Using a Sniff Controller to Self-Trigger Abdominal Functional Electrical Stimulation for Assisted Coughing Following Cervical Spinal Cord Lesions.
IEEE Trans Neural Syst Rehabil Eng
; 25(9): 1461-1471, 2017 09.
Article
en En
| MEDLINE
| ID: mdl-28166501
Individuals with cervical spinal cord lesions (SCLs) typically depend on caregivers to manually assist in coughing by pressing against their abdominal wall. Coughing can also be assisted by functional electric stimulation (FES) applied to abdominal muscles via surface electrodes. Efficacy of FES, however, depends on precise temporal synchronization. The sniff controller is a trigger that enables paralyzed individuals to precisely control external devices through alterations in nasal airflow. We hypothesized that FES self-triggering by sniff controller may allow for effective cough timing. After optimizing parameters in 16 able-bodied subjects, we measured peak expiratory flow (PEF) in 14 subjects with SCL who coughed with or without assistance. Assistance was either manual assistance of a caregiver, caregiver activated FES, button self-activated FES (for SCL participants who could press a button), or sniff-controlled self-activated FES. We found that all assisted methods provided equally effective improvements, increasing PEF on average by 25 ± 27% (F[4,52] = 7.99, p = 0.00004 ). There was no difference in efficacy between methods of assistance ( F[3,39] = 0.41, p = 0.75 ). Notably, sniff-controlled FES was the only method of those tested that can be activated by all paralyzed patients alone. This provides for added independence that is a critical factor in quality of life following SCL.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Respiración Artificial
/
Insuficiencia Respiratoria
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Traumatismos de la Médula Espinal
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Biorretroalimentación Psicológica
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Músculos Respiratorios
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Terapia por Estimulación Eléctrica
Tipo de estudio:
Clinical_trials
/
Diagnostic_studies
/
Etiology_studies
Aspecto:
Patient_preference
Límite:
Adult
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
IEEE Trans Neural Syst Rehabil Eng
Asunto de la revista:
ENGENHARIA BIOMEDICA
/
REABILITACAO
Año:
2017
Tipo del documento:
Article
Pais de publicación:
Estados Unidos