Effects of Intramuscular Trunk Stimulation on Manual Wheelchair Propulsion Mechanics in 6 Subjects With Spinal Cord Injury

Abstract: Objective: To quantify the effects of stabilizing the paralyzed trunk and pelvis with electrical stimulation on manual wheelchair propulsion.Design: Single-subject design case series with subjects acting as their own concurrent controls.Setting: Hospital-based clinical biomechanics laboratory.Participants: Individuals (N=6; 4 men, 2 women; mean age ± SD, 46±10.8y) who were long-time users (6.1±3.9y) of implanted neuroprostheses for lower extremity function and had chronic (8.6±2.8y) midcervical- or thoracic-level injuries (C6-T10).Interventions: Continuous low-level stimulation to the hip (gluteus maximus, posterior adductor, or hamstrings) and trunk extensor (lumbar erector spinae and/or quadratus lumborum) muscles with implanted intramuscular electrodes.Main Outcome Measures: Pushrim kinetics (peak resultant force, fraction effective force), kinematics (cadence, stroke length, maximum forward lean), and peak shoulder moment at preferred speed over 10-m level surface; speed, pushrim kinetics, and subjective ratings of effort for level 100-m sprints and up a 30.5-m ramp of approximately 5% grade.Results: Three of 5 subjects demonstrated reduced peak resultant pushrim forces (P≤.014) and improved efficiency (P≤.048) with stimulation during self-paced level propulsion. Peak sagittal shoulder moment remained unchanged in 3 subjects and increased in 2 others (P
Source: Archives of Physical Medicine and Rehabilitation - Category: Rehabilitation Authors: Tags: Original Articles Source Type: research