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Updated: Dec 29, 2025

Paradigms of Lower Extremity Electrical Stimulation Training After Spinal Cord Injury
Published on: February 1, 2018
Feasibility of overnight electrical stimulation-induced muscle activation in people with a spinal cord injury. A
Christof A J Smit1, Frank Berenpas2, Sonja de Groot1,3
1Amsterdam Rehabilitation Research Center | Reade, Amsterdam, The Netherlands.
Study Design:
We investigated whether overnight ES is a feasible method to activate gluteal, quadriceps, and hamstrings muscles in a two-week experiment. Electrical stimulation (ES) induced muscle contractions have proven positive effects on risk factors for developing pressure ulcers in people with a spinal cord injury (SCI). Therefore prolonged overnight ES-induced muscle activation is interesting, but has never been studied.
Objective:
To study feasibility of ES-induced leg muscle activation. In eight participants with motor complete SCI gluteal, hamstrings and quadriceps muscles were activated with a 2-weeks overnight stimulation protocol, 8 h per night, using specially developed ES-shorts.
Setting:
The Netherlands.
Methods:
Muscle fatigue was determined with a muscle contraction sensor. Questionnaires on sleep quality (SQ) and the ES-shorts usability were taken.
Results:
After 8 h of activation muscles still contracted, although fatigue occurred, and mean contraction size was lower at the end of a cycle (p = 0.03). SQ (0-100) after intervention was 75, and 66 after 4 weeks without overnight ES (p = 0.04) indicating ES improves sleep quality. The usability of the ES-shorts was good.
Conclusions:
This study shows that overnight ES-induced muscle activation using ES-shorts in SCI is a new, feasible method that does not interfere with sleep. The nightly use of the ES-shorts might be considered as an important part of the daily routine in SCI.
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