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Functional electrical stimulation for walking in paraplegia

The Journal of Bone & Joint Surgery.  1987; 69:728-733 
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Abstract

In paraplegic subjects who had functional transection of the spinal cord at a level between the fourth and the eleventh thoracic vertebra, independent reciprocal walking was achieved with the use of a portable microprocessor-controlled stimulator that electrically activated the muscles through percutaneous intramuscular wire electrodes. The electrodes were implanted, by means of hypodermic needles, in the flexors, extensors, abductors, and adductors of the hip; the extensors of the knee; and the plantar flexors and dorsiflexors of the ankle. The subjects had strong, selective, and reproducible muscular contractions that increased in strength during the twenty-two to forty-four months (average, thirty-two months) of training with the regimen. A basic pattern of stimulation was adapted for each individual; each step was initiated by the subject using a hand-operated switch. The subjects progressed to the use of a walker for support, and two of them were able to walk using axillary crutches. Three subjects were able to climb stairs.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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