Cardiorespiratory and Muscle Metabolic Responses During Conventional Versus Motion Sensor‐Assisted Strategies for Functional Electrical Stimulation Standing After Spinal Cord Injury

Abstract

This is a case series study with the objective of comparing two motion sensor automated strategies to avert knee buckle during functional electrical stimulation (FES)-standing against a conventional hand-controlled (HC) FES approach. The research was conducted in a clinical exercise laboratory gymnasium at the University of Sydney, Australia. The automated strategies, Aut-A and Aut-B, applied fixed and variable changes of neurostimulation, respectively, in quadriceps amplitude to precisely control knee extension during standing. HC was an "on-demand" increase of stimulation amplitude to maintain stance. Finally, maximal FES amplitude (MA) was used as a control condition, whereby knee buckle was prevented by maximal isometric muscle recruitment. Four AIS-A paraplegics undertook 4 days of testing each, and each assessment day comprised three FES standing trials using the same strategy. Cardiorespiratory responses were recorded, and quadriceps muscle oxygenation was quantified using near-infrared spectroscopy. For all subjects, the longest standing times were observed during Aut-A, followed by Aut-B, and then HC and MA. The standing times of the automated strategies were superior to HC by 9-64%. Apart from a lower heart rates during standing (P = 0.034), the automation of knee extension did not promote different cardiorespiratory responses compared with HC. The standing times during MA were significantly shorter than during the automated or "on-demand" strategies (by 80-250%). In fact, the higher isometric-evoked quadriceps contraction during MA resulted in a greater oxygen demand (P < 0.0001) and wider arteriovenous oxygen extraction (P = 0.08) when compared with the other strategies. In conclusion, even though increased standing times were demonstrated using automated control of knee extension, physiological benefits compared with HC were not evident.

Home-Based Functional Electrical Stimulation of Human Permanent Denervated Muscles: A Narrative Review on Diagnostics, Managements, Results and Byproducts Revisited 2020

“…In muscle biopsies, Pax7- and NCAM-positive muscle satellite cells were also increased in the absence of muscle damage and cellular inflammation [ 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ]. Finally, there are many applications of in-home or in-hospital functional electrical stimulation managements of disuse muscle atrophy related to organ diseases, from chronic cardiovascular failures to functional electrostimulation cycling in SCI [ 52 , 53 , 54 , 55 , 56 ].…”

Neural Network-Based Muscle Torque Estimation Using Mechanomyography During Electrically-Evoked Knee Extension and Standing in Spinal Cord Injury

“…The stimulation was channeled to the targeted muscle by 9 × 15 cm 2 surface adhesive electrodes (RehaStimTM, Hasomed GmbH, Magdeburg, Germany). This protocol was adapted from the procedure reported by Braz and colleagues (Braz et al, 2015 ). A harness (Biodex Offset Unweighing System) was used to support the subject's body and prevent the subject from swaying and tumbling.…”

Functional electrical stimulation of permanently denervated muscles, updated 2020

“…[34][35][36][37][38][39][40][41][42][43][44] Furthermore, there are many more applications of home or in hospital FES to manage disuse muscle atrophy related to several organ diseases, from chronic cardiovascular failures to functional electrical stimulation cycling in spinal cord injury. [45][46][47][48][49][50][51][52][53][54][55][56][57][58][59] conclusive remarks In recent years, we have demonstrated the long-term clinical value of co-activation of thigh muscle by home-based Functional Electrical Stimulation training using large surface electrodes. Indeed, the Vienna Strategy is able to reverse, at least at clinically relevant levels, the adverse effects of aging and of SCI, even the effects of the worst case scenario of complete conus and cauda equina syndrome.…”