Functional electrical stimulation after spinal cord injury: current use, therapeutic effects and future directions

Abstract

Repair of the injured spinal cord by regeneration therapy remains an elusive goal. In contrast, progress in medical care and rehabilitation has resulted in improved health and function of persons with spinal cord injury (SCI). In the absence of a cure, raising the level of achievable function in mobility and selfcare will first and foremost depend on creative use of the rapidly advancing technology that has been so widely applied in our society. Building on achievements in microelectronics, microprocessing and neuroscience, rehabilitation medicine scientists have succeeded in developing functional electrical stimulation (FES) systems that enable certain individuals with SCI to use their paralyzed hands, arms, trunk, legs and diaphragm for functional purposes and gain a degree of control over bladder and bowel evacuation. This review presents an overview of the progress made, describes the current challenges and suggests ways to improve further FES systems and make these more widely available.

The locomotor central pattern generator of the rat spinal cord in vitro is optimally activated by noisy dorsal root waveforms

“…The results of this study may have interesting implications in the field of neurorehabilitation, which uses peripheral functional electrical stimulation (FES) to contrast the functional deficit of spinal cord-injured persons (Ragnarsson 2008). Although the performance of these devices has been improved, the nature of square pulse trains has not been changed ).…”

International Spinal Cord Injury Upper Extremity Basic Data Set

“…The use of FES has been reviewed on numerous occasions. [24][25][26] It should be noted that various surface FES systems have very different capabilities and fidelity of the grasp produced.…”

Abdominal functional electrical stimulation to improve respiratory function after spinal cord injury: a systematic review and meta-analysis

“…There is also evidence in the literature to suggest that exercise contributes to an increase in brain-derived neurotrophic factor, which may promote synaptic and functional plasticity within the brain and spinal cord. 42,43 While currently postulation, such corticospinal plasticity may be the reason for the continued increase in respiratory function observed after the cessation of abdominal FES.…”