Article

The purpose of this single-subject study was to determine the neurotherapeutic
and neuroprosthetic effects of an implanted functional electrical stimulation (FES) system designed to facilitate walking in an individual with a longstanding
motor and sensory incomplete spinal cord injury. An implanted pulse generator and
eight intramuscular stimulating electrodes were installed unilaterally,
activating weak or paralyzed hip flexors, hip and knee extensors, and ankle
dorsiflexors during 36 sessions of gait training with FES. The neurotherapeutic
effects were assessed by a comparison of pre- and posttraining volitional
walking. The neuroprosthetic effects were assessed by a comparison of
posttraining volitional and FES-assisted walking. Treatment resulted in
significant (p < 0.005) volitional improvements in 6-minute walking distance and
speed, speed during maximum walk, double support time, and 10 m walking speed.
Posttraining FES-assisted walking resulted in significant additional improvements
in all these measures, except 10 m walking speed. When the subject was using
FES-assisted gait, maximum walking distance, peak knee flexion in swing, peak ankle dorsiflexion in swing, and knee extension moment also significantly
increased. Neuroprosthetic gains were sufficient to enable the subject to advance
from household ambulation to limited community ambulation. Additionally, the subject could perform multiple walks per day when using FES-assisted gait, which
was impossible with volitional effort alone.

Langue : ANGLAIS