RESTORATION AND ANALYSIS OF STANDING-UP IN COMPLETE PARAPLEGIA UTILIZING FUNCTIONAL ELECTRICAL-STIMULATION

Objective: Restoration of stand-up motion in patients with complete pa raplegia utilizing multichannel functional electrical stimulation, and analysis of the restored motion. Design: Nonrandomized control trial. Setting: General community, a referral center, institutional practice , and ambulatory care. Patients: Twelve volunteer samples were used fo r the collection of normal data. Two complete paraplegics received tre atment for the restoration of stand-up motion. Main Outcome Measures: The electromyogram, joint angle, and poor reaction force were investig ated during standing-up with arms crossed in front of the chest, and h ands-assisted standing-up using parallel bars. The maximum knee joint torque during standing-up without hands-assists was calculated using a three-segment link model. Standing-up motion in complete paraplegics was restored, and then analyzed using the three-dimensional floor reac tion force and the hip, knee, and ankle angles. Results: Main muscles used to stand up were the quadriceps, tibialis anterior, and paraspina l muscles. Hands-assists reduced the muscle activity and the vertical floor reaction force. Peak muscle activity was less during hands-assis ted standing-up, except for the rectus femoris and the iliopsoas muscl e, The maximum knee joint torque during standing-up was 1.6Nm/kg for b oth knees. Two complete paraplegics were able to stand up smoothly fro m a wheelchair based on stimulation data obtained from normal subjects . The characteristic pattern during standing-up was knee flexion prece ding extension. Conclusion: Stand-up motion was restored utilizing ele ctromyogram data and knee joint torque data from normal subjects. (C) 1995 by the American Congress of Rehabilitation Medicine and tile Amer ican Academy of Physical Medicine and Rehabilitation