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Journal of NeuroEngineering and Rehabilitation

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Open Access 01-12-2014 | Research

Implanted functional electrical stimulation: case report of a paraplegic patient with complete SCI after 9 years

Authors: David Guiraud, Christine Azevedo Coste, Mourad Benoussaad, Charles Fattal

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2014

Abstract

Backgrounds

Experience of an implanted functional electrical stimulation neuroprosthesis (FES) associating 8-channel epimysial and 4-channel neural stimulations. The primary objective consisted in presenting clinical and technological experiences based on a 9-year follow-up of one patient implanted with this FES device. The secondary objective consisted in assessing resulting functional benefits.

Methods

One patient recruited in 1996 within the European Stand Up and Walk Project benefited from a 9-year follow-up with clinical and technological evaluations.

Results

The patient was still using the system nine years later making this a unique case, even when compared to other similar studies. The analysis of muscular response to FES underlined the great variability of stimulation thresholds evolution (−26% to +360%, mean +110%) and quality of the induced contraction. Three muscles out of five scored at least 4/5 on the Medical Research Council scale, all stimulated via neural pathways. The patient used the system once a week for 6 years, up to 2006, due to lack of use, the FES-induced muscular response worsened even though the implant was properly functioning, leading to significant decline in gait performances (best 3.45 m/s on 2.9 m), due to muscle fatigue and loss of muscle mass.

Conclusion

Two major issues arise: first the importance of muscle fatigue, underlining the relevance of muscle strength training, and second technological hurdles raising up the question of neural vs. epimysial FES. This advanced technology proves the concept of restoring lower limb motor functions in patients with spinal cord injury. The main features of the stimulation device remain stable even after long periods of inactivity, yet there is a real need for close clinical and technological monitoring.

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Title: Implanted functional electrical stimulation: case report of a paraplegic patient with complete SCI after 9 years
Authors: David Guiraud
Christine Azevedo Coste
Mourad Benoussaad
Charles Fattal
Publication date: 01-12-2014
Publisher: BioMed Central
Published in: Journal of NeuroEngineering and Rehabilitation / Issue 1/2014
Electronic ISSN: 1743-0003
DOI: https://doi.org/10.1186/1743-0003-11-15

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Implanted functional electrical stimulation: case report of a paraplegic patient with complete SCI after 9 years

Abstract

Backgrounds

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Backgrounds

Methods

Results

Conclusion

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