HOME-USE OF A FUNCTIONAL ELECTRICAL-STIMULATION SYSTEM FOR STANDING AND MOBILITY IN ADOLESCENTS WITH SPINAL-CORD INJURY

Objective: Functional electrical stimulation (FES) is a technology tha t may allow some patients with spinal cord injury (SCI) to integrate s tanding and upright mobility with wheelchair mobility. The purpose of this study was to document the patterns of home and community use of a FES system for standing and mobility. Design: A telephone questionnai re was administered every 1 to 4 weeks for a minimum of 1 year. An int erview was given at the end of the study to probe the motivators and b arriers to home use. Setting: Training for use of the FES system was p erformed in an inpatient pediatric rehabilitation setting. Data collec tion began after the subjects were discharged to home. Participants: F ive adolescents with complete, thoracic-level SCI. Intervention: Subje cts participated in a program of FES exercise followed by training in basic mobility skills such as standing transfers, maneuvering, level a mbulation, one-handed and reaching activities, and stair ascent/descen t. Main Outcome Measure: The frequency with which the FES system was u sed at home and the activities for which it was utilized were document ed. Motivators and barriers to FES home use were examined. Results: Su bjects donned the FES system on the average once every 3 to 4 days. Be tween 51% and 84% of the times donned, the system was used for exercis e. The remaining times it was used for standing activities, most commo nly reaching, one-handed tasks, and standing for exercise. ''Motivator s'' included being able to do things that would otherwise be difficult , perceiving a healthful benefit or a sense of well-being from standin g and exercise, and feeling an obligation to stand as a participant in a research study. ''Barriers'' to FES use included not finding time t o use the system, having difficulty seeing opportunities to stand, and being reluctant to wear the FES system all day. Conclusions: Subjects demonstrated a persistent but sporadic pattern of FES use that was in fluenced by their perception of standing as a separate, occasional act ivity performed not only to allow increased access to the environment but also for a sense of physical fitness and well-being. (C) 1996 by t he American Congress of Rehabilitation Medicine and the American Acade my of Physical Medicine and Rehabilitation