Transcutaneous functional electrical stimulation for grasping in subjects with cervical spinal cord injury

Mangold, Sabine; Keller, Thierry; Curt, Armin; Dietz, Volker

doi:10.1038/sj.sc.3101644

Cited by 108 publications

(66 citation statements)

References 20 publications

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“…11 To date, all studies on the application of FET to the Spinal Cord Injury (SCI) population have been case series conducted without a control group. The present study represents the first randomized intervention-versus-control design to be applied to FET in SCI, which is necessary to establish the efficacy of FET as an intervention compared to conventional physiotherapy and occupational therapy techniques.…”

Section: Introductionmentioning

confidence: 99%

Functional electrical therapy: retraining grasping in spinal cord injury

et al. 2005

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Objective: To determine the clinical efficacy of functional electrical therapy in the rehabilitation of grasping function for quadriplegics. Study design: Randomized intervention-versus-control trial. Setting: Rehabilitation hospital for spinal cord injury in Toronto, Canada. Methods: A total of 21 people with new spinal cord injuries ranging from C3 to C7 were randomly assigned to two groups: Control (N ¼ 9) and Intervention (N ¼ 12). The intervention was functional electrical therapy, which consisted of repetitive grasping exercises using a neuroprosthesis that applied surface electrical stimulation to the arm to generate and/or assist grasping movements. It was applied by registered Occupational Therapists in a clinical setting. Main outcome measures were: Functional Independence Measure (FIM), Spinal Cord Independence Measure (SCIM), and the Rehabilitation Engineering Laboratory Hand Function Test. Consumer perceptions of functional electrical therapy were assessed via qualitative interviews. Results: Differences between the Control and Intervention groups could be observed although they are not significant due to an insufficient number of participants. Consumer perceptions were positive, including improved Activities of Daily Living and self-satisfaction. Conclusion: Functional electrical therapy has the potential to be an effective treatment modality to restore grasping function in quadriplegia. It can be implemented by occupational therapists in a clinical setting. Further research is required to establish suitable indications for participant selection. In addition, a larger number of participants is needed to demonstrate statistical significance of the Functional Electrical Therapy.

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Section: Introductionmentioning

confidence: 99%

Functional electrical therapy: retraining grasping in spinal cord injury

et al. 2005

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“…1 Despite the rise in the proportion of persons with incomplete-SCI; the preponderance of scientific literature describing the effects of SCI on skeletal muscle involves persons with complete injuries. [5][6][7][8] To date, very little data exits describing muscle function in persons with chronic incomplete-SCI. Interestingly, the innate plasticity associated with incomplete-SCI furnishes these persons with the potential to progress functionally to a greater extent than the complete SCI population.…”

Section: Introductionmentioning

confidence: 99%

Lower extremity skeletal muscle function in persons with incomplete spinal cord injury

et al. 2005

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Study design: A cross-sectional study design. Objectives: To characterize and specifically quantify impairments in muscle function after chronic incomplete spinal cord injury (SCI). Setting: University of Florida, Gainesville, FL, USA. Methods: Voluntary and electrically elicited contractile measurements were performed and voluntary activation deficits were quantitatively determined in the knee extensor and ankle plantar flexor muscle groups in 10 individuals with chronic incomplete SCI (C5-T8, ASIA C or D) and age-, gender-, height-and body weight matched healthy controls. Results: Persons with incomplete-SCI were able to produce only 36 and 24% of the knee extensor torque and 38 and 26% of the plantar flexor torque generated by noninjured controls in the self-reported less-involved and more-involved limbs, respectively (Po0.05). In addition, both indices of explosive or instantaneous muscle strength, torque 200 (absolute torque reached at 200 ms) and the average rate of torque development (ARTD) were dramatically reduced in the ankle plantar flexor and knee extensor muscle groups in persons with incomplete-SCI. However, the deficit in instantaneous muscle strength was most pronounced in the ankle plantar flexor muscles, with an 11.7-fold difference between the torque 200 measured in the self-reported more involved limb and a 5-fold difference in the less-involved limb compared to control muscles. Voluntary activation deficits ranged between 42 and 66% in both muscle groups. Interestingly, electrically elicited contractile properties did not differ between the groups. Conclusion: The resultant impact of incomplete-SCI is that affected muscles not only become weak, but slow to develop voluntary torque. We speculate that the large deficit in torque 200 and ARTD in the ankle plantar flexors muscles of persons with incomplete-SCI may limit locomotor function. The results presented in this study provide a quantitative and sensitive assessment of muscle function upon which future research examining rehabilitation programs aimed at restoring muscle function and promoting functional recovery after incomplete-SCI may be based.

