Article

OBJECTIVE: To determine the stimulated strength of the paralyzed gluteal and
paraspinal muscles and their effects on the seated function of individuals with
paralysis. DESIGN: Case series with subjects acting as their own concurrent
controls. SETTING: Hospital-based clinical biomechanics laboratory. PARTICIPANTS:
Users (N=8) of implanted neuroprostheses for lower extremity function with
low-cervical or thoracic level injuries. INTERVENTIONS: Dynamometry and digital
motion capture both with and without stimulation to the hip and trunk muscles.
MAIN OUTCOME MEASURES: Isometric trunk extension moment at 0 degrees , 15 degrees
, and 30 degrees of flexion; seated stability in terms of simulated isokinetic
rowing; pelvic tilt, shoulder height, loaded and unloaded bimanual reaching to
different heights, and subjective ratings of difficulty during unsupported
sitting. RESULTS: Stimulation produced significant increases in mean trunk
extension moment (9.2+/-9.5Nm, P<.001) and rowing force (27.4+/-23.1N, P<.012)
over baseline volitional values. Similarly, stimulation induced positive changes
in average pelvic tilt (16.7+/-15.7 degrees ) and shoulder height (2.2+/-2.5cm)
during quiet sitting and bimanual reaching, and increased mean reach distance
(5.5+/-6.6cm) over all subjects, target heights, and loading conditions. Subjects
consistently rated tasks with stimulation easier than voluntary effort alone.
CONCLUSIONS: In spite of considerable intersubject variability, stabilizing the
paralyzed trunk with electrical stimulation can positively impact seated posture,
extend forward reach, and allow exertion of larger forces on objects in the
environment.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS