Home-Based Functional Electrical Stimulation Rescues Permanently Denervated Muscles in Paraplegic Patients With Complete Lower Motor Neuron Lesion

Abstract

Home-based FES of denervated muscle is an effective home therapy that results in rescue of muscle mass and tetanic contractility. Important immediate benefits for the patients are the improved cosmetic appearance of lower extremities and the enhanced cushioning effect for seating.

Current Trends in the Management of the Upper Limb in Spinal Cord Injury

“…Research has shown that combining task-specific training with electrical stimulation yields better results in terms of neurological and functional improvements than either of them alone [11]. But several factors may impact an individual's response to stimulation and its effective use, including long-term muscle atrophy and lower motor neuron damage [12]. A second intervention gaining popularity is gravity-compensation training (GCT), using mobile arm supports, exoskeletons, and or robotics.…”

Changes in Shape and Density of Denervated Muscles: Case Reports

“…The result is muscle atrophy and in long term a degeneration of the muscle tissue. After about a decade no contractile elements are left, only connective tissue and fat [1]. Spinal cord injured (SCI) people with a lower motor neuron lesion are subject to muscle degeneration.…”

“…To stop the degeneration or even built up volume and force of the muscles they can be treated with electrical stimulation [1,2]. Since there is no lower motor neuron the muscle fibres have to be stimulated directly demanding electrical pulses of two order of magnitude higher energy as those for nerve stimulation [1]. To achieve muscle growth stimulation treatment has to be made several times a week for from minutes up to more than an hour.…”

“…A SCI at the level of Th12 and L1 often result in a complete flaccid paralysis of the muscle of the thigh. To stop the degeneration or even built up volume and force of the muscles they can be treated with electrical stimulation [1,2]. Since there is no lower motor neuron the muscle fibres have to be stimulated directly demanding electrical pulses of two order of magnitude higher energy as those for nerve stimulation [1].…”

“…They all have SCI at Th12 to L1 level. A protocol developed in an EU funded project RISE (QLG5-CT-2001-02191) was used [1]. The quadriceps muscle group of both legs was stimulated five days a week for up to two hours.…”