Volume 50 Number 7, 2013
Pages 1035 — 1046
Abstract — Prolonged electrical stimulation-induced gluteal and hamstring muscle activation and sitting pressure in spinal cord injury: Effect of duty cycle
Christof A. J. Smit, MD;1* Karin J. A. Legemate, MSc;2 Anja de Koning, MSc;2 Sonja de Groot, PhD;1,3
Janneke M. Stolwijk-Swuste, MD, PhD;1 Thomas W. J. Janssen, PhD1–2
1Amsterdam Rehabilitation Research Centre, Reade, Amsterdam, the Netherlands; 2Research Institute MOVE, Faculty of Human Movement Sciences, VU University, Amsterdam, the Netherlands; 3Centre for Human Movement Sciences, University Medical Centre, University of Groningen, Groningen, the Netherlands
Abstract — Pressure ulcers (PUs) are highly prevalent in people with spinal cord injury (SCI). Electrical stimulation (ES) activates muscles and might reduce risk factors. Our objectives were to study and compare the effects of two duty cycles during 3 h of ES-induced gluteal and hamstring activation on interface pressure distribution in sitting individuals with SCI and study the usability of a newly developed electrode garment (ES shorts). Ten individuals with SCI participated in this study, in which two ES protocols with different duty cycles (1:1 s vs 1:4 s on-off) were applied in counterbalanced order using a custom-made garment with built-in electrodes. Outcome variables included interface pressure of the ischial tuberosities (ITs) and pressure gradient. A questionnaire was used to determine usability of the ES shorts. In both protocols, ES caused a significant decrease in average IT pressure compared with rest (no ES); on average, 35% for protocol 1:4 and 13% for protocol 1:1. The ES on-off duty cycle of protocol 1:4 showed less muscle fatigue. In general, participants scored the usability of the ES shorts as satisfactory. In this study, the application of ES resulted in a significant decrease in IT pressure. The ES on-off duty cycle of 1:4 s is recommended because of the less fatiguing effect. ES of the hamstrings and gluteal muscles might be a promising method in preventing PUs, but further study is needed.
Key words: duty cycle, electrical stimulation, interface pressure, ischial tuberosity, muscles, pressure sores, pressure ulcers, questionnaire, sitting pressure, spinal cord injury.
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This article and any supplementary material should be cited as follows:
Smit CA, Legemate KJ, de Koning A, de Groot S, Stolwijk-Swuste JM, Janssen TW. Prolonged electrical stimulation-induced gluteal and hamstring activation and sitting pressure in spinal cord injury: Effect of duty cycle. J Rehabil Res Dev. 2013;50(7):1035–46.
http://dx.doi.org/10.1682/JRRD.2012.07.0134
Smit CA, Legemate KJ, de Koning A, de Groot S, Stolwijk-Swuste JM, Janssen TW. Prolonged electrical stimulation-induced gluteal and hamstring activation and sitting pressure in spinal cord injury: Effect of duty cycle. J Rehabil Res Dev. 2013;50(7):1035–46.
http://dx.doi.org/10.1682/JRRD.2012.07.0134
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Last Reviewed or Updated Thursday, October 31, 2013 2:54 PM
