SELECTING CANDIDATES FOR A LOWER-LIMB STIMULATOR IMPLANT PROGRAM - A PATIENT-CENTERED METHOD

Objective: To develop an effective selection procedure for lower limb functional neurostimulation (LLFNS) for standing in paraplegia. Design : The selection procedure and exclusion criteria were based on the pre vious experience of two clinical centres with experience of LLFNS. Set ting: Two Regional Spinal Injuries inits in southern England. Subjects : 254 fully rehabilitated paraplegics living in the community. Interve ntion: Patients were invited to participate in the programme, and if s uitable to subject themselves to a rigorous staged selection procedure from which they could withdraw at any time. Outcome measure: Function ally successful home standing using closed-loop surface electrical sti mulation. Results: 57/254 patients were suitable on paper and were acc essible. 19 of these (CI = 10 - 28) were interested in the project and attended one of the spinal centres for details. Twelve (CI = 5-19) of these fulfilled the selection criteria and started on the training pr ogramme; and 10 of them completed the muscle training programme succes sfully. Seven patients (CI = 2-12)achieved closed-loop standing in the laboratory and four patients (CI = 1-8) did so at home.