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Assisted cough and blood pressure control in high level tetraplegia

It is common for people with tetraplegia with spinal lesions at C3/4 level to lose the ability to make an effective cough. Stimulation of the abdominal muscles can be used to augment expiration.  The increased abdominal pressure produced lifts the diaphragm so compressing the lungs and increasing expiration.  To be effective, the user must have control over expiration so the stimulation can be synchronised with voluntary effort.

Electrical stimulation of the abdominal muscles has also been shown to increase blood pressure, a useful effect for people with high level tetraplegia who are affected by postural hypotension.  This is the effect where blood pressure is reduced when sitting upright and is often worse after eating.  Electrical stimulation causes a short-term increase in blood pressure that can significantly improve ability to cope with an upright posture and reduce light-headedness and fainting.

In both applications, OML’s O2CHSII device is used.  For each individual, a specific means to control the device is required.  This can be through environmental control systems or custom-designed switches.

Important: Because there is a risk of autonomic dysreflexia in this patient group in response to electrical stimulation, it is essential that there is appropriate medical supervision when applying this technique.

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Facial paralysis / Bell’s Palsy

Loss of voluntary movement can occur following Bell’s Palsy or nerve injury.  Electrical stimulation exercises can be used to strengthen and re-educate the movements of these muscles, restoring facial expression.  OML’s Microstim 2v2 device is used in for this application.  Typically a 6 month protocol of daily home based exercise is used with follow up at 2, 8, 16 and 24 weeks


Individual applications of FES

The team at the National Clinical FES Centre are able to take referrals for other applications of FES requiring individual solutions for individuals with specific neurological conditions. Please contact the centre for more information.