Implanted functional electrical stimulation: case report of a paraplegic patient with complete SCI after 9 years

Journal of NeuroEngineering and Rehabilitation, 2014 · DOI: 10.1186/1743-0003-11-15 · Published: February 24, 2014

Spinal Cord Injury Rehabilitation Biomedical

Simple Explanation

This research explores the use of an implanted functional electrical stimulation (FES) system to help a person with complete paraplegia regain some motor function in their lower limbs. The system combines electrical stimulation of both the muscles directly and the nerves that control those muscles. The study followed a patient with complete spinal cord injury (SCI) for nine years, examining the clinical and technological aspects of the implanted FES device, as well as the functional benefits it provided.

Study Duration

9 Years

Participants

One paraplegic patient with complete SCI

Evidence Level

Case Report

Key Findings

1
The patient continued using the implanted FES system for nine years, representing a unique case of long-term use compared to other similar studies.
2
Muscle response to FES varied greatly, with stimulation thresholds changing significantly over time and the quality of muscle contraction also fluctuating.
3
After six years of using the system once a week, the patient stopped in 2006, which led to a decline in muscle response and gait performance despite the implant still functioning correctly.

Research Summary

This study presents a 9-year follow-up of a paraplegic patient with complete SCI using an implanted functional electrical stimulation (FES) neuroprosthesis associating epimysial and neural stimulations. The patient used the system for six years, but a lack of continued use led to worsened muscular response and a decline in gait performance, despite the implant functioning properly. The study highlights the importance of muscle strength training to combat muscle fatigue and raises questions about the technological challenges of neural versus epimysial FES.

Practical Implications

Importance of Muscle Training

Regular muscle strength training is crucial to combat muscle fatigue and maintain the benefits of FES in patients with SCI.

Technological Considerations

Further research is needed to address the technological hurdles and optimize the use of neural versus epimysial FES techniques.

Long-Term Monitoring

Close clinical and technological monitoring is essential for assessing patient performance, ensuring proper system functioning, and learning from the long-term use of neuroprostheses.

Study Limitations

1
The study focuses on a single patient, limiting the generalizability of the findings.
2
The patient's disuse of the system after six years complicates the assessment of long-term FES effectiveness.
3
Specific reasons for the failure of right HA stimulation could not be determined without surgical exploration.

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