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Functional electrical stimulation for walking in paraplegia.

E B Marsolais, R Kobetic

    The Journal of Bone and Joint Surgery. American Volume
    |June 1, 1987
    PubMed
    Summary
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    Paraplegic individuals achieved independent walking using a microprocessor-controlled stimulator and implanted electrodes. This functional electrical stimulation (FES) enabled reciprocal leg movements and improved muscle strength over time.

    Area of Science:

    • Neuroscience
    • Biomedical Engineering
    • Rehabilitation Medicine

    Background:

    • Spinal cord injury (SCI) often results in paraplegia, leading to loss of voluntary leg movement.
    • Restoring ambulation is a primary goal in SCI rehabilitation.
    • Functional electrical stimulation (FES) offers a potential avenue for regaining mobility.

    Purpose of the Study:

    • To assess the efficacy of a portable microprocessor-controlled stimulator for achieving independent reciprocal walking in paraplegic subjects.
    • To evaluate the long-term effects of FES training on muscle strength and control.

    Main Methods:

    • Percutaneous intramuscular wire electrodes were implanted in hip, knee, and ankle muscles of paraplegic subjects.
    • A portable microprocessor-controlled stimulator delivered electrical impulses to activate muscles.

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  • Subjects initiated each step using a hand-operated switch and underwent extensive training.

    • Main Results:

    • Independent reciprocal walking was achieved in subjects with thoracic spinal cord transection.
    • Subjects demonstrated strong, selective, and reproducible muscular contractions.
    • Muscle strength increased significantly during 22-44 months of training.
    • Some subjects progressed to using walkers, crutches, and even climbing stairs.

    Conclusions:

    • Microprocessor-controlled FES is a viable method for restoring reciprocal walking in paraplegic individuals.
    • Long-term training leads to improved muscle function and functional gains.
    • This technology holds promise for enhancing mobility and independence after spinal cord injury.