Implanted Electrical Stimulation of the Trunk for Seated Postural Stability and Function After Cervical Spinal Cord Injury: A Single Case Study

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Objectives: To explore and quantify the physical and functional effects of stabilizing the torso with electrical stimulation of the paralyzed hip and trunk musculature after motor complete tetraplegia. Design: Single-subject case study with repeated measures and concurrent controls. Setting: Academic outpatient rehabilitation center. Participants: Forty-four-year– old man with C4 American Spinal Injury Association grade A tetraplegia 20 years postspinal cord injury. Intervention: A surgically implanted multichannel pulse generator and intramuscular stimulating electrodes to activate lumbar erector spinae, quadratus lumborum, and gluteus maximus muscles bilaterally. Main Outcome Measures: Outcomes assessed with and without stimulation included (1) spinal alignment and pelvic orientation, (2) pulmonary function and ventilatory volumes, (3) forward bimanual reaching distance, (4) seated stability and resistance to externally applied disturbances, (5) maximal force and speed of rowing-like movements, and the ability to (6) independently return to an erect seated position from full forward or lateral flexion and (7) roll in bed without assistance.

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