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Selecting candidates for a lower limb stimulator implant programme: a patient-centred method
D N Rushton1, F M Barr, N de N Donaldson
1Department of Rehabilitation, King's College Hospital, London.
Spinal Cord
|May 28, 1998
Summary
Developing an effective selection procedure for lower limb functional neurostimulation (LLFNS) for standing in paraplegia is crucial. This study refined criteria, with a small percentage of participants achieving successful home standing via LLFNS.
Area of Science:
- Biomedical Engineering
- Rehabilitation Science
- Neuroscience
Background:
- Paraplegia presents significant mobility challenges, impacting independence and quality of life.
- Lower Limb Functional Neurostimulation (LLFNS) offers a potential solution for restoring standing function.
- Effective patient selection is critical for successful LLFNS outcomes.
Purpose of the Study:
- To establish a robust selection procedure for identifying suitable candidates for LLFNS.
- To optimize the process for achieving functional standing in individuals with paraplegia.
Main Methods:
- A staged selection procedure was developed based on prior LLFNS experience.
- 254 community-dwelling paraplegics were assessed for suitability.
- The procedure included rigorous criteria and allowed participant withdrawal.
Main Results:
- 57 out of 254 patients initially met paper criteria.
- Only 19 expressed interest, and 12 fulfilled all selection criteria.
- Ten patients completed muscle training, with seven achieving laboratory standing and four achieving home standing.
Conclusions:
- The developed selection procedure effectively identified individuals capable of achieving functional standing with LLFNS.
- A significant drop-off rate highlights the importance of stringent selection for this technology.
- Further refinement may improve accessibility and success rates for LLFNS.