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[Therapeutic and functional electrical stimulation for paraplegics]

H Kagaya1

  • 1Department of Orthopedic Surgery, Akita University School of Medicine, Japan.

Nihon Seikeigeka Gakkai Zasshi
|September 1, 1994
PubMed
Summary

Therapeutic electrical stimulation (TES) can improve muscle strength and size in paraplegics. Early intervention is key for maintaining muscle quality and aiding standing-up motion reconstruction.

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Area of Science:

  • Rehabilitation Medicine
  • Biomedical Engineering
  • Neurology

Background:

  • Paraplegia leads to significant muscle atrophy and functional loss.
  • Restoring motor function, particularly standing, is a critical goal in paraplegic rehabilitation.
  • Understanding muscle activation patterns during standing is essential for developing assistive technologies.

Purpose of the Study:

  • To evaluate the effects of therapeutic electrical stimulation (TES) on muscle cross-sectional area and force in paraplegics.
  • To analyze muscle activity and biomechanics during standing-up in healthy individuals to inform paraplegic rehabilitation.
  • To assess the feasibility of using TES to enable standing-up motion in a paraplegic patient.

Main Methods:

  • Computed tomography (CT), Cybex II, strain-gauge, and manual muscle testing (MMT) were used to assess muscle changes after 6 months of TES in 5 paraplegics.
  • Electromyography (EMG), joint angle, and floor reaction force were measured in 12 healthy subjects during two standing-up tasks.
  • A T6 paraplegic patient underwent TES-assisted standing-up using parallel bars, with biomechanical parameters recorded.

Main Results:

  • TES increased muscle cross-sectional area, CT numbers, torque, and force in paraplegics, provided initial MMT was > poor-minus.
  • Hands-assisted standing-up involved less muscle activity and lower peak vertical floor reaction force compared to unassisted standing.
  • The paraplegic patient demonstrated successful standing-up with TES, exhibiting distinct knee and ankle joint kinematics compared to healthy subjects.

Conclusions:

  • Early initiation of TES is recommended to maintain and improve muscle quality in paraplegia.
  • Data from healthy subjects' standing-up mechanics can guide TES protocols for paraplegic patients.
  • TES shows promise for reconstructing functional movements like standing-up in individuals with paraplegia.

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