Restoring Standing and Stepping after Spinal Cord Injury

Spinal cord injury (SCI) resulting in paralysis has§an enormous impact not only on the health of the§individual, but more fundamentally, on their§independence and self-image. Advancements in§treatment and rehabilitation strategies have lead to§an improvement in the quality of life of these§individuals. Physiological systems and current§rehabilitative devices are presented along with a§series of studies conducted with the goal of§developing functional electrical stimulation (FES)§techniques for restoring standing and stepping after§SCI. Knowledge of natural systems was applied to the§development of physiologically-based control§strategies and stimulation paradigms to achieve this§goal. Intraspinal microstimulation (ISMS) is§highlighted; a centrally applied FES technique which§taps into some of the physiological characteristics§of neuronal recruitment. ISMS results in increased§fatigue resistance and more graded force recruitment§relative to classical peripheral FES techniques. The§studies described here have advanced the development§of a FES system for restoring standing and stepping§after SCI while also providing insight into the§neural control of locomotion.