Selecting candidates for a lower limb stimulator implant programme: a patient-centred method.
OBJECTIVE
To develop an effective selection procedure for lower limb functional neurostimulation (LLFNS) for standing in paraplegia.


METHODS
The selection procedure and exclusion criteria were based on the previous experience for two clinical centres with experience of LLFNS.


METHODS
Two Regional Spinal Injuries units in southern England.


METHODS
254 fully rehabilitated paraplegics living in the community.


METHODS
Patients were invited to participate in the programme, and if suitable to subject themselves to a rigorous staged selection procedure from which they could withdraw at any time.


METHODS
Functionally successful home standing using closed-loop surface electrical stimulation.


RESULTS
57/254 patients were suitable on paper and were accessible. 19 of these (CI = 10-28) were interested in the project and attended one of the spinal centres for details. Twelve (CI = 5-19) of these fulfilled the selection criteria and started on the training programme; and 10 of them completed the muscle training programme successfully. Seven patients (CI = 2-12) achieved closed-loop standing in the laboratory and four patients (CI = 1-8) did so at home.
Rushton
D N
DN
Department of Rehabilitation, King's College Hospital, London.
Barr
F M
FM
Donaldson
N de N
Nde N
Harper
V J
VJ
Perkins
T A
TA
Taylor
P N
PN
Tromans
A M
AM
D000328:Adult; D001007:Anxiety / Q000209:etiology; D015519:Bone Density; D003863:Depression / Q000209:etiology; D004599:Electric Stimulation Therapy / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000503:physiopathology; D009132:Muscles / Q000473:pathology / Q000503:physiopathology; D010264:Paraplegia / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D018802:Patient-Centered Care; D010560:Personnel Selection; D010807:Physical Endurance / Q000502:physiology; D019736:Prostheses and Implants; D012039:Regional Blood Flow / Q000502:physiology; D019415:Torque