Article

OBJECTIVE: To compare the magnitude of interface pressure changes during gluteal
maximus contraction by stimulating sacral nerve roots with surface electrical
stimulations in patients with spinal cord injuries (SCIs). DESIGN: Pilot
interventional study. SETTING: Spinal injury research laboratory. PARTICIPANTS:
Adults (N=18) with suprasacral complete SCI. INTERVENTIONS: Sacral nerve root
stimulation (SNRS) via a functional magnetic stimulator (FMS) or a sacral
anterior root stimulator (SARS) implant; and surface functional electrical
stimulation (FES). MAIN OUTCOME MEASURES: Interface pressure under the ischial
tuberosity (IT) defined as peak pressure, gradient at peak pressure, and average
pressure. RESULTS: With optimal FMS, a 29% average reduction of IT peak pressure
was achieved during FMS (mean +/- SD: 160.1+/-24.3mmHg at rest vs
114.7+/-18.0mmHg during FMS, t5=6.3, P=.002). A 30% average reduction of peak
pressure during stimulation via an SARS implant (143.2+/-31.7mmHg at rest vs
98.5+/-21.5mmHg during SARS, t5=4.4, P=.007) and a 22% average decrease of IT
peak pressure during FES stimulation (153.7+/-34.8mmHg at rest vs
120.5+/-26.1mmHg during FES, t5=5.3, P=.003) were obtained. In 4 participants who
completed both the FMS and FES studies, the percentage of peak pressure reduction
with FMS was slightly greater than with FES (mean difference, 7.8%; 95%
confidence interval, 1.6%-14.0; P=.04). CONCLUSIONS: SNRS or surface FES can
induce sufficient gluteus maximus contraction and significantly reduce ischial
pressure. SNRS via an SARS implant may be more convenient and efficient for
frequently activating the gluteus maximus.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS