医学
振膜(声学)
麻醉
神经调节
呼吸系统
脊髓
反射
脊髓损伤
经颅直流电刺激
咳嗽反射
刺激
物理医学与康复
内科学
扬声器
物理
精神科
声学
作者
Priscila de Carvalho,Juliana Barbosa Goulardins,Danilo Miyoji Nakamura de Sousa,Cristiane Marcela da Silva Barbosa,Thabata Cristina Candido Caetano,Lucas de Macedo dos Santos,Clara Hikari Ito,Adriana Sayuri Hirota,Rita Pavione Rodrigues Pereira,Abrahão Fontes Baptista,Clarice Tanaka
出处
期刊:Chest
[Elsevier]
日期:2021-05-01
卷期号:159 (5): e299-e302
被引量:3
标识
DOI:10.1016/j.chest.2020.11.065
摘要
High spinal cord injured patients (SCI) are susceptible to respiratory muscle impairments. Transcranial direct current stimulation (tDCS) and peripheral electrical stimulation (PES) may influence the diaphragm's central control, but until now they are not described as a therapeutic resource for difficult weaning. We present two case reports of SCI patients (P1 and P2) with long-term tracheostomy (>40 days) and hospital stay (>50 days). In association with respiratory exercise, P1 received a combined application of anodal tDCS over the supplementary motor area plus sensory PES in the thoracic-abdominal muscles, and P2 received isolated excitatory PES in the abdominal muscles, applied daily except on weekends. Maximum inspiratory/expiratory pressure, peak cough flow, diaphragm excursion, and thickening fraction were measured in the first and last days of the protocol. Both patients had improvements, with clinical impact such as cough effectiveness, decannulated after 15 applications of stimulation. Augmentation of neural respiratory drive and corticospinal excitability is suggested.
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