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Optimal electrode position for abdominal functional electrical stimulation.

Euan J McCaughey1,2, Claire L Boswell-Ruys1,2,3, Anna L Hudson1,2

  • 1Neuroscience Research Australia, Randwick, New South Wales , Australia.

Journal of Applied Physiology (Bethesda, Md. : 1985)
|July 20, 2018
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Summary
This summary is machine-generated.

Optimal electrode placement for abdominal functional electrical stimulation (FES) was determined by measuring expiratory twitch pressure. Placing electrodes on the posterolateral abdominal wall yielded the greatest expiratory pressures, suggesting this position enhances cough efficacy for therapeutic FES applications.

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Area of Science:

  • Physiology
  • Rehabilitation Medicine
  • Biomedical Engineering

Background:

  • Abdominal functional electrical stimulation (FES) can improve respiratory function, but its clinical adoption is limited.
  • A key barrier to clinical use is the lack of consensus on the optimal electrode placement for abdominal FES.
  • Expiratory twitch pressure is a critical measure for assessing expiratory muscle strength and cough effectiveness.

Purpose of the Study:

  • To identify the optimal electrode position for abdominal FES to maximize expiratory twitch pressure.
  • To compare the efficacy of different electrode placements on expiratory muscle activation.

Main Methods:

  • Ten healthy participants underwent abdominal FES with electrodes placed in three configurations: posterolateral abdominal wall, external oblique and rectus abdominis motor points, and external obliques alone.
  • Gastric and esophageal pressures were measured during stimulation at functional residual capacity.
  • Stimulation current was incrementally increased to maximal tolerance or until gastric pressure plateaued.

Main Results:

  • Posterolateral abdominal wall stimulation resulted in significantly higher gastric (71%) and esophageal (53%) twitch pressures compared to stimulating external oblique and rectus abdominis muscles.
  • This position also yielded significantly greater pressures (95% gastric, 56% esophageal) than stimulating external obliques alone.
  • Stimulating both external oblique and rectus abdominis muscles showed a trend towards decreased gastric pressure (-18.3%) compared to external obliques alone.

Conclusions:

  • Electrode placement on the posterolateral abdominal wall is superior for generating expiratory twitch pressures with abdominal FES.
  • This position is recommended for all therapeutic applications of abdominal FES to optimize expiratory muscle strength and cough efficacy.