title: Effects of electrical stimulation-induced gluteal versus gluteal and hamstring muscles activation on sitting pressure distribution in persons with a spinal cord injury.
abstract: METHODS
  Ten participants underwent two electrical stimulation (ES) protocols applied using a custom-made electrode garment with built-in electrodes. Interface pressure was measured using a force-sensitive area. In one protocol, both the gluteal and hamstring (g+h) muscles were activated, in the other gluteal (g) muscles only.
  
  
  OBJECTIVE
  To study and compare the effects of electrically induced activation of g+h muscles versus g muscles only on sitting pressure distribution in individuals with a spinal cord injury (SCI).
  
  
  METHODS
  Ischial tuberosities interface pressure (ITs pressure) and pressure gradient.
  
  
  RESULTS
  In all participants, both protocols of g and g+h ES-induced activation caused a significant decrease in IT pressure. IT pressure after g+h muscles activation was reduced significantly by 34.5% compared with rest pressure, whereas a significant reduction of 10.2% after activation of g muscles only was found. Pressure gradient reduced significantly only after stimulation of g+h muscles (49.3%). g+h muscles activation showed a decrease in pressure relief (Δ IT) over time compared with g muscles only.
  
  
  CONCLUSIONS
  Both protocols of surface ES-induced of g and g+h activation gave pressure relief from the ITs. Activation of both g+h muscles in SCI resulted in better IT pressure reduction in sitting individuals with a SCI than activation of g muscles only. ES might be a promising method in preventing pressure ulcers (PUs) on the ITs in people with SCI. Further research needs to show which pressure reduction is sufficient in preventing PUs.
authors.affiliation: Amsterdam Rehabilitation Research Institute, Reade, Centre for Rehabilitation and Rheumatology, Amsterdam, The Netherlands. c.smit@reade.nl
authors.forename: C A J
authors.initials: CA
authors.lastname: Smit
authors.forename: G L G
authors.initials: GL
authors.lastname: Haverkamp
authors.forename: S
authors.initials: S
authors.lastname: de Groot
authors.forename: J M
authors.initials: JM
authors.lastname: Stolwijk-Swuste
authors.forename: T W J
authors.initials: TW
authors.lastname: Janssen
mesh_terms: D000328:Adult; D004558:Electric Stimulation / Q000379:methods; D004599:Electric Stimulation Therapy / Q000379:methods*; D006801:Humans; D007512:Ischium / Q000503:physiopathology; D008875:Middle Aged; D009043:Motor Activity; D018482:Muscle, Skeletal / Q000503:physiopathology*; D011187:Posture / Q000502:physiology; D011312:Pressure; D003668:Pressure Ulcer / Q000517:prevention & control*; D013119:Spinal Cord Injuries / Q000150:complications / Q000628:therapy*; D055815:Young Adult