Using a Sniff Controller to Self-Trigger Abdominal Functional Electrical Stimulation for Assisted Coughing Following Cervical Spinal Cord Lesions
| Autor: | Anton Plotkin, Amiram Catz, Sagit Shushan, Lior Haviv, Hagit Friedman, Noam Sobel, Aharon Weissbrod, Elena Aidinoff, Uri Bierman, Itzhak Glass, V Bluvshtein |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male 030506 rehabilitation medicine.medical_specialty Biomedical Engineering Electric Stimulation Therapy Electromyography Sensitivity and Specificity Effective cough 03 medical and health sciences Young Adult 0302 clinical medicine Atmospheric measurements Physical medicine and rehabilitation Abdominal muscles Internal Medicine Medicine Functional electrical stimulation Humans Electronic Nose Electric stimulation Spinal Cord Injuries Abdominal Muscles medicine.diagnostic_test business.industry General Neuroscience Rehabilitation Cervical Cord Reproducibility of Results Biofeedback Psychology Equipment Design Middle Aged Spinal cord Respiration Artificial Respiratory Muscles Equipment Failure Analysis medicine.anatomical_structure Treatment Outcome Breath Tests Anesthesia Therapy Computer-Assisted Nasal airflow Female 0305 other medical science business Respiratory Insufficiency 030217 neurology & neurosurgery |
| Zdroj: | IEEE transactions on neural systems and rehabilitation engineering : a publication of the IEEE Engineering in Medicine and Biology Society. 25(9) |
| ISSN: | 1558-0210 |
| Popis: | 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% $({F}[\textsf {4},\textsf {52}] = \textsf {7.99}, {p} = \textsf {0.00004}$ ). There was no difference in efficacy between methods of assistance ( ${F}[\textsf {3},\textsf {39}] = \textsf {0.41}, {p} = \textsf {0.75}$ ). 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. |
| Databáze: | OpenAIRE |
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