| Posterolateral surface electrical stimulation of abdominal expiratory muscles to enhance cough in spinal cord injury. | |
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MedLine Citation:
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PMID: 20952633 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: . Spinal cord injury (SCI) patients have respiratory complications because of abdominal muscle weakness and paralysis, which impair the ability to cough. OBJECTIVE: . This study aims to enhance cough in high-level SCI subjects (n = 11, SCI at or above T6) using surface electrical stimulation of the abdominal muscles via 2 pairs of posterolaterally placed electrodes. METHODS: . From total lung capacity, subjects performed maximum expiratory pressure (MEP) efforts against a closed airway and voluntary cough efforts. Both efforts were performed with and without superimposed trains of electrical stimulation (50 Hz, 1 second) at a submaximal intensity set to evoke a gastric pressure (P(ga)) of 40 cm H(2)O at functional residual capacity. RESULTS: . In the MEP effort, stimulation increased the maximal P(ga) (from 21.4 ± 7.0 to 59.0 ± 5.7 cm H(2)O) and esophageal pressure (P(es); 47.2 ± 11.7 to 65.6 ± 13.6 cm H(2)O). During the cough efforts, stimulation increased P(ga) (19.5 ± 6.0 to 57.9 ± 7.0 cm H(2)O) and P(es) (31.2 ± 8.7 to 56.6 ± 10.5 cm H(2)O). The increased expiratory pressures during cough efforts with stimulation increased peak expiratory flow (PEF, by 36% ± 5%), mean expiratory flow (by 80% ± 8%), and expired lung volume (by 41% ± 16%). In every subject, superimposed electrical stimulation improved peak expiratory flow during cough efforts (by 0.99 ± 0.12 L/s; range, 0.41-1.80 L/s). Wearing an abdominal binder did not improve stimulated cough flows or pressures. CONCLUSIONS: . The increases in P(ga) and PEF with electrical stimulation using the novel posterolateral electrode placement are 2 to 3 times greater than improvements reported in other studies. This suggests that posterolateral electrical stimulation of abdominal muscles is a simple noninvasive way to enhance cough in individuals with SCI. |
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Authors:
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Jane E Butler; Julianne Lim; Robert B Gorman; Claire Boswell-Ruys; Julian P Saboisky; Bonsan B Lee; Simon C Gandevia |
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Publication Detail:
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Type: Journal Article Date: 2010-10-15 |
Journal Detail:
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Title: Neurorehabilitation and neural repair Volume: 25 ISSN: 1552-6844 ISO Abbreviation: Neurorehabil Neural Repair Publication Date: 2011 Feb |
Date Detail:
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Created Date: 2011-01-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100892086 Medline TA: Neurorehabil Neural Repair Country: United States |
Other Details:
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Languages: eng Pagination: 158-67 Citation Subset: IM |
Affiliation:
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1Prince of Wales Medical Research Institute, Randwick, New South Wales, Australia. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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