Use of the Case Western Reserve/Veterans Administration neuroprosthesis for exercise, standing and transfers by a paraplegic subject

Abstract

Functional electric stimulation (FES) is a technology that may allow patients with spinal cord injury (SCI) to transfer stand and walk. This paper reports upon the use of the Case Western Reserve Neuroprosthesis by a T6 ASIA B paraplegic subject. The subject was able to stand for two minutes and 50 seconds. He could walk 35 feet with a swing to gait. Measurement of energy consumption showed that metabolic demand was only 2.1 metabolic equivalent units. The factors that limited the use of the device that need to be improved to make the technology practical for household or community ambulation are speed (5.8 m/min) of ambulation and fatigue of the stimulated muscles.

Implications for Rehabilitation

I think that the article is worth publishing for at least three reasons.

1. It demonstrates the use and limitations of use of functional electric stimulation (FES) for standing and transfers by a paraplegic patient.

2. It implies that main limiting factor to current technology is not the stress on the cardiovascular and pulmonary systems but the stress on the muscles that are innervated by the device. It includes suggestions for and references to changes that need to be made and are in the process of being developed to improve the technology and bring it closer towards something that is more practical and beneficial for the spinal cord injured population.

3. The authors hope that the introduction and the discussion will be interesting and informative to readers who are not familiar with this technology.

Keywords::

• Functional electric stimulation
• gait
• oxygen consumption
• paraplegia

Declaration of Interest: The authors report no conflict of interest.