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Developing control algorithms of a voluntary cough for an artificial bioengineered larynx using surface electromyography of chest muscles: A prospective cohort study
Author(s) -
Banus M.S.,
Birchall M.A.,
Graveston J.A.
Publication year - 2018
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.13022
Subject(s) - medicine , exhalation , intercostal muscle , electromyography , diaphragm (acoustics) , anesthesia , larynx , surgery , respiratory system , physical medicine and rehabilitation , physics , acoustics , loudspeaker
Objective This prospective cohort study investigates the prediction of a voluntary cough using surface electromyography ( EMG ) of intercostal and diaphragm muscles, to develop control algorithms for an EMG ‐controlled artificial larynx. Setting The Ear Institute, London. Main outcome measures Electromyography onset compared to voluntary cough exhalation onset and to 100 ms (to give the artificial larynx the time to close the bioengineered vocal cords) before voluntary cough exhalation onset, in twelve healthy participants. Results In the 189 EMG of intercostal muscle‐detected voluntary coughs, 172 coughs (91% CI 70‐112) were detected before onset of cough exhalation and 128 coughs (67.6% CI 33.7‐101.7) 100 ms before onset of cough exhalation. In the 158 EMG of diaphragm muscle‐detected voluntary coughs, 149 coughs (94.3% CI 76.3‐112.3) were detected before onset of cough exhalation and 102 coughs (64.6% CI 26.6‐102.6) 100 ms before onset of cough exhalation. More coughs were detected before onset of cough exhalation when combining EMG activity of intercostal and diaphragm muscles and comparing this to intercostal muscle activity alone (183 coughs [96.8% CI 83.8‐109.8] vs 172 coughs, P = .0294). When comparing the mentioned combination to diaphragm muscle activity alone, the higher percentage of detected coughs before cough exhalation onset was not found to be significant (183 coughs vs 149 coughs, P = .295). In addition, more coughs were detected 100 ms before onset of cough exhalation with the mentioned combination of EMG activity and comparing this to intercostal muscles alone (149 coughs [78.8% CI 48.8‐108.8] vs 128 coughs, P = .0198) and to diaphragm muscles alone (149 coughs vs 102 coughs, P = .0038). Conclusions Most voluntary coughs can be predicted based on combined EMG signals of intercostal and diaphragm muscles, and therefore, these two muscle groups will be useful in controlling the bioengineered vocal cords within the artificial larynx during a voluntary cough.