Paraplegia: prolonged standing using closed-loop functional electrical stimulation and Andrews ankle-foot orthosis.
One T10 paraplegic male (CS) implanted in 1991 with a Nucleus FES-22 stimulator has been able to achieve closed-loop standing for 1 h. The knee angles are monitored by electrogoniometers, resulting in the quadriceps stimulation time being less than 10%. Stance stability is achieved by the Andrews anterior ankle-foot orthosis (AFO). The use of accelerometers for trunk inclination and vertical acceleration during controlled stand-to-sit, diminishes slamming onto the seat. CS does one-handed tasks with objects of 2.2 kg. In another T10 paraplegic male (FR), surface stimulation was applied over 1.5 years to both femoral nerves at the groin for conditioning and prolonged standing. With quadricep conditioning, 55 Nm at 45 degrees of knee flexion is produced. With the AFO and knee monitoring, FR can stand uninterrupted for up to 70 min and perform one-handed tasks. In August 1998, he was implanted with the multifunctional Praxis FES 24-A stimulator for restoration of limb movements, bladder and bowel function, and pressure sore prevention.
Davis
R
R
Neural Engineering Clinic, Augusta, Maine 04330, USA. NeuralEC@mint.net
Houdayer
T
T
Andrews
B
B
Barriskill
A
A
D000054:Acceleration; D000328:Adult; D000843:Ankle Joint / Q000502:physiology; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D004567:Electrodes, Implanted; D004568:Electrodiagnosis / Q000295:instrumentation; D005267:Femoral Nerve / Q000502:physiology; D005528:Foot / Q000502:physiology; D006225:Hand / Q000502:physiology; D006801:Humans; D007422:Intestines / Q000502:physiology; D007719:Knee Joint / Q000502:physiology; D008297:Male; D009048:Motor Skills / Q000502:physiology; D009068:Movement; D018482:Muscle, Skeletal / Q000502:physiology; D009989:Orthotic Devices; D010264:Paraplegia / Q000503:physiopathology / Q000534:rehabilitation / Q000628:therapy*; D011187:Posture / Q000502:physiology*; D003668:Pressure Ulcer / Q000517:prevention & control; D016059:Range of Motion, Articular / Q000502:physiology; D013997:Time Factors; D001743:Urinary Bladder / Q000502:physiology