scholarly journals Coactivation of Expiratory Muscles and Diaphragm During, Electrical Stimulation to the Abdominal Wall

2020 ◽  
Author(s):  
D. Colon Hidalgo ◽  
A.J. Mclachlan ◽  
H.S. Shaikh ◽  
A. Ansar ◽  
M.J. Tobin ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Abdominal Wall ◽  
Expiratory Muscles

scholarly journals Abdominal stimulation for respiratory support in tetraplegia: A tutorial review

2008 ◽  
Vol 18 (2) ◽  
pp. 85-92 ◽  
Author(s):  
H. Gollee ◽  
K.J. Hunt ◽  
M.H. Fraser ◽  
A.N. Mclean
Keyword(s):  
Muscle Contraction ◽  
Tidal Volume ◽  
Abdominal Wall ◽  
Abdominal Muscle ◽  
Respiratory Support ◽  
Muscle Stimulation ◽  
Future Developments ◽  
Expiratory Muscles ◽  
Simple Surface ◽  
Stimulation Of

Neuromuscular stimulation of the abdominal wall muscles can provide respiratory support in tetraplegia, where the main expiratory muscles are affected by paralysis. Stimulation may be applied by simple surface stimulation, resulting in a uniform muscle contraction which can help to improve expiratory function for coughing and breathing. In this review, an overview of methods and approaches available for abdominal muscle stimulation is given. Studies are discussed which show that this technique can lead to improvements in expiratory flow and tidal volume, resulting in enhanced cough and breathing functions. Approaches are introduced which aim to integrate abdominal stimulation with the subject's own voluntary breathing functions. These are illustrated with experimental results from the evaluation of automatic stimulation methods in tetraplegic patients. Clinical significance and applications are discussed and future developments are outlined.

scholarly journals Changes in Respiratory Muscle Thickness during Mechanical Ventilation

2020 ◽  
Author(s):  
Zhong-Hua Shi ◽  
Heder de Vries ◽  
Harm-Jan de Grooth ◽  
Annemijn H. Jonkman ◽  
Yingrui Zhang ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Tidal Volume ◽  
Abdominal Wall ◽  
Intraclass Correlation ◽  
Muscle Thickness ◽  
Diaphragm Thickness ◽  
Lateral Abdominal Wall ◽  
Expiratory Muscle ◽  
Expiratory Muscles ◽  
Muscle Ultrasound

Background The lateral abdominal wall muscles are recruited with active expiration, as may occur with high breathing effort, inspiratory muscle weakness, or pulmonary hyperinflation. The effects of critical illness and mechanical ventilation on these muscles are unknown. This study aimed to assess the reproducibility of expiratory muscle (i.e., lateral abdominal wall muscles and rectus abdominis muscle) ultrasound and the impact of tidal volume on expiratory muscle thickness, to evaluate changes in expiratory muscle thickness during mechanical ventilation, and to compare this to changes in diaphragm thickness. Methods Two raters assessed the interrater and intrarater reproducibility of expiratory muscle ultrasound (n = 30) and the effect of delivered tidal volume on expiratory muscle thickness (n = 10). Changes in the thickness of the expiratory muscles and the diaphragm were assessed in 77 patients with at least two serial ultrasound measurements in the first week of mechanical ventilation. Results The reproducibility of the measurements was excellent (interrater intraclass correlation coefficient: 0.994 [95% CI, 0.987 to 0.997]; intrarater intraclass correlation coefficient: 0.992 [95% CI, 0.957 to 0.998]). Expiratory muscle thickness decreased by 3.0 ± 1.7% (mean ± SD) with tidal volumes of 481 ± 64 ml (P < 0.001). The thickness of the expiratory muscles remained stable in 51 of 77 (66%), decreased in 17 of 77 (22%), and increased in 9 of 77 (12%) patients. Reduced thickness resulted from loss of muscular tissue, whereas increased thickness mainly resulted from increased interparietal fasciae thickness. Changes in thickness of the expiratory muscles were not associated with changes in the thickness of the diaphragm (R2 = 0.013; P = 0.332). Conclusions Thickness measurement of the expiratory muscles by ultrasound has excellent reproducibility. Changes in the thickness of the expiratory muscles occurred in 34% of patients and were unrelated to changes in diaphragm thickness. Increased expiratory muscle thickness resulted from increased thickness of the fasciae. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

scholarly journals Effects of chronic electrical stimulation on paralyzed expiratory muscles

2008 ◽  
Vol 104 (6) ◽  
pp. 1634-1640 ◽  
Author(s):  
Anthony F. DiMarco ◽  
Krzysztof E. Kowalski
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Electrical Stimulation ◽  
High Frequency ◽  
High Frequency Stimulation ◽  
Disuse Atrophy ◽  
Expiratory Muscle ◽  
Cord Injury ◽  
Generating Capacity ◽  
Expiratory Muscles

