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.

Figures

Figure 1

Outline of the study design.

Figure 2

Electrode placement.

Figure 3

Individual subject results for each outcome measure. Each line represents absolute results for one subject. Subjects with motor complete tetraplegia have been drawn using solid lines and subjects with motor incomplete tetraplegia are have been drawn with a dashed line.

Figure 4

Mean results for the overall group, subjects with incomplete tetraplegia and subjects with complete tetraplegia. Results are presented as absolute change relative to the first assessment session A1.