Improving Upper Extremity Strength, Function, and Trunk Stability Using Wide-Pulse Functional Electrical Stimulation in Combination With Functional Task-Specific Practice

2022 ◽  
Author(s):  
Candace Tefertiller ◽  
Patricia Bartelt ◽  
Maureen Stobelaar ◽  
Susie Charlifue ◽  
Mitch Sevigny ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Upper Extremity ◽  
Functional Electrical Stimulation ◽  
Strength Function ◽  
Case Series ◽  
Convenience Sample ◽  
Cord Injury ◽  
Specific Practice ◽  
Functional Task ◽  
Dynamic Sitting

Objectives: To evaluate upper extremity (UE) function, strength, and dynamic sitting balance in individuals with spinal cord injury (SCI) who received an intensive outpatient therapy program focused on UE training augmented with wide pulse/high frequency functional electrical stimulation (WPHF-FES). Methods: This prospective case series was conducted in an outpatient (OP) clinic in an SCI-specific rehabilitation hospital. Participants were a convenience sample (N = 50) of individuals with tetraplegia receiving OP therapy focused on UE recovery. Individuals participated in 60 minutes of UE functional task-specific practice (FTP) in combination with WPHF-FES 5 times/week for an average of 72 sessions. The primary outcome for this analysis was the Capabilities of Upper Extremity Test (CUE-T). Secondary outcomes include UE motor score (UEMS) and the modified functional reach (MFR). Results: Fifty individuals (13 motor complete; 37 motor incomplete SCI) completed an OP UE training program incorporating WPHF-FES and were included in this analysis. On average, participants demonstrated significant improvements in the total CUE-T score of 14.1 (SD = 10.0, p < .0001) points; significant changes were also noted in UEMS and MFR, improving an average of 4.6 (SD = 5.2, p < .0001) points and 13.6 (SD = 15.8, p < .0001) cm, respectively. Conclusion: Individuals with tetraplegia demonstrated significant improvements in UE strength, function, and dynamic sitting trunk balance after receiving UE training augmented with WPHF-FES. Future comparative effectiveness studies need to be completed to guide efficacious treatment interventions in OP therapy.

scholarly journals The Effect of Functional Electrical Stimulation and Therapeutic Exercises on Trunk Muscle Tone and Dynamic Sitting Balance in Persons with Chronic Spinal Cord Injury: A Crossover Trial

Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 619
Author(s):  
Margot Bergmann ◽  
Anna Zahharova ◽  
Märt Reinvee ◽  
Toomas Asser ◽  
Helena Gapeyeva ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Muscle Tone ◽  
Study Groups ◽  
Therapy Program ◽  
Sitting Balance ◽  
Cord Injury ◽  
Dynamic Sitting

Background and objectives: Functional electrical stimulation (FES) has shown good results in improving static and dynamic sitting balance in persons with spinal cord injuries. There is limited information about how regular surface FES combined with therapeutic exercise (TE) affect dynamic sitting balance and muscle tone. The objective of this study was to evaluate the effectiveness of a six-week physical therapy program consisting of FES and TE on muscle tone and sitting balance in persons with spinal cord injury (SCI). It was also important to explore the relationship between muscle tone and dynamic sitting balance. The third objective was to assess the change of characteristics over a six month period, when no intervention was carried out. Material and methods: Five men with SCI were alternately allocated to two study groups: SCI_FES+TE and SCI_TE. Eight healthy control group participants were recruited to collect reference data. SCI participants’ intervention lasted for six weeks in their homes. SCI_FES+TE conducted exercises with FES applied on erector spinae (ES) and rectus abdominis (RA) muscles. SCI_TE conducted exercises only. Muscle oscillation frequency (MOF; characterizing muscle tone) and limits of stability (LOS; characterizing sitting balance) were measured. A crossover study design was used. The time between the initial intervention and the crossover was seven months (ClinicalTrials registration ID NCT03517787). Results: MOF in SCI_FES+TE increased by 6.0% for ES and 6.1% for RA muscles. LOS of flexion increased 30.1% in SCI_FES+TE. Increase in lateral directions was similar for both study groups. Moderate to high negative correlation was found between MOF and LOS. After seven months, MOF of ES decreased 0.8%, MOF or RA decreased 1.4%, LOS of flexion decreased 31.9%, and LOS of lateral flexion to the left decreased 46.4%. Conclusions: The six-week therapy program combining FES and TE increased trunk muscle tone and dynamic sitting balance in flexion more than TE alone. Higher antagonist muscle tone negatively affects dynamic sitting balance and center of pressure (COP) trajectory distance in various directions. After seven months, a slight decline in trunk muscles tone values and an extensive decrease in sitting balance values were noticed.