Following spinal cord injury, the expiratory muscles develop significant disuse atrophy characterized by reductions in their weight, fiber cross-sectional area, and force-generating capacity. We determined the extent to which these physiological alterations can be prevented with electrical stimulation. Because a critical function of the expiratory muscles is cough generation, an important goal was the maintenance of maximal force production. In a cat model of spinal cord injury, short periods of high-frequency lower thoracic electrical spinal cord stimulation (SCS) at the T10 level (50 Hz, 15 min, twice/day, 5 days/wk) were initiated 2 wk following spinalization and continued for a 6-mo period. Airway pressure (P)-generating capacity was determined by SCS. Five acute, spinalized animals served as controls. Compared with controls, initial P fell from 43.9 ± 1.0 to 41.8 ± 0.7 cmH2O (not significant) in the chronic animals. There were small reductions in the weight of the external oblique, internal oblique, transverses abdominis, internal intercostal, and rectus abdominis muscles (not significant for each). There were no significant changes in the population of fast muscle fibers. Because prior studies (Kowalski KE, Romaniuk JR, DiMarco AF. J Appl Physiol 102: 1422–1428, 2007) have demonstrated significant atrophy following spinalization in this model, these results indicate that expiratory muscle atrophy can be prevented by the application of short periods of daily high-frequency stimulation. Because the frequency of stimulation is similar to the expected pattern of clinical use for cough generation, the daily application of electrical stimulation could potentially serve the dual purpose of maintenance of expiratory muscle function and airway clearance.

scholarly journals Posterolateral Surface Electrical Stimulation of Abdominal Expiratory Muscles to Enhance Cough in Spinal Cord Injury

2010 ◽  
Vol 25 (2) ◽  
pp. 158-167 ◽  
Author(s):  
Jane E. Butler ◽  
Julianne Lim ◽  
Robert B. Gorman ◽  
Claire Boswell-Ruys ◽  
Julian P. Saboisky ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Electrical Stimulation ◽  
Cord Injury ◽  
Expiratory Muscles ◽  
Stimulation Of

scholarly journals Functional electrical stimulation to the abdominal wall muscles synchronized with the expiratory flow does not induce muscle fatigue

2017 ◽  
Vol 29 (3) ◽  
pp. 484-486
Author(s):  
Yukako Okuno ◽  
Ryoichi Takahashi ◽  
Yoko Sewa ◽  
Hirotaka Ohse ◽  
Shigeyuki Imura ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Muscle Fatigue ◽  
Abdominal Wall ◽  
Functional Electrical Stimulation ◽  
Expiratory Flow

scholarly journals Automatic electrical stimulation of abdominal wall muscles increases tidal volume and cough peak flow in tetraplegia

2008 ◽  
Vol 16 (4) ◽  
pp. 273-281 ◽  
Author(s):  
H. Gollee ◽  
K.J. Hunt ◽  
D.B. Allan ◽  
M.H. Fraser ◽  
A.N. McLean
Keyword(s):  
Electrical Stimulation ◽  
Tidal Volume ◽  
Abdominal Wall ◽  
Peak Flow ◽  
Stimulation Of

scholarly journals Optimal electrode position for abdominal functional electrical stimulation

2018 ◽  
Vol 125 (4) ◽  
pp. 1062-1068 ◽  
Author(s):  
Euan J. McCaughey ◽  
Claire L. Boswell-Ruys ◽  
Anna L. Hudson ◽  
Simon C. Gandevia ◽  
Jane E. Butler
Keyword(s):  
Electrical Stimulation ◽  
Abdominal Wall ◽  
Functional Electrical Stimulation ◽  
Respiratory Function ◽  
Rectus Abdominis ◽  
Electrode Position ◽  
Clinical Use ◽  
Therapeutic Applications ◽  
External Oblique ◽  
Stimulation Of

Abdominal functional electrical stimulation (abdominal FES) improves respiratory function. Despite this, clinical use remains low, possibly due to lack of agreement on the optimal electrode position. This study aimed to ascertain the optimal electrode position for abdominal FES, assessed by expiratory twitch pressure. Ten able-bodied participants received abdominal FES using electrodes placed: 1) on the posterolateral abdominal wall and at the motor points of 2) the external oblique muscles plus rectus abdominis muscles, and 3) the external obliques alone. Gastric (Pga) and esophageal (Pes) twitch pressures were measured using a gastroesophageal catheter. Single-stimulation pulses were applied at functional residual capacity during step increments in stimulation current to maximal tolerance or until Pgaplateaued. Stimulation applied on the posterolateral abdominal wall led to a 71% and 53% increase in Pgaand Pes, respectively, compared with stimulation of the external oblique and rectus abdominis muscles ( P < 0.001) and a 95% and 56% increase in Pgaand Pes, respectively, compared with stimulation of the external oblique muscles alone ( P < 0.001). Stimulation of both the external oblique and rectus abdominis muscles led to an 18.3% decrease in Pgacompared with stimulation of only the external oblique muscles ( P = 0.040), with inclusion of the rectus abdominis having no effect on Pes( P = 0.809). Abdominal FES applied on the posterolateral abdominal wall generated the highest expiratory twitch pressures. As expiratory pressure is a good indicator of expiratory muscle strength and, thus, cough efficacy, we recommend this electrode position for all therapeutic applications of abdominal FES.NEW & NOTEWORTHY While abdominal functional electrical stimulation (abdominal FES) can improve respiratory function, clinical use remains low. This is at least partly due to lack of agreement on the optimal electrode position. Therefore, this study aimed to ascertain the optimal electrode position for abdominal FES. We show that electrodes placed on the posterolateral abdominal wall generated the highest expiratory twitch pressures. As such, we recommend this electrode position for all therapeutic applications of abdominal FES.

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