MULTICHANNEL FUNCTIONAL ELECTRICAL STIMULATION ASSISTED WALK FOR INCOMPLETE TETRAPLEGIA
H. Onishi, Y. Matsumura, R. Yagi, T. Ikeda, K. Ihashi, Y. Handa (Tohoku Univ., Sendai, Japan)
Abstract: Two cases of FES (functional electrical stimulation)-assisted walk for the tetraplegia were reported. Both had been suffering from tetraplegia due to traffic accident for more than two years. Intramuscular wire electrodes were implanted to their lower limbs for electrical stimulation. Before FES, therapeutic electrical stimulation (TES) was applied for about 6 months. FESMATE (NEC Co. Ltd.) was used as a FES system, and stimulated muscles or nerves for FES-assisted walk were the quadriceps muscle, gluteus maximus muscle, gluteus medius muscle, medial and lateral hamstrings muscles, tibial nerve and peroneal nerve. The on and off of the stimulation was controlled by the heel switch embedded into the "TABI". The state of the walk was analyzed by the three dimensionally motion analyzer system (VICON370) comparing FES-assisted walk with non-FES walk. Subjectively, both patients had a feeling that it was easier to walk by the application of FES. As to the changes of the joint angle, the improvement of the dorsifiexion of the ankle joint during swing phase was observed in FES-assisted walk in both cases. The double knee action that could not observed in non-FES walk was appeared in FES walk. The walking distance at one time became longer in both cases. Both patients showed better manner of walk by using this FES system. In conclusion, multichannel FES-assisted walk for the incomplete tetraplegia is a good method of rehabilitation.
COMPREHENSIVE REHABILITATION SERVICES FOR SPINAL CORD INJURED PERSON.
Suyama T., Nihei R., Kimura T., Yano H., Tobimatsu Y., Tsuyama N., Hatsuyama Y., Nakamura R. (National Rehabilitation Center for the Disabled, Japan)
Abstract: Comprehensive rehabilitation is very important for the spinal cord injured person. National Rehabilitation Center for the Disabled has four activities (NRCA) comprehensive of rehabilitation services, research and development of rehabilitation techniques, and training professional staff, information service.
Over 15 year period, 1047 spinal cord injury (SCI) patients admitted to NRCA hospital, received medical therapy and medical rehabilitation. The period from accident till ADL independency was 12.0+1.54 months in tetraplegia, and 5. 6+1.71 months in paraplegia without complications, such as pressure sore, fracture of extremities, and so on.
563 SCI persons received vocational training in our training center. About 70% persons out of them succeeded to get social return.
Otherwise high level paralysis of SCI had many problems, such as man power, social services, QOL.