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IEEE Trans Neural Syst Rehabil Eng. 2013 Jan;21(1):37-46. doi: 10.1109/TNSRE.2012.2211894. Epub 2012 Aug 9.

Cardiovascular response of individuals with spinal cord injury to dynamic functional electrical stimulation under orthostatic stress.

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Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.


In this pilot study, we examined how effectively functional electrical stimulation (FES) and passive stepping mitigated orthostatic hypotension in participants with chronic spinal cord injury (SCI). While being tilted head-up to 70 (°) from the supine position, the participants underwent four 10-min conditions in a random sequence: 1) no intervention, 2) passive stepping, 3) isometric FES of leg muscles, and 4) FES of leg muscles combined with passive stepping. We found that FES and passive stepping independently mitigated a decrease in stroke volume and helped to maintain the mean blood pressure. The effects of FES on stroke volume and mean blood pressure were greater than those of passive stepping. When combined, FES and passive stepping did not interfere with each other, but they also did not synergistically increase stroke volume or mean blood pressure. Thus, the present study suggests that FES delivered to lower limbs can be used in individuals with SCI to help them withstand orthostatic stress. Additional studies are needed to confirm whether this use of FES is applicable to a larger population of individuals with SCI.

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