PAPER FES

CLINICAL EXPERIENCE WITH

FUNCTIONAL ELECTRICAL
STIMULATION-ASSISTED GAIT
WITH PARASTEP IN SPINAL
CORDINJURED PATIENTS
Parastep

TRAINING PROGRAM

OXYGEN CONSUMPTION DURING

FUNCTIONAL
ELECTRICAL STIMULATIONASSISTED EXERCISE
IN PERSONS WITH SPINAL CORD
INJURY

Dispositivo de FES que permite la

marcha mediante electrodo
subcutneos que van a activar
alternadamente el cudriceps y el
reflejo de retirada mediante el
nervio fibular.
The impulses are delivered
transcutaneously and have the
following characteristics:
monophasic symmetrical, pulse
width 300 ms, 0300 mA, (constant
current), and 24 Hz.
Standing up was permitted as soon
as the quadriceps strength reached
34 kg (34 Nm) under
electrostimulation.
This mean value had been found to
correspond to the ability of
performing the sitstand-up
movement and maintaining
kneelocking under FES.
- when the quadriceps strength was
below this threshold,
an initial reinforcement of the knee
extensor was conducted in two 20minute sessions per day for several
days, by electrostimulation,
using the Parastep stimulator in
patients in supine position.
- Upright mobility was taught first by
using parallel bars. Gait with the
walker began as soon as the patient
had acquired the
basic principles of this ambulation
and handling of the device.

Resumen

Diferencias entre entrenamiento FES

cicloergmetro, FES Hibrido, FES
REMO de acuerdo al consumo de
VO2 max.
Superior health benefits of physical
activity
are achieved when physical activity
programmes include exercises
exceeding intensities of
21mL/kg/min (6MET [metabolic
equivalent]) and total exercise
volume exceeds 12002200
kcal/week.
The average VO2sub-peak
reported during FES-hybrid exercise
(18.3mL/
kg/min) and FES-rowing
(18.8mL/kg/min) are
close to the recommended
21mL/kg/min, while the intensity
during FES-cycling (13.8mL/kg/min)
is insufficient.
Since retractor-protractor
imbalances have been suggested as
a key element in the aetiology of
shoulder complaints in long-term
wheelchair users,[14] rowing or
other pullingexercises might be the
preferred exercise modality.
Furthermore,FES-exercise has a
range of unique benefits that cannot
be achieved with upper bodyn
exercise. Long-term electrical
stimulation of paralysed body parts
results in considerable
morphological and physiological
changes in the peripheral tissue, for
example, muscle hypertrophy,
improved blood circulation and
improved colouration of the
skin. Acomprehensive review of
these local changes has been
published else where

RECOMENDACIONES PARA TOMA

DE VO2

Furthermore, VO2 values should be

reported
both in absolute values (L/min) and
relative values (mL/kg/min). Bodyweight
can be a strong confounder and it is

therefore preferable to control for

bodyweight when reporting VO2.