scholarly journals The Performance of Aerobic Exercising by Spinal Cord Injury Patients Through the Application of Functional Electrical Stimulation

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Camellia Srikanthan ◽  
Dr. Sukhendu Dutta
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Electrical Stimulation ◽  
Exercise Training ◽  
Functional Electrical Stimulation ◽  
Repeated Measures ◽  
Case Series ◽  
Rank Test ◽  
Repeated Measures Design ◽  
Cord Injury

Evoking a muscular response using Functional Electrical Stimulation onto paralyzed muscles will allow patients with spinal cord damage at the level of C4-L1 to perform aerobic and strengthening exercise training. The provoked activity will improve body strength, body composition, mitigate disuse atrophy, and enhance cardiopulmonary function. The study designs included case report, case control, case series, pre-clinical and post-clinical intervention and outcomes measure, clinical trial, prospective cohort study, cross-sectional, and longitudinal repeated measures design. The statistical methods and methods of data analysis used were ANOVA, ASIA impairment scores, ? level and p-value, mean ± standard error, r2, Student paired t-test, PASW statistics, Spearman rank correlation coefficient, Mann-Whitney U test, regression analysis, and Wilcoxon signed-rank test. The outcome of the study showed an increase in muscle thickness, strength, and lean muscle mass. There was improvement in oxygen consumption, positive effect on cardiorespiratory functioning, metabolic activity, and a slight increase in bone density. Subjects were able to perform more intense exercising as the training regime had progressed. The significance of these findings shows a potential way to improve the health of subjects with spinal cord injury, but also to recover and eventually regain the use of the muscles that were once paralyzed. Functional electrical stimulation therapy will introduce physical activity to a population that is normally found to be inactive.   Keywords: Functional electrical stimulation, spinal cord injury, FES-cycling, FES-rowing, rehabilitation, exercise training

Effects of Mirror Therapy Combined With EMG-triggered Functional Electrical Stimulation to Improve on Upper Extremity Function in Patient with Chronic Stroke

2020 ◽  
Author(s):  
Joo Yeol Jung ◽  
Pong Sub Youn ◽  
Dong Hoon Kim
Keyword(s):  
Electrical Stimulation ◽  
Physical Therapy ◽  
Muscle Strength ◽  
Range Of Motion ◽  
Upper Extremity ◽  
Functional Electrical Stimulation ◽  
Chronic Stroke ◽  
Mirror Therapy ◽  
Extremity Function ◽  
Upper Extremity Function

AbstractThis study was performed to evaluate the effects of Mirror therapy combined with EMG-triggered Functional Electrical Stimulation on upper extremity function in patient with Chronic Stroke. A total of 24 chronic stroke patients were divided into 3 groups. Group I (n=8) was given with traditional physical therapy (TPT), group II (n=7) was given with traditional physical therapy and mirror therapy (MT), and group III (n=9) was given with traditional physical therapy and mirror therapy in conjunction with EMG-triggered Functional Electrical Stimulation (EMGFES-MT). Each group performed one hour a day 5 times a week for 6 weeks.We obtained the following result between before and after treatments about changes of elbow flexion muscle strength (EFMS), elbow extension muscle strength (EEMS), wrist flexion muscle strength (WFMS), wrist extension muscle strength (WEMS), elbow flexion range of motion (EFROM), elbow extension range of motion (EEROM), wrist flexion range of motion (WFROM), wrist extension range of motion (WEROM), grip strength (GS) and upper extremity function.Each group showed a significant difference in EFMS, EEMS, WFMS, WEMS, EFROM, EEROM, WFROM, WEROM, GS and upper extremity function (p<0.05) EMFES-MT group revealed significant differences in EEMS, WEROM, grip strength and upper extremity function as compared to the other groups (p<0.05). No difference was found in the change of spasticity among the 3 groups.Our results showed that EMFES-MT was more effective on elbow, WFMS, WEMS, AROM, grip strength and upper extremity function in patients with chronic stroke. We suggest that this study will be able to be used as an intervention data for recovering upper extremity function in chronic stroke patients

