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Updated: Jun 16, 2026
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Paradigms of Lower Extremity Electrical Stimulation Training After Spinal Cord Injury
Published on: February 1, 2018
Functional Electrical Stimulation Combined With Reactive Balance Training for Individuals With Incomplete Spinal Cord
Matthew G Heffernan1,2, Katherine Chan2, Jonguk Lee2,3
1Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, ON, Canada.
Neurorehabilitation and Neural Repair
|June 15, 2026
Summary
Reactive balance training (RBT) with or without functional electrical stimulation (FES) improved reactive stepping and balance in individuals with spinal cord injury. The addition of FES did not offer additional benefits over RBT alone.
Area of Science:
- Neurology
- Rehabilitation Medicine
- Biomechanics
Background:
- Individuals with motor incomplete spinal cord injury (iSCI) often struggle with reactive stepping, increasing fall risk.
- Functional electrical stimulation (FES) can elicit a flexor withdrawal response, potentially aiding reactive stepping.
- Combining RBT with FES may enhance reactive balance control in iSCI populations.
Purpose of the Study:
- To compare the efficacy of RBT combined with FES (RBT+FES) against RBT alone.
- To assess improvements in reactive stepping, balance, and related clinical outcomes.
- To evaluate the added benefit of FES in individuals with chronic motor iSCI.
Main Methods:
- Twenty-two individuals with chronic motor iSCI were randomized to RBT+FES or RBT alone.
- Participants completed 18 training sessions over 6 weeks.
- Outcome measures included the Lean-and-Release test, clinical balance assessments, and fall incidence monitoring for 6 months.
Main Results:
- Both groups showed significant improvements in reactive stepping (single-step responses) and clinical balance outcomes.
- No significant differences were found between the RBT+FES and RBT alone groups.
- Ankle proprioception did not significantly improve, and fall incidence did not differ between groups.
Conclusions:
- Both RBT+FES and RBT alone effectively improved reactive stepping, balance control, confidence, and strength in individuals with iSCI.
- The specific FES protocol used in this study did not provide additional benefits compared to RBT alone.
