Abstract

Background Individuals with an incomplete spinal cord injury (iSCI) have increased risk of falls during walking and standing. Our previous longitudinal pilot study demonstrated that a therapeutic system (FES+VFT system) using functional electrical stimulation (FES) and visual feedback training (VFT) improved the standing balance of individuals with iSCI. Purpose This study investigated the orthotic and acute therapeutic effects of FES in the FES+VFT system. Participants Fifteen individuals with iSCI will be recruited for this study. To date, four participants have completed the study. Methods The four participants completed three different sessions. In the first session, participants were evaluated for their balance, postural control and familiarized with the FES+VFT system. In the second and third sessions, the participant completed training sessions with the FES+VFT system with or without FES. Centre of pressure (COP) data were collected via force platforms. Before and after the training, the motor evoked potentials (MEP) of the soleus and tibialis anterior muscles were recorded. Results There was a greater increase in the total dynamic range of the COP with FES+VFT than VFT (Anterior posterior: increase of 17.5 ± 14.27mm, medial lateral: increase of 17.9 ± 19.45mm). Both the soleus and tibialis anterior muscles showed greater increases in MEP after FES+VFT than VFT (Soleus: 70.4 ± 31.1% vs 5.45 ± 29.1%; Tibialis Anterior: 115.3 ± 234.8% vs 11.0 ± 42.9%). Conclusions These findings suggest that FES improves the performance of VFT (positive orthotic effect) and increases the corticospinal connection (positive acute therapeutic effect) in individuals with iSCI.

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