Effects of electrical stimulation-induced gluteal versus gluteal and hamstring muscles activation on sitting pressure distribution in persons with a spinal cord injury

• Published in: Spinal cord Vol. 50; no. 8; pp. 590 - 594
• Main Authors: Smit, C A J, Haverkamp, G L G, de Groot, S, Stolwijk-Swuste, J M, Janssen, T W J
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01-08-2012; Nature Publishing Group
• Subjects: 631/1647/1453; 631/378/1687/1825; 692/699; 692/700/459; Adult; Anatomy; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cerebrospinal fluid. Meninges. Spinal cord; Electric Stimulation - methods; Electric Stimulation Therapy - methods; Electrical stimuli; Electrodes; Human Physiology; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Ischium - physiopathology; Medical sciences; Middle Aged; Motor Activity; Muscle, Skeletal - physiopathology; Muscles; Nervous system (semeiology, syndromes); Neurochemistry; Neurology; Neuropsychology; Neurosciences; original-article; Posture - physiology; Pressure; Pressure Ulcer - prevention & control; Spinal Cord Injuries - complications; Spinal Cord Injuries - therapy; Spinal cord injury; Traumas. Diseases due to physical agents; Ulcers; Young Adult; spinal cord injury; pressure ulcers; electrical stimulation; sitting pressure; Skin disease; Nervous system diseases; Vertebral canal; Electrical stimulus; Pressure sore; Spinal cord trauma; Central nervous system disease; Spinal cord disease; Comparative study
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/sc.2012.6

Study design:
Ten participants underwent two electrical stimulation (ES) protocols applied using a custom-made electrode garment with built-in electrodes. Interface pressure was measured using a force-sensitive area. In one protocol, both the gluteal and hamstring (g+h) muscles were activated, in the other gluteal (g) muscles only.
Objectives:
To study and compare the effects of electrically induced activation of g+h muscles versus g muscles only on sitting pressure distribution in individuals with a spinal cord injury (SCI).
Setting:
Ischial tuberosities interface pressure (ITs pressure) and pressure gradient.
Results:
In all participants, both protocols of g and g+h ES-induced activation caused a significant decrease in IT pressure. IT pressure after g+h muscles activation was reduced significantly by 34.5% compared with rest pressure, whereas a significant reduction of 10.2% after activation of g muscles only was found. Pressure gradient reduced significantly only after stimulation of g+h muscles (49.3%). g+h muscles activation showed a decrease in pressure relief (Δ IT) over time compared with g muscles only.
Conclusion:
Both protocols of surface ES-induced of g and g+h activation gave pressure relief from the ITs. Activation of both g+h muscles in SCI resulted in better IT pressure reduction in sitting individuals with a SCI than activation of g muscles only. ES might be a promising method in preventing pressure ulcers (PUs) on the ITs in people with SCI. Further research needs to show which pressure reduction is sufficient in preventing PUs.