Improvement in hemiplegic gait with multichannel, implanted electrical stimulation

The purpose of this presentation is to discuss the clinical outcomes of implanted electrical stimulation (ES) in a series of hemiplegic patients. Epimysial electrodes were implanted on key muscles for control of the hip and knee during walking. ES was provided by a portable, 8-16 channel ES system, that was triggered during the gait cycle by analog force sensitive shoe inserts. Hemiplegic patients, 2-15 years after the onset of hemiplegia, made significant improvements in walking after a 4 month ES protocol as a result of more effective control of muscle activity and achievement of critical joint motions in swing and stance. Improved velocity was a realistic goal for some, but increased safety and elimination of the need for ambulatory aids were important to the subjects. These improvements can only be achieved with implanted electrodes and flexibility in programming of a mulitichannel ES system. This is especially true for the hemiparetic patient with sensation.