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After a program of therapeutic electrical stimulation, 3 groups of incomplete spinal cord injured (SCI) patients were identified, those in whom an improvement of both voluntary and stimulated muscle force was observed, those with an increase in stimulation response only, and patients in whom no effect of electrical stimulation training could be recorded. As it is difficult to predict the outcome of the electrical stimulation rehabilitation process, a diagnostic procedure was developed to predict soon after accidents which incomplete SCI patients are candidates for permanent use of a functional electrical stimulation (FES) orthotic aid. The candidates for chronic use of FES are patients with weak ankle dorsiflexors and sufficiently strong knee extensors. These patients are equipped with a single channel peroneal stimulator augmenting dorsiflexion and knee and hip flexion in a total lower limb flexion response. By applying FES to the ankle plantar flexors, the swing phase of walking can be significantly shortened and faster walking obtained.

Thirteen tetraplegic patients were included in the study of the e ects of respiratory muscle training and of electrical stimulation of the abdominal muscles on their respiratory capabilities. Each patient was subjected for three 1 month lasting periods of the study: for inspiratory muscle training, expiratory muscle training and for a period without training. The sequence of these three periods was random for each patient. Respiratory tests (RT) measuring forced vital capacity (FVC) and forced expiratory volume in one second (FEV 1 ) were conducted before and following each monthly period. Measurements were taken under four sets of conditions: the patients' unassisted e orts, their e orts combined with pressure manually applied by a therapist to the upper part of their abdomen, and their e orts accompanied by electrical stimulation (ES) of the abdominal muscles during the early phase of expirium, once triggered by the therapist and once by the patients themselves. RT values were increased following respiratory muscle training and inspiratory training apparently had a slightly greater e ect than its expiratory counterpart. The increments of values of RT were statistically signi®cant (P50.05) after the inspiratory muscle training. RT measurements were greater when the patient's voluntary e ort was combined with ES of abdominal muscles than when it was not. This study concludes that respiratory muscle training is a potentially e ective approach and that ES of the abdominal muscles has potentials to improve coughing in tetraplegic patients.

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