Changes in pulmonary function measures following a passive abdominal functional electrical stimulation training program

Abstract Objective To demonstrate the effect of a passive abdominal functional electrical stimulation (AFES) training program on unassisted respiratory measures in tetraplegia. Design Longitudinal feasibility study. Setting National spinal injuries unit in a university teaching hospital. Participants Twelve patients with tetraplegic spinal cord injury, who could breathe independently, with reduced vital capacity and no visible abdominal movement. Intervention Three weeks of abdominal muscle conditioning using transcutaneous AFES. Main outcome measures Forced vital capacity (FVC), forced exhaled volume in 1 second (FEV1), peak expiratory flow rate (PEF), and maximum exhaled pressure (MEP). Results Mean (SD) FVC increased by 0.36 l (0.23) during training (P = 0.0027). Mean (SD) FEV1 and PEF tended to increase by 0.18 l (0.16) and 0.39 l/seconds (0.35), respectively, but this was not significant. No significant change was found in the outcome measures during a 1-week pre-training control phase and during a 3-week post-training phase. Conclusions The increase in FVC over the training period and the absence of change before or after training suggest that passive abdominal FES training can be used for respiratory rehabilitation in tetraplegia.

[1]  J S Kreutzer,et al.  Etiology and incidence of rehospitalization after traumatic brain injury: a multicenter analysis. , 1999, Archives of physical medicine and rehabilitation.

[2]  K. Nantwi,et al.  Effect of Spinal Cord Injury on the Respiratory System: Basic Research and Current Clinical Treatment Options , 2007, The journal of spinal cord medicine.

[3]  P. Cheng,et al.  Effect of neuromuscular electrical stimulation on cough capacity and pulmonary function in patients with acute cervical cord injury. , 2006, Journal of rehabilitation medicine.

[4]  J. R. Ledsome,et al.  Pulmonary function in acute cervical cord injury. , 1981, The American review of respiratory disease.

[5]  C. Winslow,et al.  Effect of spinal cord injury on the respiratory system. , 2003, American journal of physical medicine & rehabilitation.

[6]  Gary C. Sieck,et al.  ATS/ERS Statement on respiratory muscle testing. , 2002, American journal of respiratory and critical care medicine.

[7]  M. Ventura,et al.  Neuromuscular electrical stimulation of completely paralyzed abdominal muscles in spinal cord-injured patients: a pilot study , 2008, Spinal Cord.

[8]  A. Kelley,et al.  Spirometry testing standards in spinal cord injury. , 2003, Chest.

[9]  H. Reines,et al.  Pulmonary complications of acute spinal cord injuries. , 1987, Neurosurgery.

[10]  J. Hankinson,et al.  Standardisation of spirometry , 2005, European Respiratory Journal.

[11]  M. Estenne,et al.  Abdominal muscle strength in patients with tetraplegia. , 2000, American journal of respiratory and critical care medicine.

[12]  R. Waters,et al.  Pulmonary function in chronic spinal cord injury: a cross-sectional survey of 222 southern California adult outpatients. , 2000, Archives of physical medicine and rehabilitation.

[13]  A. Kralj,et al.  Effects of respiratory muscle training and electrical stimulation of abdominal muscles on respiratory capabilities in tetraplegic patients , 1997, Spinal Cord.

[14]  Steven Kirshblum,et al.  Etiology and incidence of rehospitalization after traumatic spinal cord injury: a multicenter analysis. , 2004, Archives of physical medicine and rehabilitation.