Functional electrical stimulation to enhance cough in quadriplegia

Area of Science:

• Neurology
• Rehabilitation Medicine
• Respiratory Physiology

Background:

• Cervical spinal cord injury (CSCI) frequently leads to respiratory complications, a primary cause of mortality.
• Paralysis of intercostal and abdominal muscles in CSCI severely compromises the ability to cough and clear airway secretions.
• Maximum expiratory pressure (MEP) is a key indicator for assessing cough effectiveness in neuromuscular disorders.

Purpose of the Study:

• To evaluate the efficacy of functional electrical stimulation (FES) in augmenting cough in patients with cervical spinal cord injury (CSCI).
• To compare MEP measurements during spontaneous, manually assisted, and FES-assisted cough maneuvers in CSCI patients.

Main Methods:

• Two experiments were conducted involving CSCI patients.
• Experiment 1: MEP was measured during spontaneous cough, manually assisted cough, and abdominal FES-assisted cough.
• Experiment 2: MEP was measured during spontaneous cough and portable FES-assisted cough.

Main Results:

• CSCI patients exhibited significantly reduced MEP during spontaneous coughing.
• Both manual assistance and FES-assisted coughing markedly increased MEP in all participants.
• Abdominal muscle FES demonstrated a notable enhancement of MEP.

Conclusions:

• Functional electrical stimulation (FES) of abdominal muscles is a promising method to improve cough effectiveness in individuals with CSCI.
• FES-assisted coughing can potentially mitigate respiratory complications and improve outcomes for quadriplegic patients.