Functional magnetic stimulation for conditioning of expiratory muscles in patients with spinal cord injury.
OBJECTIVE
To evaluate the effectiveness of functional magnetic stimulation (FMS) in conditioning expiratory muscles patients with spinal cord injury (SCI).


METHODS
A prospective before-after trial.


METHODS
The Functional Magnetic Stimulation Laboratory of the SCI Health Care Group, VA Long Beach Health Care System, and the Spinal Cord Injury Services, Department of Veterans Affairs, Palo Alto Health Care System.


METHODS
Eight men with tetraplegia.


METHODS
Expiratory muscle training was achieved by placing a magnetic stimulator with a round magnetic coil along subjects' lower thoracic spine.


METHODS
Measures taken were the maximal expired pressure at total lung capacity (MEP-TLC) and at functional residual capacity (MEP-FRC), expiratory reserve volume (ERV), and the forced expiratory flow rate at TLC (FEF-TLC) and at FRC (FEF-FRC) by subjects' voluntary maximal efforts.


RESULTS
After 4 weeks of conditioning, the mean +/- standard error of the mean values were: MEP-TLC, 55.3 +/- 8.6cmH(2)O; MEP-FRC, 29.6 +/- 5.6cmH(2)O; ERV,.57 +/-.08L; FEF-TLC, 4.3 +/- 0.5L/s; and FEF-FRC, 1.9 +/- 0.2L/s. These values correspond to, respectively, 129%, 137%, 162%, 109%, and 127% of pre-FMS conditioning values. When FMS was discontinued for 2 weeks, the MEP-TLC returned to its pre-FMS training value.


CONCLUSIONS
A 4-week protocol of FMS of the expiratory muscles improves voluntary expiratory muscle strength significantly, indicating that FMS can be a noninvasive therapeutic technology in respiratory muscle training for persons with tetraplegia.
Functional Magnetic Stimulation Laboratory, Spinal Cord Injury/Disorder, Health Care Group, VA Long Beach Health Care System, Long Beach, CA 90822, USA.
V W
VW
Lin
I N
IN
Hsiao
E
E
Zhu
I
I
Perkash
D000704:Analysis of Variance; D003371:Cough / Q000503:physiopathology / Q000534:rehabilitation*; D004558:Electric Stimulation; D006801:Humans; D008280:Magnetics; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011782:Quadriplegia / Q000503:physiopathology / Q000534:rehabilitation*; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000503:physiopathology*; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D016896:Treatment Outcome