scholarly journals Evaluation of Individualized Functional Electrical Stimulation-Induced Acute Changes during Walking: A Case Series in Children with Cerebral Palsy

Sensors ◽  
2021 ◽  
Vol 21 (13) ◽  
pp. 4452
Author(s):  
Nicole Zahradka ◽  
Ahad Behboodi ◽  
Ashwini Sansare ◽  
Samuel C. K. Lee
Keyword(s):  
Cerebral Palsy ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Case Series ◽  
Phase Detection ◽  
Lower Extremity Muscle ◽  
Children With Cerebral Palsy ◽  
Muscle Groups

Functional electrical stimulation (FES) walking interventions have demonstrated improvements to gait parameters; however, studies were often confined to stimulation of one or two muscle groups. Increased options such as number of muscle groups targeted, timing of stimulation delivery, and level of stimulation are needed to address subject-specific gait deviations. We aimed to demonstrate the feasibility of using a FES system with increased stimulation options during walking in children with cerebral palsy (CP). Three physical therapists designed individualized stimulation programs for six children with CP to target participant-specific gait deviations. Stimulation settings (pulse duration and current) were tuned to each participant. Participants donned our custom FES system that utilized gait phase detection to control stimulation to lower extremity muscle groups and walked on a treadmill at a self-selected speed. Motion capture data were collected during walking with and without the individualized stimulation program. Eight gait metrics and associated timing were compared between walking conditions. The prescribed participant-specific stimulation programs induced significant change towards typical gait in at least one metric for each participant with one iteration of FES-walking. FES systems with increased stimulation options have the potential to allow the physical therapist to better target the individual’s gait deviations than a one size fits all device.

scholarly journals Effects of Functional Electrical Stimulation Cycling of Different Duration on Viscoelastic and Electromyographic Properties of the Knee in Patients with Spinal Cord Injury

2020 ◽  
Vol 11 (1) ◽  
pp. 7
Author(s):  
Antonino Casabona ◽  
Maria Stella Valle ◽  
Claudio Dominante ◽  
Luca Laudani ◽  
Maria Pia Onesta ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Muscle Activity ◽  
Response Times ◽  
Electromyographic Activity ◽  
Functional Changes ◽  
Pendulum Test ◽  
Cord Injury

The benefits of functional electrical stimulation during cycling (FES-cycling) have been ascertained following spinal cord injury. The instrumented pendulum test was applied to chronic paraplegic patients to investigate the effects of FES-cycling of different duration (20-min vs. 40-min) on biomechanical and electromyographic characterization of knee mobility. Seven adults with post-traumatic paraplegia attended two FES-cycling sessions, a 20-min and a 40-min one, in a random order. Knee angular excursion, stiffness and viscosity were measured using the pendulum test before and after each session. Surface electromyographic activity was recorded from the rectus femoris (RF) and biceps femoris (BF) muscles. FES-cycling led to reduced excursion (p < 0.001) and increased stiffness (p = 0.005) of the knee, which was more evident after the 20-min than 40-min session. Noteworthy, biomechanical changes were associated with an increase of muscle activity and changes in latency of muscle activity only for 20-min, with anticipated response times for RF (p < 0.001) and delayed responses for BF (p = 0.033). These results indicate that significant functional changes in knee mobility can be achieved by FES-cycling for 20 min, as evaluated by the pendulum test in patients with chronic paraplegia. The observed muscle behaviour suggests modulatory effects of exercise on spinal network aimed to partially restore automatic neuronal processes.

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