Article

Surface electrical stimulation of the abdominal muscles, with
electrodes placed in the posterolateral position, combined with a voluntary cough
can assist clearance of airway secretions in individuals with high-level spinal
cord injury (SCI). OBJECTIVE: To determine whether an increase in stimulus
intensity of the trains of electrical stimuli delivered to the expiratory muscles
has an increasing effect on a stimulated voluntary cough and to determine at
which stimulus intensity a plateau of cough peak expiratory flow occurs. METHODS:
In 7 healthy individuals with a SCI at and above C7, gastric pressure (P(ga)),
esophageal pressure (P(es)), peak expiratory cough flow (PEF(cough)), and
expiratory volume were measured as participants coughed voluntarily with
simultaneous trains of electrical stimuli delivered over the abdominal muscles
(50 Hz, 1-s duration). The intensity of the stimulation was increased
incrementally. RESULTS: A plateau in PEF(cough) occurred in all 7 individuals at
a mean of 211 +/- 29 mA (range 120-360 mA). Peak values reached for P(ga), P(es),
and PEF(cough) were 83.0 +/- 8.0 cm H2O, 66.1 +/- 5.6 cm H2O, and 4.0 +/- 0.4 l/s
respectively. CONCLUSIONS: The plateau in expiratory cough flow that was
associated with increasing expiratory pressures is indicative of dynamic airway
compression. This suggests that the evoked cough will be effective in creating
more turbulent airflow to further assist in dislodging mucus and secretions.
CI - (c) The Author(s) 2014.

Langue : ANGLAIS