Augmenting Reactive Stepping With FES After SCI

Inclusion criteria

• have a motor incomplete SCI (i.e., AIS grade C or D) that is non-progressive;
• be at least one year post-injury (i.e., chronic injury);
• ≥ 18 years old;
• be able to stand independently for 60 sec;
• unable to take a step bilaterally without physical assistance or upper extremity support;
• able to understand spoken English;
• free of any other condition besides SCI that significantly affects walking or balance (e.g., no vestibular disorder, significant vision loss, stroke);
• be able to provide informed, written consent.

Exclusion criteria

• Contraindications for EMS. Electrical stimulation will not be used if:

• it will be applied to areas where it could cause malfunction of electronic devices, including cardiac pacemakers;
• a woman is pregnant;
• the applied region has known or suspected malignancy;
• the person has active deep vein thrombosis or thrombophlebitis;
• there are active bleeding tissues, or the person has untreated hemorrhagic disorders;
• there are infected tissues, tuberculosis, or wounds with underlying osteomyelitis;
• tissues have been radiated in the past six months;
• there are damaged skin areas or at-risk skin areas that would result in uneven conduction of current;
• severe spasticity is present in the legs;
• the person has contractures in the lower limbs that prevent achieving a neutral hip and ankle position, or extended knee;
• there is a history of prior lower limbs fragility fracture;
• the leg muscles are unresponsive to electrical stimulation (i.e., peripheral nerve damage in the legs).
• Pressure sores on pelvis or trunk, where safety harness will be donned.