Vol. 37 No. 5, September/October 2000
Pages 535 - 542
Abstract - Effect of functional neuromuscular stimulation on postural related orthostatic stress in individuals with acute spinal cord injury
Ahmed S. Elokda, MA, PT; David H. Nielsen, PhD, PT; Richard K. Shields, PhD, PT
The University of Iowa, Physical Therapy Graduate Program, 2600 Steindler Building, Iowa City, IA 52242-1008
Abstract — The purpose of the study was to evaluate the cardiovascular responses of functional neuromuscular stimulation (FNS) on postural-related orthostatic stress in individuals with acute spinal cord injury. Two tetraplegics and three paraplegics participated in this study. A repeated measure design was used in which subjects underwent two graded-tilt table (0°, 15°, 30°, 45°, 60°) orthostatic stress tests with and without FNS (randomized treatment order) of the knee extensors and foot plantar flexors. Successive one-minute digital readings of heart rate (HR) and blood pressure were obtained with an electronic pulse oximeter and automated blood pressure monitor, respectively. Analysis of covariance (ANCOVA) revealed significant test position (tilt angle) and treatment condition (with or without FNS) main effects, but no significant interactions. Between-treatment pairwise contrasts showed that systolic blood pressure was lower without FNS for 15°, 30°, 45°, and 60° of tilt, while diastolic blood pressure was lower without FNS at 30° and 45° of tilt. In contrast, HR showed a progressive rise with increasing tilt angle. Functional neuromuscular stimulation may be an important treatment adjunct to minimize cardiovascular changes during postural orthostatic stress in individuals with acute spinal cord injury.
Key words: blood pressure, functional neuromuscular stimulation, spinal cord injury, tilt table.
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