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  4. Breathing-synchronised electrical stimulation of the abdominal muscles in patients with acute tetraplegia: A prospective proof-of-concept study

Breathing-synchronised electrical stimulation of the abdominal muscles in patients with acute tetraplegia: A prospective proof-of-concept study

The Journal of Spinal Cord Medicine, 2016 · DOI: 10.1179/2045772315Y.0000000054 · Published: January 1, 2016

Spinal Cord InjuryPulmonologyNeurology

Simple Explanation

This study investigates whether using electrical stimulation to help patients with tetraplegia breathe and cough can reduce lung complications like pneumonia. The treatment involves synchronizing electrical stimulation of the abdominal muscles with the patient's breathing to improve their ability to exhale and clear their airways. The study found that this approach, called abdominal functional electrical stimulation (AFES), appears to improve breathing and prevent pneumonia in the early stages of tetraplegia.

Study Duration
90 days
Participants
11 patients with acute traumatic tetraplegia (ASIA Impairment Scale A or B)
Evidence Level
Level IV, Prospective proof-of-concept study

Key Findings

  • 1
    AFES led to a statistically significant increase in peak inspiratory and expiratory flows.
  • 2
    A non-statistically significant increase in tidal volume and inspiratory and expiratory flow was observed with AFES.
  • 3
    67% of patients reported a significant improvement in breathing and coughing with the stimulation procedure.

Research Summary

This prospective proof-of-concept study examined the impact of breathing-synchronised abdominal functional electrical stimulation (AFES) on pulmonary complications in patients with acute tetraplegia. The results indicated that AFES improved breathing and expectoration and prevented pneumonia in the acute phase of tetraplegia, with statistically significant increases in peak inspiratory and expiratory flows. The study suggests that AFES is a promising intervention for reducing pulmonary complications in acute tetraplegia, warranting further investigation in a multicentre comparative study.

Practical Implications

Clinical Practice

AFES can be integrated into the respiratory management of acute tetraplegia to improve breathing and reduce pneumonia risk.

Future Research

Further studies, particularly randomised controlled trials, are needed to validate the findings and optimise AFES protocols.

Technology Development

The developed AFES system can be refined and made more accessible for clinical use in spinal cord injury rehabilitation.

Study Limitations

  • 1
    Small sample size
  • 2
    Lack of a control group
  • 3
    Use of retrospective controls

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