Introduction
Spinal cord injury (SCI) is a condition that significantly affects quality of life, resulting in motor, sensory and even functional losses, especially in breathing. With an annual incidence of approximately 6,800 cases in Brazil, most of them in men between 10 and 30 years of age, the search for effective treatments is constant. One of the recent focuses in the rehabilitation of patients with SCI has been the use of electrical stimulation (ES) to strengthen affected muscles, such as the diaphragm.
What is Electrostimulation?
Neuromuscular electrical stimulation (NMES) is a therapeutic technique that uses electrical currents to stimulate muscle contraction and has been used for over a century. There are several forms of ES, such as Functional Electrical Stimulation (FES) and Transcutaneous Electrical Nerve Stimulation (TENS), each with specific purposes, from muscle strengthening to pain control.
Effects of Spinal Cord Injury on Respiration
The diaphragm, the main muscle responsible for breathing, can weaken significantly after a SCI, especially if the injury occurs in the cervical region, which can lead to quadriplegia and dependence on mechanical ventilation. Diaphragmatic weakness can result from numerous causes, including the trauma itself, but EE may offer a viable alternative to recovering its functionality.
Application of Electrostimulation to the Diaphragm
The purpose of diaphragmatic ES is to recruit muscle fibers that are not being activated due to injury, thus promoting the recovery of muscle strength and respiratory capacity. The electrodes are positioned at specific points such as the paraxiphoid region and along the ribs, where the phrenic nerve can be stimulated. The intensity, frequency and duration of stimulation are adjusted according to the patient’s response, aiming not only at strengthening but also at respiratory independence.
Search Results
Studies indicate that ES can accelerate weaning from mechanical ventilation in patients with incomplete spinal cord injuries, improve ventilation in cases of chronic obstructive pulmonary disease (COPD), and increase quality of life by improving diaphragmatic function. Application protocols vary, but all aim at a gradual increase in the patient’s respiratory autonomy.
Conclusion
Diaphragmatic electrostimulation is a promising physiotherapy technique for patients with SCI, offering a safe and effective approach to strengthening the diaphragm and improving breathing. Although further research is needed, the results so far are encouraging, enhancing patients’ independence and quality of life.
Reference:
Santos, NS, Tomaz, EJC, Soares, CN (2019). Electrical stimulation in diaphragm muscle weakness due to spinal cord injury. Brazilian Journal of Health Review, 2(5), 4088-4101. DOI:10.34119/bjhrv2n5-016
