Electric belly zaps may help spinal cord injury patients cough better

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Adults (≥ 22 years of age) admitted to rehabilitation with a new SCI. 2. New non-progressive SCI occurring in the past 3 to 8 weeks. 3. Neurological level of injury of C1-T5. 4. American Spinal Injuries Association Impairment Scale A to C. 5. CPF of \<160 L/min (Note: A CPF of \<270 L/min has been shown to be associated with decreased secretion clearance and increased respiratory complications, while a CPF of \<160 L/min has been shown to lead to an ineffective cough). 6. Not dependent on mechanical ventilation (people dependent on mechanical ventilation are at greatly increased risk of respiratory complications and are excluded due to this heterogeneity). 7. Able to sit upright. 8. Expected to remain in rehabilitation for at least another 3 weeks. Exclusion Criteria: 1. Respiratory complications in previous 24 hours (screening out iatrogenic complications). 2. Chronic respiratory disease. 3. No contraction of the abdominal wall muscles in response to abdominal NMES. 4. Open abdominal surgery ≤ 4 weeks prior to enrollment. 5. Have yet to undergo spinal surgery to stabilize injury, where required. 6. Body mass index \>40 kg/m2. 7. Pacemaker (external or internal) or implanted electronic device (e.g., a defibrillator). 8. Known or expected to be pregnant. 9. Placed on a palliative/supportive care only pathway. 10. Receiving any of the following as standard of care: * Abdominal FES * Inspiratory or Expiratory muscle training * Transcutaneous or implanted thoracolumbar spinal stimulation 11. Participating in any of the following: * A study with the same or similar primary endpoint * A study investigating electrical stimulation or respiratory muscle therapy * Any study in which the investigator determines may interfere with the results of this study 12. Unable or unwilling to comply with protocol requirements, including assessments, tests, and follow-up visits including facial or dental trauma. 13. Any other medical condition which in the opinion of the Investigator will make participation medically unsafe or interfere with the study results. 14. Unable to provide informed consent. 15. Unwilling to provide informed consent.