Abdominal functional electrical stimulation to enhance mechanical insufflation-exsufflation

Area of Science:

• Rehabilitation Medicine
• Respiratory Physiology
• Assistive Technology

Background:

• Respiratory complications from airway secretion build-up are a major cause of rehospitalization in tetraplegia.
• Abdominal Functional Electrical Stimulation (AFES) has previously shown potential to improve cough function and aid secretion removal.
• Mechanical Insufflation-Exsufflation (MI-E) is a standard clinical method for simulating a cough to clear secretions.

Purpose of the Study:

• To evaluate the feasibility of combining Abdominal Functional Electrical Stimulation (AFES) with Mechanical Insufflation-Exsufflation (MI-E).
• To assess the potential benefits of this combined technique for secretion clearance in individuals with tetraplegia.

Main Methods:

• AFES was integrated with an MI-E device equipped with a pressure sensor for synchronized application.
• Feasibility was assessed over eight fortnightly sessions with one sub-acute participant with tetraplegia.
• The accuracy of AFES application synchronized with MI-E was recorded.

Main Results:

• Successful combination of AFES and MI-E was achieved across eight assessment sessions.
• AFES was applied in synchrony with MI-E with 96.7% accuracy.
• Acute increases in exhaled volume and peak expiratory flow were observed during AFES-assisted MI-E compared to MI-E alone in most sessions.

Conclusions:

• The integration of AFES with MI-E is feasible for secretion clearance in tetraplegia.
• The observed acute increases in respiratory function suggest AFES-assisted MI-E may be more effective than MI-E alone.
• This technique warrants further investigation for its efficacy in improving airway clearance.