Article

OBJECTIVE: To investigate the longitudinal performance of a surgically implanted
neuroprosthesis for lower-extremity exercise, standing, and transfers after
spinal cord injury. DESIGN: Case series. SETTING: Research or outpatient physical
therapy departments of 4 academic hospitals. PARTICIPANTS:
Subjects (N=15) with
thoracic or low cervical level spinal cord injuries who had received the
8-channel neuroprosthesis for exercise and standing. INTERVENTION: After
completing rehabilitation with the device, the subjects were discharged to
unrestricted home use of the system. A series of assessments were performed
before discharge and at a follow-up appointment approximately 1 year later. MAIN
OUTCOME MEASURES: Neuroprosthesis usage, maximum standing time, body weight
support, knee strength, knee fatigue index, electrode stability, and component
survivability. RESULTS: Levels of maximum standing time, body weight support,
knee strength, and knee fatigue index were not statistically different from
discharge to follow-up (P>.05). Additionally, neuroprosthesis usage was
consistent with subjects choosing to use the system on approximately half of the
days during each monitoring period. Although the number of hours using the
neuroprosthesis remained constant, subjects shifted their usage to more
functional standing versus more maintenance exercise, suggesting that the
subjects incorporated the neuroprosthesis into their lives. Safety and
reliability of the system were demonstrated by electrode stability and a high
component survivability rate (>90%). CONCLUSIONS:
This group of 15 subjects is
the largest cohort of implanted lower-extremity neuroprosthetic exercise and
standing system users. The safety and efficiency data from this group, and
acceptance of the neuroprosthesis as demonstrated by continued usage, indicate
that future efforts toward commercialization of a similar device may be
warranted.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS