Functional electric stimulation to augment partial weight-bearing supported treadmill training for patients with acute incomplete spinal cord injury: a pilot study

Abstract

Postans NJ, Hasler JP, Granat MH, Maxwell DJ. Functional electric stimulation to augment partial weight-bearing supported treadmill training for patients with acute incomplete spinal cord injury: a pilot study. Arch Phys Med Rehabil 2004;85:604–10. Objective To study the application of partial weight-bearing (PWB) supported treadmill gait training augmented by functional electric stimulation (FES) in subjects with acute incomplete spinal cord injury (SCI). Design Before-after crossover trial with control (A) and intervention (B) periods. Setting Physiotherapy (PT) department of a spinal injuries unit in Scotland. Participants Fourteen inpatients with acute incomplete SCI with American Spinal Injury Association class C or D injury. Intervention Training consisted of treadmill walking with PWB support augmented by FES. Subjects walked on the treadmill for up to 25 minutes a day, 5 days a week for 4 weeks. The intervention was compared with a 4-week control period in which standard PT was given. Main outcome measures Overground walking endurance and speed, cadence, stride length, and observational gait analysis and walking speed, distance, and percentage PWB support on the treadmill. Results A greater increase in overground walking endurance was achieved after the intervention (AB group mean, 72.2m; confidence interval [CI], 39.8–104.6m; BA group mean, 63.8m; CI, –10.2 to 137.9m), as compared with after standard PT (AB group mean, 38.4m; CI, 1.8–75.0m; BA group mean, 60.1m; CI, 9.2–110.9m). A similar pattern was observed for overground walking speed. Conclusions This pilot study indicated that PWB supported treadmill training with FES had a positive effect on overground gait parameters and could potentially accelerate gait training in subjects with incomplete SCI. A larger randomized trial is required to substantiate these findings.