Functional electrical stimulation for augmented walking in adolescents with incomplete spinal cord injury.
OBJECTIVE
This study evaluated the effects of functional electrical stimulation (FES) applied to the muscles acting on the pelvis, hip, and knee on muscle strength, energy cost of walking, maximum walking distance and speed, step length and cadence, and joint kinematics during gait in 3 ambulatory adolescents with incomplete spinal cord injury (SCI).


METHODS
Percutaneous FES was used to strengthen weakened muscles and to augment walking. After training, participants walked as desired at home with FES for 1 year. Data were collected at baseline (preintervention), and with FES on and FES off immediately following the training period and with FES on and FES off at 3, 6, and 12 months posttraining.


RESULTS
Voluntary strength improved in 12 out of 13 stimulated muscles. Decreased energy cost, increased maximum walking distance and speed, increased step length, and improved joint kinematics during gait were demonstrated with FES on and FES off.


CONCLUSIONS
FES was able to achieve selective stimulation of key weakened muscles for augmented walking. The data suggest that FES had both direct and carryover effects.
Research Department, Shriners Hospitals for Children, Philadelphia, Pennsylvania 19140, USA. tjohnston@shrinenet.org
Therese E
TE
Johnston
Richard L
RL
Finson
Brian T
BT
Smith
Daniel M
DM
Bonaroti
Randal R
RR
Betz
M J
MJ
Mulcahey
D000293:Adolescent; D002648:Child; D004567:Electrodes, Implanted; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D005684:Gait / Q000502:physiology*; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology; D008297:Male; D009046:Motor Neurons / Q000502:physiology; D018482:Muscle, Skeletal / Q000294:innervation; D010342:Patient Acceptance of Health Care; D011187:Posture / Q000502:physiology; D011782:Quadriplegia / Q000503:physiopathology / Q000534:rehabilitation; D013119:Spinal Cord Injuries / Q000503:physiopathology / Q000534:rehabilitation*; D004561:Transcutaneous Electric Nerve Stimulation / Q000295:instrumentation*; D016138:Walking / Q000502:physiology*