Implanted FES for upright mobility in paediatric spinal cord injury: A follow-up report

Ten subjects, ages 7 to 20 years, received an 8-channel implanted lower extremity functional electrical stimulation (FES) system for standing and walking. Electrodes were placed for stimulation of hip and knee extensors, and for hip abduction and adduction. Standing and walking were achieved through constant stimulation to the implanted muscles, allowing a swing through gait pattern with an assistive device. After training with FES, subjects were tested in 3 upright mobility activities on an annual basis, which were scored based upon completion time and level of independence. Follow-up data were available for 7 of 10 subjects and spanned 1 to 5 years. Of the 21 activities tested (7 subjects × 3 activities), independence level with FES was improved or maintained in 15 cases (71%). For the 6 remaining cases (29%), moderate to minimal assistance was required at follow-up where no assistance was needed initially. Completion times were maintained or improved over follow-up in 17 of the 21 cases (81%). Perceived effort was rated as most reasonable in 71% of the cases initially and in 62% of the cases at the latest follow-up.