effectiveness of SES is improved by the use of posterolateral SES techniques.

Study Limitations

1
Single case study limits generalizability
2
Potential for measurement error with flanged mouthpieces
3
Problems specific to SES include the potential to cause local skin burns or irritation

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