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Electromechanical gait training with functional electrical stimulation: case studies in spinal cord injury
S Hesse1, C Werner, A Bardeleben
1Klinik Berlin, Department of Neurological Rehabilitation, Free University Berlin, Germany.
Study Design:
Single case studies.
Objectives:
To describe the technique of intensive locomotor training on an electromechanical gait trainer (GT) combined with functional electrical stimulation (FES).
Setting:
Neurological Rehabilitation Clinic, Berlin, Germany.
Methods:
Four spinal cord-injured (SCI) patients, one tetraparetic, two paraparetic, and one patient with an incomplete cauda syndrome, more than 3 months postinjury, who were unable to walk at all, or with two therapists. They received 25 min of locomotor training on the GT plus FES daily for 5 weeks in addition to the regular therapy.
Results:
The patients tolerated the programme well, and therapists rated the programme less strenuous compared to manually assisted treadmill training. Gait ability improved in all four patients; three patients could walk independently on the floor with the help of technical aids, and one required the help of one therapist after therapy; gait speed and endurance more than doubled, and the gastrocnemius activity increased in the patients with a central paresis.
Conclusion:
This combined technique allows intensive locomotor therapy in SCI subjects with reduced effort from the therapists. The patients' improved walking ability confirmed the potential of locomotor therapy in SCI subjects.