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“…Among our 18 CSA patients, MRI demonstrated compression of the anterior horn in 15 patients and an intramedullary high intensity zone in 9 patients. Recently, several groups reported motor neuron excitability below the level of spinal cord injury [20][21][22][23] . Curt and colleages 20) studied the F-wave parameters in the median and ulnar nerves of healthy subjects and patients with spinal cord injury in the acute or chronic phase.…”

Section: Discussionmentioning

confidence: 99%

Evidence that impaired motor conduction in the bilateral ulnar and tibial nerves underlies cervical spondylotic amyotrophy in patients with unilateral deltoid muscle atrophy

Nakanishi

Tanaka

Kamei

et al. 2018

Spine Surg Relat Res

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Abstract:Introduction: The clinical entity of cervical spondylotic amyotrophy (CSA) is characterized by severe muscle atrophy in the upper extremities with insignificant sensory deficits in patients with cervical spondylosis. However, the pathogenesis of CSA is still unclear.Methods: We assessed electrophysiological motor conduction through the corticospinal tract and ulnar and tibial nerves, which do not supply the deltoid or biceps muscles, of 18 patients with CSA, 12 patients with compressive cervical myelopathy, and 18 control subjects with cervical spondylotic radiculopathy. Motor evoked potentials following transcranial magnetic stimulation and M-waves and F-waves following electrical stimulation were measured from the bilateral abductor digiti minimi muscles (ADMs) and abductor hallucis muscles (AHs). The peripheral conduction time (PCT) was calculated from the latencies of the CMAPs and F-waves as follows: (latency of CMAPs + latency of F-waves -1) / 2. The central motor conduction time (CMCT) was calculated by subtracting the PCT from the onset latency of the MEPs.Results: The M-wave (M) latency and minimum F-wave (Fmin) latency from the ADM, and Fmin-M latency from the ADM/AH were significantly longer in the CSA group than in the other groups, on both the affected (p = 0.000-0.007) and unaffected sides (p = 0.000-0.033). F-wave persistence from the bilateral ADMs was significantly lower in the CSA group than in the other groups (p = 0.000-0.002). Among the CSA patients, there were no significant differences in these parameters between the affected and unaffected sides. The CMCT showed no significant differences between the CSA and control groups, but significant differences between the CSA and CCM groups (p = 0.000-0.004).Conclusions: CSA patients with unilateral deltoid muscle atrophy had subclinical impairments of lower motor neurons and/or peripheral axons in the ulnar nerve, and subclinical impairments of peripheral axons in the tibial nerve. These motor impairments may have originally existed in these individuals before the onset of CSA.

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Transcutaneous functional electrical stimulation for grasping in subjects with cervical spinal cord injury

Cited by 108 publications

References 20 publications

Functional electrical therapy: retraining grasping in spinal cord injury

Functional electrical therapy: retraining grasping in spinal cord injury

Lower extremity skeletal muscle function in persons with incomplete spinal cord injury

Evidence that impaired motor conduction in the bilateral ulnar and tibial nerves underlies cervical spondylotic amyotrophy in patients with unilateral deltoid muscle atrophy

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