Key result
Posterolateral abdominal FES increases gastric twitch pressure ~71% versus other electrode positions.
Why the study?
Does abdominal FES applied on the posterolateral abdominal wall improve expiratory twitch pressure compared to other electrode positions in able-bodied participants?
Does abdominal FES applied on the posterolateral abdominal wall improve expiratory twitch pressure compared to other electrode positions in able-bodied participants?
Placing electrodes on the posterolateral abdominal wall for abdominal functional electrical stimulation generates the highest expiratory twitch pressures, suggesting it is the optimal position for improving cough efficacy.
Answers are grounded in this paper and cite their sources.
Posterolateral placement may maximize gastric twitch pressure with abdominal FES; leaves open translation to cough efficacy in clinical populations.
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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McCaughey et al. (2018) studied Able-bodied (n=10). Abdominal functional electrical stimulation on the posterolateral abdominal wall vs. Stimulation of the external oblique muscles with or without rectus abdominis muscles was evaluated on Gastric (Pga) and esophageal (Pes) twitch pressures (71% increase in Pga and 53% increase in Pes vs external oblique and rectus abdominis, p=<0.001). Abdominal functional electrical stimulation on the posterolateral abdominal wall increased gastric twitch pressure by 71-95% compared to other electrode positions (P<0.001).
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