The Orthotic Effect of Functional Electrical Stimulation on Reactive Stepping for People With Incomplete Spinal Cord...

Area of Science:

• Neuroscience and Rehabilitation Engineering
• Spinal Cord Injury Research
• Biomechanics of Human Movement

Background:

• Individuals with incomplete spinal cord injury (iSCI) experience difficulties initiating reactive steps, increasing fall risk.
• Reactive balance training (RBT) improves balance, but requires independent stepping ability.
• Functional electrical stimulation (FES) can aid RBT participation by facilitating stepping responses.

Purpose of the Study:

• To evaluate the immediate (orthotic) effect of FES on reactive stepping parameters in individuals with chronic motor iSCI.
• To determine if FES applied to the common fibular nerve (CFN) improves reactive stepping responses following a simulated fall.

Main Methods:

• Sixteen participants with chronic motor iSCI underwent a Lean-and-Release test to elicit reactive steps.
• Functional electrical stimulation (FES) was applied to the common fibular nerve (CFN) in half of the trials, randomly.
• Behavioral responses (step count, fall) and temporal/spatial parameters of the first reactive step were recorded.

Main Results:

• No significant differences were observed in the proportion of single-step, two-step, ≥3-step, or fall responses between FES and No-FES conditions.
• Temporal parameters of the first reactive step (foot-off time, swing time, step time) did not differ significantly with FES.
• Spatial parameters of the first reactive step (length, height, width) also showed no significant differences between conditions.

Conclusions:

• Functional electrical stimulation (FES) demonstrated no immediate orthotic effect on reactive stepping parameters in individuals with chronic motor iSCI.
• The application of FES to the common fibular nerve (CFN) did not enhance the ability to initiate or execute reactive steps in this cohort.