Reduction of seating pressure using FES in patients with spinal cord injury. A preliminary report

Abstract

Reduction of seating pressure using FES in patients with spinal cord injury. A preliminary report. The aim of this study was to investigate the use of functional electrical stimulation (FES) as a means of pressure sore prevention in seated spinal cord injured (SCI) subjects. Nine SCI subjects took part in tests in which electrical stimulation was applied to the quadriceps with the lower legs restrained. Ischial pressures were measured during periods of quiet sitting and FES application. A strain gauged lever arm was used to measure the knee moment during quadriceps stimulation. The average pressure drop at the right and left buttocks was 44 mmHg and 27 mmHg respectively. In general the greatest reductions occurred in subjects with larger knee moments; however, there was no direct relationship between the pressure reduction obtained and the quadriceps strength. This form of FES may be useful as a prophylactic aid in the management of pressure sores in SCI subjects.

Seat Pressure Changes after Eight Weeks of Functional Electrical Stimulation Cycling: A Pilot Study

“…Ferguson et al applied electrical stimulation to the quadriceps muscles and found that the greater the knee extension movement, the more significant the decreases in pressure at the ischial tuberosity. 18 A decade later, Bogie and Triolo used implanted neuromuscular stimulation of the gluteal muscles to assist individuals with standing and transfer activities.…”

Preventing Ischial Pressure Ulcers: I. Review of Neuromuscular Electrical Stimulation

“…They proposed that these reductions were more appropriate than the redistributions that had been shown by Levine's group with NMES of GM [21]. Their protocol involved a 3 months conditioning program (30 min/day × 5+ days/week) prior to testing, and resulted in average ischial pressure reductions of 3.6 kPa (27 mmHg) and 5.9 kPa (44 mmHg) on the left & right sides respectively (from means of 10.1 kPa (76 mmHg) and 13.2 kPa (99 mmHg) respectively at rest).…”

“…Flap reconstruction to provide well-vascularized, bulky tissue to cover bony prominences was pioneered by Davis in the 1930s [18]. Since 1970, gluteal flaps have been used widely, as originally described by Ger [21,50]. Although still the best option available, post-operative recurrence rates are as high as 61% within the first year of repair, and vary widely [19,65] (Table 1).…”

Gluteal blood flow and oxygenation during electrical stimulation-induced muscle activation versus pressure relief movements in wheelchair users with a spinal cord injury

“…[7][8][9][10][11] Levine et al 8,9 used surface ES in the gluteal muscles of individuals with an SCI and found a changed buttock tissue shape 8 and increased muscle BF. 9 Ferguson et al 7 stimulated the quadriceps muscles and found a decrease in interface pressure as well.…”

“…[7][8][9][10][11] Levine et al 8,9 used surface ES in the gluteal muscles of individuals with an SCI and found a changed buttock tissue shape 8 and increased muscle BF. 9 Ferguson et al 7 stimulated the quadriceps muscles and found a decrease in interface pressure as well. Smit et al 12 found that ES-induced gluteal and hamstring muscle activation reduces IT pressure and, in a 3-h stimulation period with a 1:4 s on-off duty cycle, does not cause muscle fatigue.…”