상부 척수손상 환자에서 기능적 전기자극이 객담 배출능력에 미치는 효과

Abstract

Objective : To determine the effects of abdominal functional electrical stimulation(FES) on the ability to clear the broncheal secretion in high spinal cord injury(SCI) patients. Method : Eleven cervical SCI male patients were assessed for the pulmonary function using a routine pulmonary function test. Maximal expiratory pressure(MEP) and peak expiratory flow rate(PEFR) measurements were recorded during (1) spontaneous cough attempts and (2) cough attempts with FES applied to the abdominal wall. Each measurement was recorded in supine and sitting positions. The portable FES unit was set at 24 Hz, with a pulse width of 150 microsecond(Is), an asymmetrical biphasic waveform and a maximal intensity to 90 mA. Results : All subjects had a decreased vital capacity, peak expiratory flow and increased ratio of forced expiratory volume at one second(FEV 1) to the forced vital capacity(FVC) in a routine pulmonary function test. These cervical SCI patients were greatly reduced the MEP and the PEFR when they coughed spontaneously. FES-assisted coughing increased the MEP and PEFR in all patients in a supine and sitting positions with statistical significance(p<0.05). Conclusion : By increasing the MEP and PEFR, abdominal FES could enhance the coughs in high SCI patients. Abdominal FES can be a useful physical therapy for the prevention and treatment of pulmonary complications in high SCI patients at the bed side as well as at homes.