Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 4 , Pages 564-570 , April 2009

A Comparison of Functional Electrical and Magnetic Stimulation for Propelled Cycling of Paretic Patients

  • Johann Szecsi, MD

      Affiliations

    • Center for Sensorimotor Research, Department of Neurology, Ludwig-Maximillians University, Munich, Germany
    • Corresponding Author InformationCorrespondence to Johann Szecsi, MD, Center for Sensorimotor Research, Dept of Neurology, Ludwig-Maximillians University, Marchioninistrasse 23, 81377 Munich, Germany
  • ,
  • Martin Schiller, MD

      Affiliations

    • Center for Sensorimotor Research, Department of Neurology, Ludwig-Maximillians University, Munich, Germany
  • ,
  • Andreas Straube, MD

      Affiliations

    • Center for Sensorimotor Research, Department of Neurology, Ludwig-Maximillians University, Munich, Germany
  • ,
  • Dieter Gerling, PhD

      Affiliations

    • Department of Electrical Drives, University of Federal Defense, Munich, Germany

  • Image Result

    Isometric and cycling measurement setup. Both FMS and FES stimulation are possible. A subject with complete SCI performing FMS-propelled cycling using 2 magnetic stimulators can be seen. (1) torque tr

    Isometric and cycling measurement setup. Both FMS and FES stimulation are possible. A subject with complete SCI performing FMS-propelled cycling using 2 magnetic stimulators can be seen. (1) torque transducer, (2) angular encoder, (3) right side repetitive magnetic stimulator, (4) left side coil, (4, 5) straps made of foam and Velcro. Inset: definition of the crank angle.

  • Image Result
    Isometric measurements performed on a representative subject belonging to the stroke group. Starting from the motor threshold, stepwise-increasing FES and FMS burst amplitudes were applied until maxim

    Isometric measurements performed on a representative subject belonging to the stroke group. Starting from the motor threshold, stepwise-increasing FES and FMS burst amplitudes were applied until maximum tolerable intensity was reached in the first and the last part of the protocol, respectively. Combined stimulation (the FMS burst sequence was superimposed on the FES) was applied in the middle part of the protocol.

  • Image Result
    Isometric measurements performed on a representative subject belonging to the SCI group. In the first part of the test, starting from the motor threshold, stepwise-increasing FMS burst amplitudes were

    Isometric measurements performed on a representative subject belonging to the SCI group. In the first part of the test, starting from the motor threshold, stepwise-increasing FMS burst amplitudes were used until maximal intensity was reached. In the second part of the test, combined stimulation was applied (the FMS burst sequence was superimposed twice on the FES).

  • Image Result
    Cadence (upper graph) and crank torque (lower graph) profiles measured in a subject of the stroke group with right hemiparesis during volitional (gray) and FMS-supported volitional (black) cycling con

    Cadence (upper graph) and crank torque (lower graph) profiles measured in a subject of the stroke group with right hemiparesis during volitional (gray) and FMS-supported volitional (black) cycling conditions taken over 15-second periods. Measurement points and 10th-order polynomial fitting curve are represented. Abbreviation: QUAD, stimulation interval of the right quadriceps.

  • Image Result
    Isometric torque, power, smoothness, and symmetry of n=29 chronic poststroke patients with hemiplegia measured under volitional, FMS, and FES stimulation conditions. Bars and segments plotted represen

    Isometric torque, power, smoothness, and symmetry of n=29 chronic poststroke patients with hemiplegia measured under volitional, FMS, and FES stimulation conditions. Bars and segments plotted represent group means ± SDs. *FMS compared with FES with significance of P<.05; ##stimulation compared with volitional with significance of P<.001. Abbreviation: VOL, volitional.

  • Image Result
    Isometric torque and power of n=11 patients with chronic complete SCI measured under FMS and FES stimulation conditions. Bars and segments plotted represent group means ± SDs. Significant comparisons

    Isometric torque and power of n=11 patients with chronic complete SCI measured under FMS and FES stimulation conditions. Bars and segments plotted represent group means ± SDs. Significant comparisons of FES and FMS: *P=.003, **P<10−4, respectively.

 Supported by the Else-Kröner Fresenius Foundation, Bad-Homburg, Germany (grant no. P35/06//A09/06).

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

 Reprints are not available from the author.

PII: S0003-9993(08)01707-3

doi: 10.1016/j.apmr.2008.09.572

Archives of Physical Medicine and Rehabilitation
Volume 90, Issue 4 , Pages 564-570 , April 2009