A clinical exercise system for paraplegics using functional electrical stimulation

A low cost clinical exercise system was developed for the spinal cord injured, based on a bicycle ergometer and electrical stimulation. A pilot project was conducted, using the system, to examine the effects of stimulation induced cycling in long term paraplegics. The project comprised 2 phases of exercise, a strengthening phase involving a 12 week programme of electrical stimulation to the quadriceps and hamstrings and a 12 week cycling phase. Physiological, morphological and biochemical parameters were measured for each subject, at the beginning of the programme and following each phase. Results showed that a programme of stimulation induced lower limb exercise increased the exercise tolerance of all patients, as determined by a progressive increase in exercise time, cycling rate and exercise load. The enhanced exercise tolerance was a result of increases in local muscle strength and endurance. Increases in thigh muscle area and joint range of motion were recorded and all incomplete subjects reported an improvement in functional capabilities and general wellbeing.

[1]  E. Condie,et al.  Functional Electrical Stimulation: Standing and Walking After Spinal Cord Injury , 1990 .

[2]  M. J. Parker,et al.  Measurement of quadriceps muscle wasting by ultrasonography. , 1980, Rheumatology and rehabilitation.

[3]  J S Petrofsky,et al.  Closed loop control for restoration of movement in paralyzed muscle. , 1984, Orthopedics.

[4]  T. Ingemann-Hansen,et al.  Computerized tomographic determination of human thigh components. The effects of immobilization in plaster and subsequent physical training. , 1980, Scandinavian journal of rehabilitation medicine.

[5]  K. Ragnarsson,et al.  Physiologic effects of functional electrical stimulation-induced exercises in spinal cord-injured individuals. , 1988, Clinical orthopaedics and related research.

[6]  H Thoma,et al.  Functional electrostimulation of paraplegics: experimental investigations and first clinical experience with an implantable stimulation device. , 1984, Orthopedics.

[7]  Chandler A. Phillips,et al.  Aerobic Trainer with Physiological Monitoring for Exercise in Paraplegic and Quadriplegic Patients , 1985 .

[8]  P. Cavanagh,et al.  The physiology and biomechanics of cycling , 1978 .

[9]  J S Petrofsky,et al.  Functional electrical exercise: a comprehensive approach for physical conditioning of the spinal cord injured patient. , 1984, Orthopedics.

[10]  S. P. Levine,et al.  Electric muscle stimulation for pressure sore prevention: tissue shape variation. , 1990, Archives of physical medicine and rehabilitation.

[11]  T. Ackland,et al.  The Uniform Density Assumption: Its Effect upon the Estimation of Body Segment Inertial Parameters , 1988 .

[12]  L. Guttmann Spinal cord injuries: comprehensive management and research , 1973 .

[13]  J. Petrofsky,et al.  Clinical evaluation of computerized functional electrical stimulation after spinal cord injury: a multicenter pilot study. , 1988, Archives of physical medicine and rehabilitation.

[14]  D. Halliday,et al.  Muscle and bone in paraplegic patients, and the effect of functional electrical stimulation. , 1988, Clinical science.

[15]  T. Bajd,et al.  Electrical stimulation providing functional use of paraplegic patient muscles. , 1980, Medical progress through technology.

[16]  R. M. Glaser,et al.  Physiologic aspects of spinal cord injury and functional neuromuscular stimulation. , 1986, Central nervous system trauma : journal of the American Paralysis Association.

[17]  G F Inbar,et al.  Optimization of pulse duration and pulse charge during transcutaneous electrical nerve stimulation. , 1983, The Australian journal of physiotherapy.

[18]  R. Maughan,et al.  Strength and cross‐sectional area of human skeletal muscle. , 1983, The Journal of physiology.

[19]  N. Ramanathan,et al.  A NEW WEIGHTING SYSTEM FOR MEAN SURFACE TEMPERATURE OF THE HUMAN BODY. , 1964, Journal of applied physiology.

[20]  D. Halliday,et al.  Effect of anaerobic and aerobic exercise promoted by computer regulated functional electrical stimulation (FES) on muscle size, strength and histology in paraplegic males , 1987, Prosthetics and orthotics international.

[21]  E. Marsolais,et al.  Functional walking in paralyzed patients by means of electrical stimulation. , 1983, Clinical orthopaedics and related research.

[22]  J. Petrofsky,et al.  A medical evaluation of the effects of computer assisted muscle stimulation in paraplegic patients. , 1984, Orthopedics.

[23]  Cross-sectional area of the thigh muscle in man measured by computed tomography. , 1978 .

[24]  S. P. Levine,et al.  Electrical muscle stimulation for pressure variation at the seating interface. , 1989, Journal of rehabilitation research and development.

[25]  T L Munsat,et al.  Effects of nerve stimulation on human muscle. , 1976, Archives of neurology.

[26]  M O Ericson,et al.  Muscular activity during ergometer cycling. , 1985, Scandinavian journal of rehabilitation medicine.

[27]  K. Ottenbacher Evaluating Clinical Change: Strategies for Occupational and Physical Therapists , 1986 .

[28]  K. Ragnarsson,et al.  Aerobic training effects of electrically induced lower extremity exercises in spinal cord injured people. , 1989, Archives of physical medicine and rehabilitation.

[29]  D. R. White,et al.  The composition of body tissues. , 1986, The British journal of radiology.

[30]  P W Henson,et al.  Tissue density measurement using CT scanning. , 1987, Australasian physical & engineering sciences in medicine.

[31]  J S Petrofsky,et al.  The use of functional electrical stimulation for rehabilitation of spinal cord injured patients. , 1984, Central nervous system trauma : journal of the American Paralysis Association.

[32]  R. Tiwari,et al.  Massive Scalar Field: Source of the Graviton and 'Strong Gravity' , 1976 .