Activation of paraplegic patients by functional electrical stimulation: training and biomechanical evaluation

A training method for the activation of the lower limb muscles of paraplegics by functional electrical stimulation (FES) for standing and walking is described. It consists of a daily program which does not interfere with the normal routine of the patient. The treatment of four patients, paralysed form 7 to 30 years, is described. In these patients, a good standing position was achieved by stimulating the quadriceps, sometimes supplemented by the gluteus maximus or medius muscles. Gait was obtained by activation of the flexion reflex in a single stimulation and by tilting the trunk. Difficulties during gait were encountered due to the strong adduction of the legs. No mechanical support was required for locking of the lower limb joints. However, to maintain the equilibrium of the body, external support such as parallel bars, walker or Canadian crutches were used. During treatment gait improved due to reduction of spasticity and better stability of the body. Biomechanical measurements of weight bearing on the legs indicated values ranging between 41 to 65% of the body weight. During gait, a steady improvement of velocity was noted, with a parallel decrease in stance and stride times.