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Standing up with denervated muscles in humans using functional electrical stimulation
H Kern1, C Hofer, M Strohhofer
1Department of Physical Medicine and Rehabilitation, Wilhelminenspital, Vienna, Austria.
Artificial Organs
|June 23, 1999
Summary
Electrical stimulation can effectively train denervated muscles, leading to functional improvements in paraplegic patients. This approach, using high-amplitude, long-duration pulses, helps build muscle strength for activities like standing.
Area of Science:
- Neuroscience
- Rehabilitation Medicine
- Biomedical Engineering
Background:
- Electrical stimulation for denervated muscles is controversial due to past challenges with exponential currents.
- Previous methods were considered ineffective for long-term denervated muscle treatment.
Purpose of the Study:
- To investigate the efficacy of long-duration, high-amplitude electrical stimulation for training denervated muscles.
- To determine if denervated muscles can achieve functional strength and performance.
Main Methods:
- Utilized long-duration electrical stimulation with anatomically shaped electrodes and high pulse amplitudes (exceeding 300 mJ/impulse).
- Applied functional electrical stimulation (FES) with ankle weights to patients with spinal cord injury (D12/L1) and lower extremity paralysis.
- Conducted daily FES training over 1-2 years.
Main Results:
- Successfully evoked tetanic contractions in denervated muscles, achieving muscle fiber tension and hypertrophic stimulus.
- Patients with complete spinal cord injury demonstrated trainable denervated muscles, progressing from single to tetanic contractions against gravity.
- Quadriceps muscles generated 16-38 Nm torques, enabling patients to stand from a sitting position.
Conclusions:
- Denervated human muscle is trainable using the described FES method, achieving functional strength.
- This FES approach can aid in decubitus ulcer prevention and enhance paraplegic mobility.