Effect of neuromuscular electrical stimulation on cough capacity and pulmonary function in patients with acute cervical cord injury.

OBJECTIVE To assess the effectiveness of neuromuscular electrical stimulation (NMES) on cough capacity and prevention of pulmonary complication in patients with acute cervical cord injury. DESIGN A randomized controlled trial. SUBJECTS Twenty-six tetraplegic patients with cervical spinal cord injury, 13 in the NMES therapy group and 13 in the control group. METHODS NMES was applied to the clavicular portion of the pectoralis major and abdominal muscle. Pulmonary function tests were performed before and after therapy, and at 3 months and 6 months follow-up. The pulmonary complications in this 6-month follow-up period were also recorded. RESULTS After the 4-week therapy, and at 3 months and 6 months follow-up testing, patients in the NMES therapy group displayed significant improvement in their peak expiratory flow, forced expiratory volume in 1 second, forced vital capacity, maximal expiratory pressure and maximal inspiratory pressure, compared with those in the control group (p<0.05). Patients in the NMES therapy group also had fewer pulmonary complications in the follow-up period. CONCLUSION NMES over the pectoralis and abdominal muscles might improve cough capacity and pulmonary function in cervical spinal cord injury with tetraplegia. This improvement might last for 6 months. With this improvement, pulmonary complications were reduced.