Abstract
Study design:
Single case cross-over design with multiple baselines.
Objective:
To compare two functional electrical stimulation (FES) training protocols to assist sit-to-stand in people with incomplete spinal cord injury (SCI).
Setting:
The study was conducted in Sydney, Australia.
Methods:
Four subjects with incomplete SCI undertook nine sessions of FES supported cycling at either 100 or 35 Hz stimulus frequency repeated. Ground reaction force and rate of generation of vertical ground reaction force during standing from sitting were measured before and after each training series.
Results:
Subjects improved their ability to generate greater support through the feet after training with 35 Hz stimulus paradigm but increased the rate of force production after training with 100 Hz stimulation.
Conclusions:
Different FES training paradigms appear to produce different responses; however the ability to stand up seems more responsive to training with 35 Hz FES stimulation.
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References
Liberson WT, Holmquest HJ, Scott D, Dow M . Functional electrotherapy, stimulation of the peroneal nerve synchronized with the swing phase of the gait of hemiplegic patients. Arch Phys Med Rehabil 1961; 42: 101–105.
Raymond J, Crameri R . Electrical stimulation for individuals with spinal cord injury. Am J Med Sports 2001; 3: 209–222.
Mahoney ET, Bickel CS, Elder C, Black C, Slade JM, Apple D et al. Changes in skeletal muscle size and glucose tolerance with electrically stimulated resistance training in subjects with chronic spinal cord injury. Arch Phys Med Rehabil 2005; 86: 1502–1504.
Klose K, Jacobs P, Broton J, Guest RS, Needham-Shropshire BM, Lebwohl N et al. Evaluation of a training program for persons with SCI paraplegia using the Parastep ambulation system: part 1. Ambulation performance and anthropometric measures. Arch Phys Med Rehabil 1997; 78: 789–793.
Castro MJ, Apple DF Jr, Hillegass EA, Dudley GA . Influence of complete spinal cord injury on skeletal muscle cross-sectional area within the first 6 months of injury. Eur J Appl Physiol 1999; 80: 373–378.
Herbison GJ, Zerby SA, Cohen ME, Marino RJ, Ditunno JF . Motor power differences within the first two weeks post SCI in cervical spinal cord injured quadriplegic subjects. J Neurotrauma 1992; 9: 373–380.
Norton L . Spinal Cord Injury, Australia 2007–08, Injury research and statistics series no. 52 AIHW: Canberra. 2010.
Kroll T, Neri MT, Ho PS, Kroll T, Neri MT, Ho P-S . Secondary conditions in spinal cord injury: results from a prospective survey. Disab Rehabil 2007; 29: 1229–1237.
Lindemann U, Claus H, Stuber M, Augat P, Muche R, Nikolaus T et al. Measuring power during the sit-to-stand transfer. Eur J Appl Physiol 2003; 89: 466–470.
Nightingale EJ, Raymond J, Middleton JW, Crosbie J, Davis GM . Benefits of FES gait in a spinal cord injured population. Spinal Cord 2007; 45: 646–657.
Reichenfelser W, Hackl H, Hufgard J, Kastner J, Gstatlner K, Gfohler M . Monitoring of spasticity and functional ability in individuals with incomplete spinal cord injury with a functional electrical stimulation cycling system. J Rehabil Med 2012; 44: 444–449.
Hjeltnes N, Aksnes AK, Birkeland KI, Johansen J, Lannem A, Wallberg-Henriksson H . Improved body composition after 8 wk of electrically stimulated leg cycling in tetraplegic patients. Am J Physiol 1997; 273: R1072–R1079.
Nickolls P, Collins DF, Gorman RB, Burke D, Gandevia SC . Forces consistent with plateau-like behaviour of spinal neurons evoked in patients with spinal cord injuries. Brain 2004; 127: 660–670.
Matsunaga T, Shimada Y, Sato K . Muscle fatigue from intermittent stimulation with low and high frequency electrical pulses. Arch Phys Med Rehabil 1999; 80: 48–53.
Eser PC, Donaldson NdN, Knecht H, Stussi E . Influence of different simulation frequencies on power output and fatigue during FES-cycling in recently injured SCI people. IEEE Trans Neural Systems Rehabil Engin 2003; 11: 236–240.
Collins DF . Central contributions to contractions evoked by tetanic neuromuscular electrical stimulation. Exerc Sport Sci Rev 2007; 35: 102–109.
Harrison PJ, Taylor A . Individual excitatory post-synaptic potentials due to muscle spindle Ia afferents in cat triceps surae motoneurones. J Physiol 1981; 312: 455–470.
Fornusek C, Davis GM, Sinclair PJ, Milthorpe B . Development of an isokinetic functional electrical stimulation cycle ergometer. Neuromodulation 2004; 7: 56–64.
Acknowledgements
This project was supported by National Health and Medical Research Council Project Grant #5512351. Ms Tanhoffer was a masters candidate and had been awarded a Postgraduate Scholarship in Clinical Rehabilitation Sciences, Faculty of Health Sciences, The University of Sydney. The contributions of Associate Professor Jane Butler of Neuroscience, Australia and Professor Glen Davis and Associate Professor James Middleton of the University of Sydney are acknowledged with gratitude.
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Crosbie, J., Tanhoffer, A. & Fornusek, C. FES assisted standing in people with incomplete spinal cord injury: a single case design series. Spinal Cord 52, 251–254 (2014). https://doi.org/10.1038/sc.2013.158
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DOI: https://doi.org/10.1038/sc.2013.158
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