title: Abdominal functional electrical stimulation to improve respiratory function after spinal cord injury: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Abdominal functional electrical stimulation (abdominal FES) is the application of a train of electrical pulses to the abdominal muscles, causing them to contract. Abdominal FES has been used as a neuroprosthesis to acutely augment respiratory function and as a rehabilitation tool to achieve a chronic increase in respiratory function after abdominal FES training, primarily focusing on patients with spinal cord injury (SCI). This study aimed to review the evidence surrounding the use of abdominal FES to improve respiratory function in both an acute and chronic manner after SCI.
  
  
  METHODS
  A systematic search was performed on PubMed, with studies included if they applied abdominal FES to improve respiratory function in patients with SCI.
  
  
  METHODS
  Fourteen studies met the inclusion criteria (10 acute and 4 chronic). Low participant numbers and heterogeneity across studies reduced the power of the meta-analysis. Despite this, abdominal FES was found to cause a significant acute improvement in cough peak flow, whereas forced exhaled volume in 1 s approached significance. A significant chronic increase in unassisted vital capacity, forced vital capacity and peak expiratory flow was found after abdominal FES training compared with baseline.
  
  
  CONCLUSIONS
  This systematic review suggests that abdominal FES is an effective technique for improving respiratory function in both an acute and chronic manner after SCI. However, further randomised controlled trials, with larger participant numbers and standardised protocols, are needed to fully establish the clinical efficacy of this technique.
authors.affiliation: Centre for Health Systems and Safety Research, Australian Institute for Health Innovation, Macquarie University, North Ryde, New South Wales, Australia.
authors.forename: E J
authors.initials: EJ
authors.lastname: McCaughey
authors.affiliation: Centre for Health Systems and Safety Research, Australian Institute for Health Innovation, Macquarie University, North Ryde, New South Wales, Australia.|Bloomberg School of Public Health, John Hopkins University, MD, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Borotkanics
authors.affiliation: School of Engineering, University of Glasgow, Scotland, UK.|Scottish Centre for Innovation in Spinal Cord Injury, Glasgow, Scotland, UK.
authors.forename: H
authors.initials: H
authors.lastname: Gollee
authors.affiliation: School of Medicine, Case Western Reserve University, Cleveland, OH, USA.
authors.forename: R J
authors.initials: RJ
authors.lastname: Folz
authors.affiliation: Liberate Medical LLC, Crestwood, KY, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: McLachlan
mesh_terms: D000005:Abdomen / Q000502:physiology*; D004599:Electric Stimulation Therapy / Q000379:methods*; D006801:Humans; D012120:Respiration Disorders / Q000209:etiology* / Q000628:therapy*; D013119:Spinal Cord Injuries / Q000150:complications*