Abdominal Muscle Stimulation

The abdominal muscles are major contributors to respiration, both through their expiratory action on the rib cage and their mechanical linkage with the diaphragm. Their function can be explored by voluntary maneuvers (see Volitional Tests of Respiratory Muscle Strength), with the usual limitations of subjects understanding and cooperation. A nonvolitional test giving information on abdominal muscle mechanical output would, therefore, be of interest.

Contraction of the abdominal muscles can be provoked by their direct electrical stimulation. This technique has been used in humans to study the action of various abdominal muscles on the rib cage (200), and in a study of diaphragm maximal voluntary activation (155). From a therapeutic point of view, its use has been considered to enhance cough in patients with cervical cord injury (201). However, direct electrical stimulation is painful and supramaximality is difficult to achieve. it is also difficult to activate all muscles groups at once.

Contraction of the abdominal muscles can also be provoked by stimulation of their parent nerves and roots (202). Theoretically, this allows supramaximal stimulation (and therefore reproducibility) and, if the stimulus is widespread enough, simultaneous activation of all abdominal muscles. Magnetic stimulation over the vertebral column at the level of the eighth to tenth thoracic vertebra could provide an easy-to-use nonvoli-tional assessment of abdominal muscle strength and fatigue (202, 203).

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