Developing Control Algorithms of a Voluntary Cough for an Artificial Bioengineered Larynx Using Surface Electromyography of Chest Muscles

Banus, M. (Marlieke) (2016) Developing Control Algorithms of a Voluntary Cough for an Artificial Bioengineered Larynx Using Surface Electromyography of Chest Muscles. thesis, Medicine.

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Abstract

Introduction: The development of an artificial bioengineered larynx will undoubtedly alleviate suffering and restore the quality of life to a great extend for those who have lost their own larynx due to trauma or cancer. This research is intended to investigate the prediction of a voluntary cough using surface electromyography (EMG) of intercostal and diaphragm muscles, in order to develop control algorithms for an EMG controlled artificial larynx. Methods: Surface EMG of intercostal and diaphragm muscles as well as breathing and cough flow rates were measured in twelve healthy subjects. EMG onset was compared to voluntary cough exhalation onset and also to 0.1 second before onset of voluntary cough exhalation. This time interval is to give the artificial larynx the time to close the bioengineered vocal cords. Results: In the 189 EMG of intercostal muscle detected voluntary coughs, 172 coughs (91% [95% CI 86.9-95.1]) were detected before onset of cough exhalation and 128 coughs (67.7% [95% CI 61-74.4]) 0.1 second before onset of cough exhalation. In the 158 EMG of diaphragm muscle detected voluntary coughs, 149 coughs (94.3% [95% CI 90.7-97.9]) were detected before onset of cough exhalation and 102 coughs (64.6% [95% CI 57.1-72.1]) 0.1 second 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%, 95% CI 94.2-99.4] v 172 coughs, p=0.0294). When comparing the mentioned combination to diaphragm muscle activity alone, the higher percentage detected coughs before cough exhalation onset was not found to be significant (183 coughs v 149 coughs, p=0.295). In addition, more coughs were detected 0.1 second before onset of cough exhalation with the mentioned combination of EMG activity and comparing this to intercostal muscle activity alone (149 coughs [78.8%, 95% CI 73-84.6] v 128 coughs, p=0.0198) and to diaphragm muscle activity alone (149 coughs v 102 coughs, p=0.0038). Conclusion: Results of findings have clearly illustrated that most voluntary coughs can indeed be predicted based on combined EMG signals of intercostal and diaphragm muscles. EMG signals of these two muscle groups will therefore be useful in controlling the bioengineered vocal cords within the artificial larynx during a voluntary cough.

Item Type:	Thesis (Thesis)
Supervisor name:	Supervisor Groningen, the Netherlands and Dikkers, Dr. F.G. and Otolaryngologist and University Medical Center Groningen and Groningen International Program of and Science in Medicine (GIPS-M) and Lisman, Prof. T. and Department of Surgery and University Medical Center Groningen
Supervisor name:	Supervisor London, United Kingdom and Birchall, Prof. M. and Otolaryngologist & Consultant Head & and Neck Surgeon and University College of London and Supervisor London, United Kingdom and Graveston, Dr. J.A. and Honorary Research Associate and University College of London
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:43
Last Modified:	25 Jun 2020 10:43
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/493

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