Feasibility and safety of automated multi-channel FES-assisted gait training in incomplete spinal cord injury

Objective: The feasibility, safety, and efficacy of automated multi-channel functional electrical stimulation-assisted gait training was assessed in individuals with chronic incomplete spinal cord injury, using an electrical stimulation suit with built-in surface electrodes and motion capture sensors (Teslasuit).

Design: 10-week functional electrical stimulation-assisted gait training, twice weekly for 30 min.

Subjects/Patients: Five individuals with chronic incomplete spinal cord injury (≥ 12 months post-injury, ASIA C/D, minimal Walking Index Spinal Cord Injury II ≥ 9).

Methods: The quadriceps, gluteii, hamstrings, tibialis anterior, and gastrocnemius muscles were stimulated bilaterally during gait. Feasibility and safety were evaluated via questionnaires, session adherence, and adverse events. Gait function was assessed using a 10 m walk test, Walking Index Spinal Cord Injury II, and Hoffer classification at baseline, post-intervention, and follow-up. Surface electromyography and spatiotemporal parameters (walking speed, step length and width, cadence) were recorded during the 10 m walk test.

Results: All participants completed the training (91% adherence) with no serious adverse events. Temporary skin redness, muscle soreness, and fatigue were reported by participants. Post-intervention, 4 participants increased their walking speed, step length, and cadence, with 2 maintaining and 2 further improving at follow-up. No consistent changes were found in muscle activity post training.

Conclusion: Automated multi-channel functional electrical stimulation-assisted gait training was feasible, safe, and well received. Preliminary findings suggest that gait improved in most participants, though individual responses varied. The results highlight the potential of multi-channel functional electrical stimulation-assisted gait training as a valuable tool for enhancing gait recovery.