EFFECTS OF FUNCTIONAL ELECTRICAL-STIMULATION ON THE JOINTS OF ADOLESCENTS WITH SPINAL-CORD INJURY

Nineteen adolescent subjects with complete spinal cord injuries result ing in paraplegia or tetraplegia participated in a functional electric al stimulation (FES) program consisting of computerized, controlled ex ercise and/or weight bearing. The effects of stimulated exercise and s tanding/walking on the lower extremity joints were prospectively studi ed. Plain radiographs and MRIs were obtained prior to and following co mpletion of the exercise and standing and walking stages. In addition, the joints of five subjects were studied with synovial biopsies, arth roscopy, and the analysis of serum and synovial fluid for a 550 000 da lton cartilage matrix glycoprotein (CMGP). Pre-exercise joint abnormal ities secondary to the spinal cord injury improved following the stimu lation program. None of the subjects developed Charcot joint changes, Upon standing with FES, one subject with poor hip coverage prior to pa rticipation developed hip subluxation which required surgical repair. No other detrimental clinical effects occured in the lower extremity j oints of subjects participating in an FES program over a 1-year period .