Functional electrical stimulation therapy for upper extremity rehabilitation following spinal cord injury: a pilot study

Spinal Cord Series and Cases, 2023 · DOI: https://doi.org/10.1038/s41394-023-00568-4 · Published: March 16, 2023

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

This study investigates if functional electrical stimulation therapy (FEST) can improve the neuromuscular factors that impact upper limb function in people with spinal cord injuries (SCI). FEST uses electrical stimulation to create useful muscle contractions. The researchers analyzed muscle activation changes and how treatment altered muscle control and coordination during voluntary movements in individuals with chronic, cervical, and incomplete SCI. The study found evidence of increased muscle strength, activation, and median frequency following FEST. Some participants also demonstrated improved muscle contraction control and reduced co-contraction of antagonist muscles.

Study Duration

Not specified

Participants

4 individuals with chronic, cervical, and incomplete SCI and 5 non-disabled participants

Evidence Level

Pilot study

Key Findings

1
FEST can lead to gains in muscle strength and activation in individuals with SCI, indicating the activation of more motor units and faster motor units.
2
In some participants, FEST enhanced the control of muscle contraction, reducing co-contraction of antagonist muscles and increasing cortical drive.
3
The amount of strength gained after FEST was related to the level of muscle activation at baseline, indicating that residual muscle activity is important for the treatment's effectiveness.

Research Summary

This pilot study provides evidence that FEST can improve muscle strength and activation in individuals with SCI, accompanied by electrophysiological changes. FEST might enhance sensory-motor integration, as evidenced by improved control of muscle contraction and coordination between muscle groups. The study highlights the potential of sEMG as a tool to assess the effectiveness of FEST, particularly for weak muscles where traditional measures like MMT may not be sensitive enough.

Practical Implications

Rehabilitation Programs

Supports the use of FEST in rehabilitation programs for individuals with SCI to improve upper limb function.

Personalized Therapy

sEMG can assess which muscles might benefit from FEST, leading to customized and efficient treatment programs.

Predictive Biomarker

sEMG can be a biomarker to identify patients who are most likely to benefit from FEST, especially those with some residual muscle activity.

Study Limitations

1
Small sample size limits the generalizability of the findings.
2
The data analysis did not control for the presence of spasticity.
3
Future studies should account for spasticity's importance for recovery after SCI.

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