Three-year follow-up of an implanted functional electrical stimulation system for upright mobility in a child with a thoracic level spinal cord injury.
OBJECTIVE
The purpose of this study was to compare the use of a functional electrical stimulation (FES) system with the use of knee-ankle-foot orthoses (KAFO) for upright mobility over a 3-year period in a child with a spinal cord injury (SCI).


METHODS
A 13-year-old boy with a T8 complete SCI received a lower extremity implanted FES system. Electrodes were implanted for knee extension and for hip extension, abduction, and adduction. After training and at annual intervals, independence and timeliness in completing 7 upright mobility activities with FES and KAFO, as well as stimulated muscle strength, were assessed.


RESULTS
Results have shown that FES provided independence equal to that of KAFO for all activities. Four activities were accomplished more quickly with FES, including donning the system, reaching a high object, transferring to a high surface, and walking 6 m. A floor-to-stand transfer was faster with KAFO. Functional results and stimulated muscle strength have remained stable over the 3-year period.


CONCLUSIONS
The results indicate that FES can provide function equal to or faster than KAFO in a child with a T8 complete SCI and that performance with the FES system can remain stable for at least 3 years.
Betz
Randal R
RR
Shriners Hospitals for Children, Philadelphia, Pennsylvania 19140, USA.
Johnston
Therese E
TE
Smith
Brian T
BT
Mulcahey
M J
MJ
McCarthy
James J
JJ
D000293:Adolescent; D000842:Ankle / Q000503:physiopathology / Q000601:surgery; D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D005500:Follow-Up Studies; D005528:Foot / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007717:Knee / Q000503:physiopathology / Q000601:surgery; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D009989:Orthotic Devices; D011187:Posture / Q000502:physiology*; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000628:therapy*; D013904:Thoracic Vertebrae / Q000503:physiopathology*; D013997:Time Factors