Prospective study on breathing synchronized electrical stimulation of the abdominal muscles in patients with acute and chronic tetraplegia

Status:

completed 01/2013

Aims:

A major concern in posttraumatic care of spinal cord injured (SCI) patients with a lesion at cervical and thoracic level is airway management and prevention of secondary medical complications. The aim of this DGUV funded research project was the development and clinical evaluation of an assistive system for supporting the process of weaning, for reducing the risk of pulmonary complications and for enabling increased coughing.

Activities/Methods:

The developed system is based on a commercially available multi-channel electrical stimulator which was modified to allow the stimulation of the abdominal muscles through surface electrodes during the expiration phase in order to support the breathing and coughing in patients with acute tetraplegia. The device has been designed to enable an intuitive use even by non-medical staff. The therapy concept was investigated in a prospective proof of concept study in comparison with a historical patient group. Aim of the study was to show that at least nine out of fifteen patients in the electrical stimulation group do not develop pulmonary complications (pneumonia).

Results:

The aim of this proof of concept study could be achieved already after including the first nine patients as none of these patients developed pneumonia. Respiration parameters (duration of inspiration and expiration, peak flow as well as volume) improved continuously over time by the application of electrical stimulation. A muscle training effect was visible. No complications associated with the electrical stimulation could be observed. The majority of patients reported in a questionnaire significant improvements in breathing and coughing due to the stimulation support.

All study aims could be achieved. The pre-requirements for a controlled, randomized prospective, multi-centric study have been established. This study is already planned.

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