title: Effects of quadriceps and anterior tibial muscles electrical stimulation on the feet and ankles of patients with spinal cord injuries.
abstract: METHODS
  Controlled clinical test.
  
  
  OBJECTIVE
  The purpose of this study was to assess the effects of quadriceps and anterior tibial muscles electrical stimulation on the feet and ankles of patients with spinal cord injuries and to compare them with able-bodied individuals and a group of patients who did not undergo neuromuscular electrical stimulation (NMES).
  
  
  METHODS
  This study was conducted at the Hospital das Clínicas of Unicamp, Campinas, São Paulo, Brazil.
  
  
  METHODS
  Between January and April 2008, 30 patients at the spinal cord injury ambulatory clinic who underwent NMES (group A) were submitted to a clinical and radiographic assessment of their feet and ankles and compared with a spinal cord injury group (group B) who did not undergo NMES and a group of able-bodied individuals (group C). The Kruskal-Wallis test was used to compare all the three groups, and between-group differences (P<0.05) were investigated with the Mann-Whitney test.
  
  
  RESULTS
  The mean mobility of the midfoot and ankle subtalar joint was significantly higher in group C than in groups A and B. Differences in the mean measurements of the profiles of the talocalcaneal and the talus-first metatarsal angles were statistically significant for group A vs the other groups (P=0.0020, 0.0024, respectively). Foot deformities were found in groups including claw toes and flat feet (group A) and grade I ulcers on the lateral malleolus and calcaneus (group B).
  
  
  CONCLUSIONS
  Partial-load NMES maintains the feet and ankles in a planted and adequate walking position in patients with spinal cord injuries, a favorable result of new technologies that allows these patients to reacquire independent walking capacity.
authors.affiliation: Orthopaedics Department, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil. ckbit@uol.com.br
authors.forename: C K
authors.initials: CK
authors.lastname: Bittar
authors.forename: A
authors.initials: A
authors.lastname: Cliquet
mesh_terms: D000328:Adult; D000842:Ankle / Q000294:innervation; D002648:Child; D004599:Electric Stimulation Therapy; D005260:Female; D005528:Foot / Q000294:innervation; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000502:physiology*; D052097:Quadriceps Muscle / Q000502:physiology*; D016059:Range of Motion, Articular; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D055815:Young Adult