Restoration and analysis of standing-up in complete paraplegia utilizing functional electrical stimulation.
OBJECTIVE
Restoration of stand-up motion in patients with complete paraplegia utilizing multichannel functional electrical stimulation, and analysis of the restored motion.


METHODS
Nonrandomized control trial.


METHODS
General community, a referral center, institutional practice, and ambulatory care:


METHODS
Twelve volunteer samples were used for the collection of normal data. Two complete paraplegics received treatment for the restoration of stand-up motion.


METHODS
The electromyogram, joint angle, and floor reaction force were investigated during standing-up with arms crossed in front of the chest, and hands-assisted standing-up using parallel bars. The maximum knee joint torque during standing-up without hands-assists was calculated using a three-segment link model. Standing-up motion in complete paraplegics was restored, and then analyzed using the three-dimensional floor reaction force and the hip, knee, and ankle angles.


RESULTS
Main muscles used to stand up were the quadriceps, tibialis anterior, and paraspinal muscles. Hands-assists reduced the muscle activity and the vertical floor reaction force. Peak muscle activity was less during hands-assisted standing-up, except for the rectus femoris and the iliopsoas muscle. The maximum knee joint torque during standing-up was 1.6Nm/kg for both knees. Two complete paraplegics were able to stand up smoothly from a wheelchair based on stimulation data obtained from normal subjects. The characteristic pattern during standing-up was knee flexion preceding extension.


CONCLUSIONS
Stand-up motion was restored utilizing electromyogram data and knee joint torque data from normal subjects.
Kagaya
H
H
Department of Orthopedic Surgery, Akita University School of Medicine, Japan.
Shimada
Y
Y
Ebata
K
K
Sato
M
M
Sato
K
K
Yukawa
T
T
Obinata
G
G
D000328:Adult; D004599:Electric Stimulation Therapy; D004576:Electromyography; D006801:Humans; D007719:Knee Joint / Q000502:physiology; D008297:Male; D009068:Movement / Q000502:physiology*; D009132:Muscles / Q000502:physiology; D010264:Paraplegia / Q000503:physiopathology / Q000534:rehabilitation*; D011187:Posture