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Eur Spine J (2008) 17:12561269 DOI 10.1007/s00586-008-0729-3
ORIGINAL ARTICLE
Role of electrical stimulation for rehabilitation and regeneration after spinal cord injury: an overview
Samar Hamid Ray Hayek
Received: 12 February 2008 / Accepted: 15 July 2008 / Published online: 2 August 2008 Springer-Verlag 2008
Abstract Structural discontinuity in the spinal cord after injury results in a disruption in the impulse conduction resulting in loss of various bodily functions depending upon the level of injury. This article presents a summary of the scientic research employing electrical stimulation as a means for anatomical or functional recovery for patients suffering from spinal cord injury. Electrical stimulation in the form of functional electrical stimulation (FES) can help facilitate and improve upper/lower limb mobility along with other body functions lost due to injury e.g. respiratory, sexual, bladder or bowel functions by applying a controlled electrical stimulus to generate contractions and functional movement in the paralysed muscles. The available rehabilitative techniques based on FES technology and various Food and Drug Administration, USA approved neuro-prosthetic devices that are in use are discussed. The second part of the article summarises the experimental work done in the past 2 decades to study the effects of weakly applied direct current elds in promoting regeneration of neurites towards the cathode and the new emerging technique of oscillating eld stimulation which has shown to promote bidirectional regeneration in the injured nerve bres. The present article is not intended to be an exhaustive review but rather a summary aiming to highlight these two applications of electrical stimulation and the degree of anatomical/functional recovery associated with these in the eld of spinal cord injury research.
Keywords Spinal cord injury Oscillating eld stimulation Functional electrical stimulation
Axonal regeneration Advances in spinal cord research
Introduction
Spinal cord injury (SCI) is one of the most catastrophic injuries of the nervous system resulting in permanent neurological decits. Typically SCI occurs in young, otherwise healthy adults as a result of trauma. Nearly 50% of SCI occurs in the age bracket of 1630 years (Fig. 1) [18, 25]. The number of people suffering from SCI is quite signicant. There are approximately 11,000 new cases each year in the United States [25]. The number of people living with SCI in June 2006 was approximately 253,000 [25]....