Trunk Muscle Electrical Stimulation to Stabilize Seated Posture: effects on respiration, mobility, and wheelchair function

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Ron Triolo, PhD
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Objective: To quantify the physiologic impact of stabilizing the torso with neuromuscular electrical stimulation (NMES) of the paralyzed hip and trunk musculature after SCI in 4 subjects. Design: Case Series Participants/methods: Four subjects with SCI and a surgically implanted multichannel pulse generator and intramuscular stimulating electrodes to activate some combination of lumbar erector spinae, quadratus lumborum, gluteus maximus, and gluteus medius muscles bilaterally. Each subject was assessed with and without NMES for changes in spinal alignment with AP and Lateral vertebral column x-rays, respiratory function with pulmonary function studies, and cardiovascular changes with blood pressure (BP) and heart rate (HR) monitoring. Results: Stimulation improved spinal convexity in all subjects ranging from a 100 to 260 improvement and improved kyphosis 70 to 210. Stimulation showed significant improvement in forced expiratory volume and vital capacity in one subject (10% and 22%), however 3 of 4 subjects showed no significant change. Stimulation increased Systolic BP to a maximum of 129 mmHg, Diastolic BP to 89 mmHg and HR to 87 beats per minute. Conclusion: A neuroprosthesis for controlling the paralyzed torso can positively impact spinal alignment. Overall the neuroprosthesis had no significant effects on pulmonary function. There was an increase in BP and HR during NMES but no other signs or symptoms of autonomic dysreflexia were noted.