Post Doc Competition (Clinical/Best Practice Implementation) ID 1985647 4th Place Winner: Validity and feasibility of different functional electrical stimulation protocols for walking in individuals with incomplete spinal cord injury: a case series

• Published in: Topics in spinal cord injury rehabilitation Vol. 29; no. Supplement; p. 204
• Main Authors: Tajali, Shirin, Iwasa, Stephanie N, Atputharaj, Sharmini, Sin, Vivian, Desai, Naaz, Musselman, Kristin E, Popovic, Milos R, Masani, Kei
• Format: Journal Article
• Language: English
• Published: Frederick Allen Press Inc 01.09.2023; American Spinal Injury Association
• Subjects: Kinematics; Post-Doc Competition Abstract; Rehabilitation; Spinal cord injuries
• ISSN: 1082-0744; 1945-5763
• DOI: 10.46292/sci23-1985647S

BackgroundFunctional electrical stimulation (FES) of paralyzed muscles can facilitate walking after spinal cord injury (SCI).ObjectiveTo test the orthotic effects of different FES walking protocols on lower joint kinematics in individuals with incomplete SCI.MethodsThree adults with motor incomplete SCI participated in this study. Their lower extremity motor scores [LEMS (left, right)] were as follows: subject A: 25/25, subject B:15/25, subject C:9/23. They were asked to randomly complete four conditions of overground walking in a 4-meter walkway (6-10 times/condition) including no FES, and three bilateral FES walking protocols as follows: drop-foot (tibialis anterior stimulation), flexor withdrawal (common peroneal nerve stimulation), and multi-muscle stimulation (stimulation of quadriceps and gastrocnemius in the stance phase, and hamstring and tibialis anterior in the swing phase). The FES system obtained gait phase information from the two footswitches located under the individuals’ feet. Three-dimensional kinematic analysis was undertaken to measure minimum toe clearance (MTC), ankle, and hip range of motion (ROM) using a 100 Hz eight infrared camera (Vicon Motion Systems, Oxford, UK).ResultsThe three FES-walking conditions significantly increased MTC compared to the no-FES condition in all participants. A significant decrease in ankle ROM was seen in the drop-foot (all subjects), multi-muscle (subjects A and C), and flexor withdrawal (subject A) stimulations. Hip ROM increased in the drop-foot (subjects B and C), flexor withdrawal (subject B), and multi-muscle (subject C) stimulations.ConclusionsThree FES-walking protocols induced positive kinematic changes (increased hip flexion and toe clearance) during walking in subjects with incomplete SCI.